Sample records for comparative des melanges

  1. Caracterisation des melanges developpes pour le moulage basse pression des poudres metalliques (LPIM) =

    NASA Astrophysics Data System (ADS)

    Fareh, Fouad

    Le moulage par injection basse pression des poudres metalliques est une technique de fabrication qui permet de fabriquer des pieces possedant la complexite des pieces coulees mais avec les proprietes mecaniques des pieces corroyees. Cependant, l'optimisation des etapes de deliantage et de frittage a ete jusqu'a maintenant effectuee a l'aide de melange pour lesquels la moulabilite optimale n'a pas encore ete demontree. Ainsi, la comprehension des proprietes rheologiques et de la segregation des melanges est tres limitee et cela presente le point faible du processus de LPIM. L'objectif de ce projet de recherche etait de caracteriser l'influence des liants sur le comportement rheologique des melanges en mesurant la viscosite et la segregation des melanges faible viscosite utilises dans le procede LPIM. Afin d'atteindre cet objectif, des essais rheologiques et thermogravimetriques ont ete conduits sur 12 melanges. Ces melanges ont ete prepares a base de poudre d'Inconel 718 de forme spherique (chargement solide constant a 60%) et de cires, d'agents surfactants ou epaississants. Les essais rheologiques ont ete utilises entre autre pour calculer l'indice d'injectabilite ?STV des melanges, tandis que les essais thermogravimetriques ont permis d'evaluer precisement la segregation des poudres dans les melanges. Il a ete demontre que les trois (3) melanges contenant de la cire de paraffine et de l'acide stearique presentent des indices alpha STV plus eleves qui sont avantageux pour le moulage par injection des poudres metalliques (MIM), mais segregent beaucoup trop pour que la piece fabriquee produise de bonnes caracteristiques mecaniques. A l'oppose, le melange contenant de la cire de paraffine et de l'ethylene-vinyle acetate ainsi que le melange contenant seulement de la cire de carnauba segregent peu voire pas du tout, mais possedent de tres faibles indices alphaSTV : ils sont donc difficilement injectables. Le meilleur compromis semble donc etre les melanges contenant de la cire (de paraffine, d'abeille et de carnauba) et de faible teneur en acide stearique et en ethylene-vinyle acetate. Par ailleurs, les lois physiques preexistantes ont permis de confirmer les resultats des essais rheologiques et thermogravimetriques, mais aussi de mettre en evidence l'influence de la segregation sur les proprietes rheologiques des melanges. Ces essais ont aussi montre l'effet de constituants de liant et du temps passe a l'etat fondu sur l'intensite de la segregation dans les melanges. Les melanges contenants de l'acide stearique segregent rapidement. La caracterisation des melanges developpes pour le moulage basse pression des poudres metalliques doit etre obtenue a l'aide d'une methode de courte duree pour eviter la segregation et de mesurer precisement l'aptitude a l'ecoulement de ces melanges.

  2. Conception, fabrication et validation d'une presse a injection basse pression pour le procede des poudres metalliques =

    NASA Astrophysics Data System (ADS)

    Lamarre, Simon G.

    Le moulage par injection a basse pression de poudre metallique est une technique de mise en forme de pieces de formes complexes. La poudre metallique est melangee avec des polymeres basse viscosite (ex. : cire) pour former un melange homogene a une temperature superieure a la temperature de fusion des polymeres. Pour faciliter l'injection dans la cavite du moule, la composition des melanges est ajustee pour diminuer la viscosite. D'une part, les melanges peu visqueux possedent une bonne moulabilite. D'autre part, le phenomene de la segregation se manifeste rapidement avec les melanges peu visqueux. Les machines commerciales sont munies d'un canal d'injection et d'une valve qui relient le reservoir de melange et la cavite du moule. Le melange reste stationnaire dans ces composantes entre deux sequences d'injection, ce qui le rend propice a la segregation. Plusieurs brevets tentent de resoudre ce probleme en utilisant des pompes et des canaux de recirculation. Ces composantes sont difficiles a nettoyer en raison de leur complexite. Une machine a injection basse pression a ete concue et fabriquee pour l'etude de l'aptitude au moulage des melanges de tres faible viscosite (ex. : 0.1 Pa˙s), qui tient compte du phenomene de segregation et des contraintes de nettoyage. Un piston d'injection puise le volume desire d'un reservoir. Ensuite, un mouvement lateral cisaille le melange a l'intersection entre le reservoir et le cylindre et bouche l'orifice de sortie du reservoir. Le cylindre est degage et peut recevoir le moule. A la suite de l'injection, le piston retourne a la position du reservoir et entre dans son orifice de sortie. Le melange residuel est retourne dans le reservoir, melange et desaere a nouveau. L'appareil a ete valide par des essais d'injectabilite avec un melange de poudre d'acier inoxydable et de liants a basse viscosite. Des essais d'injection ont montre que le melange contenant l'acide stearique a parcouru la plus grande distance dans le moule de forme spirale, suivi du melange contenant l'acide stearique et l'ethylene vinyle acetate et finalement du melange contenant seulement la cire de paraffine. Des essais de rheologie ont correle ces resultats pour une viscosite associee a un faible taux de cisaillement. Un essai de segregation a montre qu'un temps d'attente de moins d'une minute devait etre respecte avant de mesurer une segregation importante. De plus, le fonctionnement du systeme de vacuum a ete valide par des analyses radiographiques. Un temps de melange sous vacuum de 30 min est suffisant pour eliminer completement la presence de bulles d'air dans la piece injectee.

  3. Nouvelles morphologies de fibres electrofilees de polymere thermosensible =

    NASA Astrophysics Data System (ADS)

    Sta, Marwa

    Ce memoire presente une etude sur la possibilite d'obtenir des membranes a base de polymeres thermosensibles avec differentes morphologies pour des applications d'administration de medicaments. Ces membranes ont ete obtenues par electrofilage du Poly (N vinylcaprolactame) (PNVCL), un polymere thermosensible, soit seul ou en melange avec du Polycaprolactone (PCL), un polymere biodegradable. Les parametres de procede ainsi que les proprietes de la solution a electrofiler ont ete optimises dans le but de creer des fibres de PNVCL lisses, continues et sans perles. Des solutions du melange (PNVCL) / (PCL) ont ete ensuite preparees en suivant quatre methodes differentes de preparation. Ces methodes se basent sur l'emploi de solvants distincts, eau distillee et chloroforme, avec differentes concentrations de polymere, 42wt% et 30wt% respectivement. Ces solutions ont ete electrofilees en utilisant les parametres de procede qui correspondaient aux meilleures conditions pour l'electrofilage du PNVCL. Ensuite, le ketophofene, un medicament hydrophobe, a ete ajoute au PNVCL et au melange PNVCL/PCL avant l'electrofilage afin d'etudier la capacite des fibres de PNVCL et de melanges de retenir le medicament hydrophobe et a en faire sa liberation. Enfin, des fibres noyau-enveloppes ont ete obtenues par electrofilage coaxial, en utilisant une solution aqueuse du melange PNVCL/PCL (42 wt%) pour l'enveloppe et une solution aqueuse du PEG (30 wt%) pour le noyau. Les morphologies des membranes resultantes et de leurs fibres ont ete caracterisees par microscopie electronique a balayage (MEB). La temperature de solution critique inferieure (LCST) de ces fibres, qui est la temperature en dessous de laquelle le polymere est soluble dans l'eau et au-dessus duquel il precipite, a ete evaluee par calorimetrie differentielle a balayage (DSC). L'efficacite d'encapsulation (EE) et la liberation du medicament ont ete evaluees en utilisant la technique de spectrophotometrie UV-visible. Des coupes transversales des fibres du melange (PNVCL) / (PCL) et des fibres preparees par electrofilage coaxial ont ete caracterisees par microscopie electronique a balayage (MEB) a haute resolution dans le but de determiner la taille des particules de PCL a l'interieur des fibres et de visualiser la morphologie noyau/enveloppe des fibres resultantes. Une membrane a nanofibres lisses et continues a ete obtenue par l'optimisation de l'electrofilage de PNVCL. L'addition de PCL au melange a conduit a un controle de la LCST et de l'hydrophobicite de la membrane. Il a egalement ete demontre que la liberation de medicament hydrophobe peut etre controlee par la morphologie de ce melange PCL/PNVCL. Finalement, il a ete possible de fabriquer des fibres noyau-enveloppe par l'electrofilage coaxial de PNVCL.

  4. Etude des melanges co-continus d'acide polylactique et d'amidon thermoplastique (PLA/TPS)

    NASA Astrophysics Data System (ADS)

    Chavez Garcia, Maria Graciela

    Les melanges co-continus sont des melanges polymeriques ou chaque composant se trouve dans une phase continue. Pour cette raison, les caracteristiques de chacun des composants se combinent et il en resulte un materiau avec une morphologie et des proprietes particulieres. L'acide polylactique (PLA) et l'amidon thermoplastique (TPS) sont des biopolymeres qui proviennent de ressources renouvelables et qui sont biodegradables. Dans ce projet, differents melanges de PLA et TPS a une haute concentration de TPS ont ete prepares dans une extrudeuse bi-vis afin de generer des structures co-continues. Grace a la technique de lixiviation selective, le TPS est enleve pour creer une structure poreuse de PLA qui a pu etre analysee au moyen de la microtomographie R-X et de la microscopie electronique a balayage MEB. L'analyse des images 2D et 3D confirme la presence de la structure co-continue dans les melanges dont la concentration en TPS. se situe entre 66% et 80%. L'effet de deux plastifiants, le glycerol seul et le melange de glycerol et de sorbitol, dans la formulation de TPS est etudie dans ce travail. De plus, nous avons evalue l'effet du PLA greffe a l'anhydride maleique (PLAg) en tant que compatibilisant. On a trouve que la phase de TPS obtenue avec le glycerol est plus grande. L'effet de recuit sur la taille de phases est aussi analyse. Grace aux memes techniques d'analyse, on a etudie l'effet du procede de moulage par injection sur la morphologie. On a constate que les pieces injectees presentent une microstructure heterogene et differente entre la surface et le centre de la piece. Pres de la surface, une peau plus riche en PLA est presente et les phases de TPS y sont allongees sous forme de lamelles. Plus au centre de la piece, une morphologie plus cellulaire est observee pour chaque phase continue. L'effet des formulations sur les proprietes mecaniques a aussi ete etudie. Les pieces injectees dont la concentration de TPS est plus grande presentent une moindre resistance a la traction. La presence du compatibilisant dans la region co-continue affecte negativement cette resistance. En considerant que l'amidon est un biomateriau abondant, moins cher et plus rapidement biodegradable, son ajout dans le PLA presente l'avantage de reduire le cout tout en augmentant la vitesse de degradation du PLA. De plus, une structure continue poreuse de PLA produit par la technique de lixiviation selective a des applications potentielles soit comme materiau a degradation rapide ou encore, une fois la phase TPS retiree, comme substrat a porosite ouverte pour la fabrication de membranes, de supports cellulaires ou de filtres. Mots-cles : melanges immiscibles, acide polylactique, amidon thermoplastique, morphologie cocontinue, lixiviation selective, microtomographie R-X, materiau rigide poreux biodegradable.

  5. Cold pearl surfactant-based blends.

    PubMed

    Crombie, R L

    1997-10-01

    Pearlizing agents have been used for many years in cosmetic formulations to add a pearlescent effect. Cold pearl surfactant-based blends are mixtures of glycol stearates and surfactants which can be blended in the cold into a wide range of personal-care formulations to create a pearlescent lustre effect. Under controlled manufacturing conditions constant viscosities and crystalline characteristics can be obtained. The development of these blends has been driven by efforts to improve the economics of adding solid pearlizing agents directly into a hot mix formulation. This paper summarizes the history of pearlizers, describes their advantages and physical chemistry of the manufacturing process. Finally some suggestions for applications are given. Les agents nacrants sont utilises depuis de nombreuses annees dans les formulations cosmetiques pour ajouter un effet nacre. Les melanges a froid a base de tensioactif nacre sont des melanges de stearates de glycol et de tensioactifs qui peuvent etre melanges a froid dans une large gamme de formulations d'hygiene personnelle pour creer un effet de lustre nacre. On peut obtenir des viscosites et des proprietes cristallines constantes avec des conditions de fabrication maitrisees. Le developpement de ces melanges a ete porte par les efforts pour ameliorer les couts de l'ajout d'agents nacrants solides directement dans une formulation melangee de l'ajout d'agents nacrants solides directement dans une formulation melangee a chaud. Cet article resume l'histoire des agents nacrants, decrit leurs avantages et al physico-chimie du procede de fabrication. On emet a la fin cetaines suggestions d'applications.

  6. Une alternative au cobalt pour la synthese de nanotubes de carbone monoparoi par plasma inductif thermique

    NASA Astrophysics Data System (ADS)

    Carrier, Jean-Francois

    Les nanotubes de carbone de type monoparoi (C-SWNT) sont une classe recente de nanomateriaux qui ont fait leur apparition en 1991. L'interet qu'on leur accorde provient des nombreuses proprietes d'avant-plan qu'ils possedent. Leur resistance mecanique serait des plus rigide, tout comme ils peuvent conduire l'electricite et la chaleur d'une maniere inegalee. Non moins, les C-SWNT promettent de devenir une nouvelle classe de plateforme moleculaire, en servant de site d'attache pour des groupements reactifs. Les promesses de ce type particulier de nanomateriau sont nombreuses, la question aujourd'hui est de comment les realiser. La technologie de synthese par plasma inductif thermique se situe avantageusement pour la qualite de ses produits, sa productivite et les faibles couts d'operation. Par contre, des recherches recentes ont permis de mettre en lumiere des risques d'expositions reliees a l'utilisation du cobalt, comme catalyseur de synthese; son elimination ou bien son remplacement est devenu une preoccupation importante. Quatre recettes alternatives ont ete mises a l'essai afin de trouver une alternative plus securitaire a la recette de base; un melange catalytique ternaire, compose de nickel, de cobalt et d'oxyde d'yttrium. La premiere consiste essentiellement a remplacer la proportion massique de cobalt par du nickel, qui etait deja present dans la recette de base. Les trois options suivantes contiennent de nouveaux catalyseurs, en remplacement au Co, qui sont apparus dans plusieurs recherches scientifiques au courant des dernieres annees: le dioxyde de zircone (ZrO2), dioxyde de manganese (MnO2) et le molybdene (Mo). La methode utilisee consiste a vaporiser la matiere premiere, sous forme solide, dans un reacteur plasma a haute frequence (3 MHz) a paroi refroidi. Apres le passage dans le plasma, le systeme traverse une section dite de "croissance", isolee thermiquement a l'aide de graphite, afin de maintenir une certaine plage de temperature favorable a la synthese de C-SWNT. Le produit final est par la suite recolte sur des filtres metalliques poreux, une fois le systeme mis a l'arret. Dans un premier temps, une analyse thermodynamique, calculee avec le logiciel Fact-Sage, a permis de mettre en lumiere l'etat des differentes produits et reactifs, tout au long de leur passage dans le systeme. Elle a permis de reveler la similitude de composition de la phase liquide du melange catalytique ternaire de base, avec celui du melange binaire, avec nickel et oxyde d'yttrium. Par la suite, une analyse du bilan d'energie, a l'aide d'un systeme d'acquisition de donnees, a permis de determiner que les conditions operatoires des cinq echantillons mis a l'essai etaient similaires. Au total, le produit final a ete caracterise a l'aide de six methodes de caracterisations differentes : l'analyse thermogravimetrique, la diffraction de rayons X, la microscopie electronique a balayage a haute resolution (HRSEM), la microscopie electronique a transmission (MET), la spectroscopie RAMAN, ainsi que la mesure de la surface specifique (BET). Les resultats de ces analyses ont permis de constater, de facon coherente, que le melange a base de molybdene etait celui qui produisait la moins bonne qualite de produit. Ensuite, en ordre croissant, s'en suivait du melange a base de MnO2 et de ZrO2. Le melange de reference, a base de cobalt, est au deuxieme rang en matiere de qualite. La palme revient au melange binaire, dont la proportion est double en nickel. Les resultats de ce travail de recherche permettent d'affirmer qu'il existe une alternative performante au cobalt pour effectuer la synthese de nanotubes de carbone monoparoi, par plasma inductif thermique. Cette alternative est l'utilisation d'un melange catalytique binaire a base de nickel et d'oxyde d'yttrium. Il est suggere que les performances plus faibles des recettes alternatives, moins performantes, pourraient etre expliquees par le profil thermique fixe du reacteur. Ceci pourrait favoriser certains melanges, au detriment des autres, qui possedent des proprietes thermodynamiques differentes. Le montage, l'equipement, ainsi que les parametres d'operations, pourraient etre modifies en fonction de ces catalyseurs afin d'optimiser la synthese. Mots cles : nanotubes de carbone mono paroi, plasma inductif thermique, cobalt, nickel, dioxyde de zirconium, dioxyde de manganese, molybdene, trioxyde d'yttrium et noir de carbone

  7. Melanges, No. 23.

    ERIC Educational Resources Information Center

    Melanges, 1997

    1997-01-01

    Articles on second language teaching and learning include: "Ethnographie comparee de la salle de classe en France et en grande-Bretagne" (Comparative Ethnography of the Classroom Environment in France and Great Britain) (F. Carton); "Pour une approche micro et macro du francais parle dans la formation des enseignants de FLE"…

  8. Melanges pedagogiques 1990 (Pedagogical Miscellany 1990).

    ERIC Educational Resources Information Center

    Centre de Recherches et d'Applications Pedagogiques en Langues, Nancy (France).

    This issue of an annual publication on second language teaching contains nine articles. All but one of the these is written in French; each paper, however, is preceded by an English-language abstract. The articles are as follows: "Des cultures, des pubs" ("Cultures, Advertising") (Sophie Bailly, Isabelle Tolle);…

  9. Mise en oeuvre et caracterisation de pieces autotrempantes elaborees avec de nouveaux alliages meres

    NASA Astrophysics Data System (ADS)

    Bouchemit, Arslane Abdelkader

    : L'autotrempabilite des aciers en metallurgie des poudres (MP) permet d'obtenir des pieces ayant une microstructure de trempe (martensite et/ou bainite), et ce, directement lors du refroidissement a la sortie du four de frittage (frittage industriel : 10 45 °C/min [550 a 350 °C]). Cela permet entre autres d'eliminer les traitements thermiques d'austenisation et de trempe (a l'eau : ≈ 2700 °C/min ou a l'huile : ≈ 1100 °C/min [550 a 350 °C] [17]) generalement requis apres le frittage afin d'obtenir une microstructure martensitique. Ainsi, le procede de fabrication est simplifie, moins couteux et la distorsion des pieces due au refroidissement rapide lors de la trempe est evitee. De plus, l'utilisation des bains d'huile est eliminee ce qui rend le procede plus securitaire et ecologique. Les principaux parametres commandant l'autotrempabilite sont : le taux de refroidissement et la composition chimique de l'acier. De nos jours, les systemes de refroidissement a convection forcee combines aux fours industriels permettent d'obtenir des taux de refroidissement eleves a la sortie des fours (60 300 °C/min [550 a 350 °C]) [18, 19]. De plus, le taux de refroidissement critique induisant la formation de la structure de trempe est largement influence par la composition chimique de l'acier. Ainsi, plus l'acier est allie (jusqu'a une certaine limite), plus ce taux de refroidissement critique est moindre. Le molybdene, le nickel et le cuivre sont les elements usuellement utilises en MP. Cependant, le manganese et le chrome sont moins couteux et ont un impact plus marque sur l'autotrempabilite, malgre cela, ils sont rarement utilises a cause de leur susceptibilite a l'oxydation et la degradation de la compressibilite causee par le manganese. L'objectif principal de ce projet est de developper des melanges autotrempants en ajoutant des alliages meres (MA : MA1, MA2 et MA4) fortement allies au manganese (5 15 %m) et au chrome (5 15 %m) qui contiennent beaucoup de carbone (≈ 4 %m) developpes par Ian Bailon-Poujol lors de sa maitrise [20]. La haute teneur en carbone de ces alliages meres assure la protection des elements d'alliage susceptibles a l'oxydation durant toutes les etapes du procede : dans le bain liquide lors de la fusion et l'atomisation a l'eau, pendant le broyage ainsi que lors du frittage des pieces contenant ces alliages meres. Precedemment, Ian Bailon-Poujol avait etudie le broyage de certains alliages meres atomises a l'eau et avait amorce le developpement de melanges autotrempants ainsi que des etudes de diffusion des elements d'alliage. Pour ce projet, le developpement des melanges autotrempants a implique l'optimisation de toutes les etapes de la mise en oeuvre afin d'obtenir les meilleures proprietes possibles des melanges avant frittage (ecoulement, resistance a cru...) et apres frittage (durete, microstructure...), et ce, pour des alliages meres atomises a l'eau par Ian Bailon-Poujol ainsi qu'un alliage mere de chimie similaire qui fut atomise au gaz. (Abstract shortened by ProQuest.).

  10. Computational and Experimental Assessment of Jets in Cross Flow (Evaluation Numerique et Experimentale des Jets dans des Courants Transversaux)

    DTIC Science & Technology

    1993-11-01

    sont caracterises par la striosconic continue tic la la partie tie la couche tie melange situde sous le jet figure 3 ainsi que par la tomoscopie tie... caracterisent les ondzs). Ces ondes un disque; de Mach. Sur la figuire 4, on observe la semblent proveriir tie la r6gion tie l’jccteur, juste trace du

  11. L'Entrainement a la Comprehension Ecrite des Etudiants Etrangers de la Faculte des Sciences (Reading Comprehension Training for Foreign Students in the Science Faculty). Melanges Pedagogiques, 1977.

    ERIC Educational Resources Information Center

    Duda, R.; Regent, O.

    The ability of foreign students to read non-scientific material efficiently is important for rapid social and cultural integration. This report describes the reading comprehension section of a French language course aimed at foreign students at the Nancy Science Faculty. Exercises are presented which cover morpho-syntactic, communicative and…

  12. Melanges Pedagogiques (Pedagogical Mixture), 1984.

    ERIC Educational Resources Information Center

    Melanges Pedagogiques, 1984

    1984-01-01

    The 1984 issue of the journal on second language teaching and learning contains five articles in French and two in English. These include the following: "Enseignement individuel vs. enseignement de masse (Individual Instruction vs. Large Group Instruction)" (Jacqueline Billant, Pascal Fade); "Systemes 'autonomisants' d'apprentissage des langues…

  13. Melanges Pedagogiques (Pedagogical Mixture), 1988.

    ERIC Educational Resources Information Center

    Melanges Pedagogiques, 1988

    1988-01-01

    The 1988 issue of the journal on second language teaching and learning contains six articles in French and two in English, including: "Production orale: Comment mettre en place des strategies d'enseignment/apprentissage (Oral Production: How To Put Teaching/Learning Strategies in Place)" (Francis Carton, Richard Duda); "Trois jours pour parler…

  14. Mise au point du rheometre a cisaillement annulaire pour l'etude de rheologie d'un mastic bitumineux avec verre incorpore =

    NASA Astrophysics Data System (ADS)

    El Mansouri, Souleimane

    Dans le domaine viscoelastique lineaire (VEL, domaine des petites deformations), le comportement thermomecanique du bitume et du mastic bitumineux (melange uniforme de bitume et de fillers) a ete caracterise au Laboratoire des Chaussees et Materiaux Bitumineux (LCMB) de l'Ecole de technologie superieure (ETS) avec l'appui de nos partenaires externes : la Societe des Alcools du Quebec (SAQ) et Eco Entreprises Quebec (EEQ). Les proprietes rheologiques des bitumes et des mastics ont ete mesurees grâce a un nouvel outil d'investigation appele, Rheometre a Cisaillement Annulaire (RCA), sous differentes conditions de chargement. Cet appareil permet non seulement de solliciter des eprouvettes de tailles importantes par rapport a celles utilisees lors des essais classiques, mais aussi d'effectuer des essais en conditions quasi-homogenes, ce qui permet de donner acces a la loi de comportement des materiaux. Les essais sont realises sur une large gamme de temperatures et de frequences (de -15 °C a 45°C et de 0,03Hz a 10 Hz). Cette etude a ete menee principalement pour comparer le comportement d'un bitume avec celui d'un mastic bitumineux dans le domaine des petites deformations. neanmoins, dans une seconde perspective, on s'interesse a l'influence des fillers de verre de post-consommation sur le comportement d'un mastic a faibles niveaux de deformations en comparant l'evolution des modules complexes de cisaillements (G*) d'un mastic avec fillers de verre et un mastic avec fillers conventionnels (calcaire). Enfin, le modele analogique 2S2P1D est utilise pour simuler le comportement viscoelastique lineaire des bitumes et des mastics bitumineux testes lors de la campagne experimentale.

  15. Simple model of melange and its influence on rapid ice retreat in a large-scale Antarctic ice sheet model.

    NASA Astrophysics Data System (ADS)

    Pollard, D.; Deconto, R. M.

    2017-12-01

    Theory, modeling and observations point to the prospect of runaway grounding-line retreat and marine ice loss from West Antarctica and major East Antarctic basins, in response to climate warming. These rapid retreats are associated with geologic evidence of past high sea-level stands, and pose a threat of drastic sea-level rise in the future.Rapid calving of ice from deep grounding lines generates substantial downstream melange (floating ice debris). It is unknown whether this melange has a significant effect on ice dynamics during major Antarctic retreats, through clogging of seaways and back pressure at the grounding line. Observations in Greenland fjords suggest that melange can have a significant buttressing effect, but the lateral scales of Antarctic basins are an order of magnitude larger (100's km compared to 10's km), with presumably much less influence of confining margins.Here we attempt to include melange as a prognostic variable in a 3-DAntarctic ice sheet-shelf model. Continuum mechanics is used as aheuristic representation of discrete particle physics. Melange is createdby ice calving and cliff failure. Its dynamics are treated similarly to ice flow, but with little or no resistance to divergence. Melange providesback pressure where adjacent to grounded tidewater ice faces or ice-shelf edges. We examine the influence of the new melange component during rapid Antarctic retreat in warm-Pliocene and future warming scenarios.

  16. Determination des Parametres Atmospheriques des Etoiles Naines Blanches de Type DB

    NASA Astrophysics Data System (ADS)

    Beauchamp, Alain

    1995-01-01

    Les etoiles naines blanches dont les spectres visibles sont domines par des raies fortes d'helium neutre sont subdivisees en trois classes, DB (raies d'helium neutre seulement), DBA (raies d'helium neutre et d'hydrogene) et DBZ (raies d'helium neutre et d'elements lourds). Nous analysons trois echantillons de spectres observes de ces types de naines blanches. Les echantillons consistent, respectivement, de 48 spectres dans le domaine du visible (3700-5100 A). 24 dans l'ultraviolet (1200-3100 A) et quatre dans la partie rouge du visible (5100-6900) A). Parmi les objets de l'echantillon visible, nous identifions quatre nouvelles DBA, ainsi que deux nouvelles DBZ, auparavant classees DB. L'analyse nous permet de determiner spectroscopiquement les parametres atmospheriques, soit la temperature effective, la gravite de surface, ainsi que l'abondance relative de l'hydrogene, N(H)/N(He), dans le cas des DBA. Pour les objets plus chauds que ~15,000 K, la gravite de surface determinee est fiable, et nous obtenons les masses stellaires avec une relation masse -rayon theorique. Les exigences propres a l'analyse de ces objets ont requis d'importantes ameliorations dans la modelisation de leurs atmospheres et distributions de flux de radiation emis par ces derniers. Nous avons inclus dans les modeles d'atmospheres, pour la premiere fois a notre connaissance, les effets dus a la molecule He_sp{2 }{+}, ainsi que l'equation d'etat de Hummer et Mihalas (1988), qui tient compte des perturbations entre particules dans le calcul des populations des differents niveaux atomiques. Nous traitons la convection dans le cadre de la theorie de la longueur de melange. Trois grilles de modeles d'atmospheres a l'ETL (equilibre thermodynamique local) ont ete produites, pour un ensemble de temperatures effectives, gravites de surface et abondances d'hydrogene couvrant les proprietes des etoiles de nos echantillons; elles sont caracterisees par differentes parametrisations appelees, respectivement, ML1, ML2 et ML3, de la theorie de longueur de melange. Nous avons calcule une grille de spectres synthetiques avec les memes parametrisations que la grille de modeles d'atmospheres. Notre traitement de l'elargissement des raies de l'helium neutre a ete ameliore de facon significative par rapport aux etudes precedentes. D'une part, nous tenons compte de l'elargissement des raies produit par les interactions entre l'emetteur et les particules neutres (elargissements par resonance et de van der Waals) en plus de celui par les particules chargees (elargissement Stark). D'autre part, nous avons calcule nous-memes les profils Stark avec les meilleures theories d'elargissement disponibles pour la majorite des raies observees; ces profils depassent en qualite ce qui a ete publie jusqu'a ce jour. Nous avons calcule la distribution de masse des etoiles DB plus chaudes que 15,000 K. La distribution de masse des DB est tres etroite, avec environ les trois quarts des etoiles incluses dans l'intervalle 0.55-0.65 Modot. La masse moyenne des etoiles DB est de 0.58 M_⊙ avec sigma = 0.07. La difference principale entre les distributions de masse des DB et DA est la faible proportion de DB dans les ailes de la distribution, ce qui implique que les DA moins massives que ~0.4 M odot et plus massives que ~0.8 M_⊙ ne se convertissent pas en DB. Les objets les plus massifs de notre echantillon sont de type DBA, ce qui suggere que la masse elevee favorise la visibilite de l'hydrogene. (Abstract shortened by UMI.).

  17. Late Mesozoic and possible early Tertiary accretion in western Washington State: the Helena-Haystack melange and the Darrington- Devils Mountain fault zone

    USGS Publications Warehouse

    Tabor, R.W.

    1994-01-01

    The Helena-Haystack melange (HH melange) and coincident Darrington-Devils Mountain fault zone (DDMFZ) in northwestern Washington separate two terranes, the northwest Cascade System (NWCS) and the western and eastern melange belts (WEMB). The two terranes of Paleozoic and Mesozoic rocks superficially resemble each other but record considerable differences in structural and metamorphic history. The HH melange is a serpentinite-matrix melange containing blocks of adjacent terranes but also exotic blocks. The HH melange must have formed between early Cretaceous and late middle Eocene time, because it contains tectonic clasts of early Cretaceous Shuksan Greenschist and is overlain by late middle Eocene sedimentary and volcanic rocks. The possible continuation of the DDMFZ to the northwest as the San Juan and the West Coast faults on Vancouver Island suggests that the structure has had a major role in the emplacement of all the westernmost terranes in the Pacific Northwest. -from Author

  18. Application of imaging spectrometer data to the Kings-Kaweah ophiolite melange

    NASA Technical Reports Server (NTRS)

    Mustard, John F.; Pieters, Carle M.

    1988-01-01

    The Kings-Kaweah ophiolite melange in east-central California is thought to be an obducted oceanic fracture zone and provides the rare opportunity to examine in detail the complex nature of this type of terrain. It is anticipated that the distribution and abundance of components in the melange can be used to determine the relative importance of geologic processes responsible for the formation of fracture zone crust. Laboratory reflectance spectra of field samples indicate that the melange components have distinct, diagnostic absorptions at visible to near-infrared wavelengths. The spatial and spectral resolution of AVIRIS is ideally suited for addressing important scientific questions concerning the Kings-Kaweah ophiolite melange and fracture zones in general.

  19. Tectonic implications of the Indian Run Formation; a newly recognized sedimentary melange in the northern Virginia Piedmont

    USGS Publications Warehouse

    Drake, Avery Ala

    1985-01-01

    Sedimentary melange in the northeastern part of Fairfax County, Virginia, contains both mesoscopic and mappable fragments of Accotink Schist, Lake Barcroft Metasandstone, metagabbro, and ultramafic rocks as well as smaller fragments of other rock types. This melange was originally mapped as the Sykesville Formation, a major precursory sedimentary melange in northern Virginia and Maryland. The fragments of Accotink Schist and Lake Barcroft Metasandstone within the Sykesville were considered to be rip-ups of these units over which the Sykesville slid when finally emplaced. More recent study has shown that fragments of Accotink and Lake Barcroft are restricted to a certain area of sedimentary melange originally defined as Sykesville, and this part of the melange is now considered to be a separate mappable unit, here named the Indian Run Formation. The Indian Run underlies the sequence Accotink Schist and Lake Barcroft Metasandstone which is here formally named the Annandale Group. The Indian Run is intruded by the Occoquan Granite of Cambrian age, so it is of Cambrian or Late Proterozoic age. The Sykesville Formation (restricted) is a much more extensive unit than the Indian Run Formation and is characterized by its contained olistoliths of the Peters Creek Schist, the unit that tectonically overlies it. The Sykesville and Peters Creek constitute a precursory melange-allochthon pair which is here termed a 'tectonic motif.' The Indian Run-Annandale pair then forms a tectonically lower motif, and the overlying pair, the Yorkshire Formation-Piney Branch Complex, forms a tectonically higher motif. The Chopawamsic Formation and underlying sedimentary melange in the area south of Fairfax County may form a tectonic motif beneath the Indian Run-Annandale tectonic motif. Thus, three and perhaps four repetitions of precursory melange-allochthon pairs occur in northern Virginia. Other percursory melanges and motifs may occur in the Maryland Piedmont to the north. The tectonic setting of the motif formation and assemblage is uncertain at this time. A model involving the obduction of several separate sheets onto the ancestral North American continental margin is appealing in that it involves the closing and destruction of a marginal basin, a relatively simple concept. This model fails, however, to supply a source for the sediment necessary to form the precursory melanges. A trench-slope origin would supply the vast amount of needed sediment by accretion. The precursory melangeallochthon motifs would then be stacked near the base of the trench slope. This model is appealing and requires a rather complicated assemblage of continental, arc, and oceanic fragments, such as those that occur on many modern continental margins.

  20. Controls on accretion of flysch and melange belts at convergent margins: evidence from the Chugach Bay thrust and Iceworm melange, Chugach accretionary wedge, Alaska

    USGS Publications Warehouse

    Kusky, Timothy M.; Bradley, Dwight C.; Haeussler, Peter J.; Karl, Susan M.

    1997-01-01

    Controls on accretion of flysch and melange terranes at convergent margins are poorly understood. Southern Alaska's Chugach terrane forms the outboard accretionary margin of the Wrangellia composite terrane, and consists of two major lithotectonic units, including Triassic-Cretaceous melange of the McHugh Complex and Late Cretaceous flysch of the Valdez Group. The contact between the McHugh Complex and the Valdez Group on the Kenai Peninsula is a tectonic boundary between chaotically deformed melange of argillite, chert, greenstone, and graywacke of the McHugh Complex and a less chaotically deformed melange of argillite and graywacke of the Valdez Group. We assign the latter to a new, informal unit of formational rank, the Iceworm melange, and interpret it as a contractional fault zone (Chugach Bay thrust) along which the Valdez Group was emplaced beneath the McHugh Complex. The McHugh Complex had already been deformed and metamorphosed to prehnite-pumpellyite facies prior to formation of the Iceworm melange. The Chugach Bay thrust formed between 75 and 55 Ma, as shown by Campanian-Maastrichtian depositional ages of the Valdez Group, and fault-related fabrics in the Iceworm melange that are cut by Paleocene dikes. Motion along the Chugach Bay thrust thus followed Middle to Late Cretaceous collision (circa 90-100 Ma) of the Wrangellia composite terrane with North America. Collision related uplift and erosion of mountains in British Columbia formed a submarine fan on the Farallon plate, and we suggest that attempted subduction of this fan dramatically changed the subduction/accretion style within the Chugach accretionary wedge. We propose a model in which subduction of thinly sedimented plates concentrates shear strains in a narrow zone, generating melanges like the McHugh in accretionary complexes. Subduction of thickly sedimented plates allows wider distribution of shear strains to accommodate plate convergence, generating a more coherent accretionary style including the fold-thrust structures that dominate the outcrop pattern in the Valdez belt. Rapid underplating and frontal accretion of the Valdez Group caused a critical taper adjustment of the accretionary wedge, including exhumation of the metamorphosed McHugh Complex, and its emplacement over the Valdez Group. The Iceworm melange formed in a zone of focused fluid flow at the boundary between the McHugh Complex and Valdez Group during this critical taper adjustment of the wedge to these changing boundary conditions.

  1. Spectrometre de masse a ionisation Penning selective: Elimination des corrections necessaires a la determination du rapport isotopique de l'hydrogene

    NASA Astrophysics Data System (ADS)

    Letarte, Sylvain

    Dans le but d'ameliorer la precision avec laquelle le rapport isotopique de l'hydrogene peut etre determine, un spectrometre de masse a ionisation Penning a ete construit pour provoquer l'ionisation selective de l'hydrogene moleculaire et de l'hydrure de deuterium a partir d'un melange gazeux. L'utilisation d'atomes dans des etats d'excitation metastable s'est averee une solution adequate pour reponde a cette attente. L'emploi de l'helium, a l'interieur d'une source d'atomes metastables construit specifiquement pour ce travail, ne permet pas d'obtenir un spectre de masse compose uniquement des deux molecules d'interet. L'ionisation de ces dernieres provient de deux processus distincts, soient l'ionisation Penning et l'ionisation par bombardement electronique. Contrairement a l'helium, il a ete demontre que le neon metastable est un candidat ideal pour produire l'ionisation selective de type Penning. Le nombre d'ions produits est directement proportionnel au courant de la decharge electrique et de la pression d'operation de la source d'atomes metastables. Ces resultats demontrent le potentiel d'un tel spectrometre de masse pour ameliorer la precision a laquelle le rapport isotopique peut etre determine comparativement aux autres techniques existantes.

  2. Sr-Nd-Pb Isotope Geochemistry of Melange Formation: Implications for Identification of Fluid Sources in the Mantle Wedge and the Arc

    NASA Astrophysics Data System (ADS)

    Bebout, G. E.; King, R. L.; Moriguti, T.; Nakamura, E.

    2004-12-01

    Paramount to our ability to decipher the behavior of fluids and melts within the mantle wedge and the overall subduction system are the chemical compositions of rocks adjacent to the slab-mantle interface. Profound metamorphic and metasomatic alteration of pre-subduction lithologies to form melange along the slab-mantle interface may yield rock types inheriting mixed chemical compositions of diverse pre-subduction lithologies. Early work on melange geochemistry indicates competitive effects between mechanical mixing, metasomatism by fluids or melts, and mineral stabilities imposed by the resulting bulk composition. We have explored the Sr-Nd-Pb isotope geochemistry of low- to high-grade melange zones in the Catalina Schist, CA, to address this crucial missing component in studies of subduction-zone mass flux. The Catalina Schist contains lawsonite-albite (LA), lawsonite-blueschist (LB), and amphibolite (AM) facies melange zones, all with mineralogy dominated by talc, chlorite, and Na-Ca amphiboles, with additional minerals such as micas, rutile, zircon, and apatite stabilized based on bulk sample chemistry. Major element compositions vary, from strongly ultramafic in the AM melange, to more crustal-like compositions (i.e., more reminiscent of basaltic to sedimentary protoliths) for LA and LB melange. However, initial Sr and Nd isotope ratios for all grades of melange are essentially indistinguishable, displaying a wide variation from 87Sr/86Sr=0.703-0.709 and ɛ Nd= +15 to -15. Covariations are generally negative, similar to that of the mantle array, but with some samples extending to higher Sr ratios at constant ɛ Nd that probably reflect inheritance of seawater Sr. No clear mixing relationships between 87Sr/86Sr and 1/Sr exist, suggesting either localized buffering of Sr isotope ratios or that mixing relations are obscured by secondary devolatilization. However, a clear mixing trend for Nd indicates two end-members, one a high-concentration, positive ɛ Nd source (AOC?), the other with low-concentration and negative ɛ Nd (devolatilized sediments?). Likewise, initial Pb isotope ratios for all grades of melange form a single array independent of rock type or inferred protolith. Melange matrix of the Catalina Schist preserves initial 206Pb/204Pb of 18.95-19.59, 207Pb/204Pb of 15.61-15.68, and 208Pb/204Pb of 37.85-39.05. Such elevated Pb ratios are typical of subducting oceanic sediments, but not of MORB-like oceanic crust or peridotites of the depleted mantle. The similarity of these initial ratios suggests pervasive alteration of Pb isotope signatures within diverse rock types by fluids during subduction. As Pb concentrations decline from LA/LB to AM melange, this suggests devolatilization of Pb from the ultramafic AM melange will transfer crustal-like Pb isotope ratios. Sr-Nd-Pb isotope systematics for arc volcanic rocks are commonly used as indicators of fluid sources from the subducting slab to the arc magma source region. Our results suggest such an assumption is extremely dangerous, as hybridization processes common to melange zones are more likely to occur along the slab-mantle interface than is preservation of a pre-subduction section. Such metamorphic mediation and buffering of "slab" compositions is essentially unknown, yet our data support an interpretation where these processes impart a fundamental control on the chemistry of fluids passed to the mantle wedge.

  3. Preliminary evaluation of the petroleum potential of the Tertiary accretionary terrane, west side of the Olympic Peninsula, Washington

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

    Not Available

    1989-01-01

    Convergence between the Pacific and North American plates during late Eocene and late middle Miocene times produced two principal terranes of melange and broken formation (Eocene, Ozette Melange and Miocene, Hoh Melange) exposed onshore along the west side of the Olympic Peninsula. Organic geochemical analyses of 150 samples collected from these two accretionary terranes indicate that they are marginally mature and have a low content of type III organic matter, therefore, they are gas prone rather than oil prone. Geochemical analyses, using molecular markers, indicate that the oil in the Sunshine Mining Co. Medina No. 1 is related to oilmore » extracted from middle Eocene siltstone of the Ozette Melange located as much as 140 km north of the well. The stable carbon and hydrogen isotopic abundance of methane in natural gas seeps and gas in the melange along the west side of the Olympic Peninsula indicate that the gas is mainly thermogenic; however, the relation between these two sources of gas is uncertain.« less

  4. The role of serpentinite melanges in the unroofing of UHPM rocks: An example from the Western Alps of Italy: Chapter 6

    USGS Publications Warehouse

    Blake, M. Clark; Moore, D.E.; Jayko, A.S.; Coleman, Robert G.

    1995-01-01

    The ultrahigh pressure metamorphic rocks (UHPM) of the Dora-Maira continental massif are overlain by a stack of oceanic nappes. Metamorphic grade appears to increase downward but with marked discontinuities between each of the nappes, suggesting that section has been removed along the bounding faults. This apparent omission of section is greatest in the lowest oceanic unit where a serpentinite melange containing blocks and slabs of eclogite, metamorphosed at 12–19 kbar, lies on the UHPM rocks. We suggest that this serpentinite melange represents a highly attenuated upper mantle section that structurally overlay the UHP rocks during subduction. Similar serpentinite melanges are known from other high-pressure (HP) and UHPM areas and may have a similar origin.

  5. Investigation experimentale de l'ecoulement et des performances thermiques du nanofluide eau-oxyde de cuivre dans un Micro-Canal Chauffe

    NASA Astrophysics Data System (ADS)

    Rimbault, Benjamin

    Cette these de maitrise presentee par articles visait a etudier le comportement hydraulique et thermique d'un ecoulement de nanofluides en micro-canal chauffe. Nous avons etudie premierement de l'eau distillee, ensuite des melanges de particules d'oxyde de cuivre (taille 29nm) avec de l'eau distillee en concentrations particulaires volumiques 4.5%, 1.03%, et 0.24% (CuO-H2O). L'ecoulement force des differents fluides a ete realise au moyen de pompes a engrenages au sein d'un circuit ferme, comprenant un micro-canal a section rectangulaire (e=1.116mm,1=25.229mm) chauffe sur deux faces paralleles via des cartouches electriques, deux echangeurs de chaleurs en serie, ainsi qu'un debitmetre magnetique. A notre connaissance peu d'etudes sur l'ecoulement de nanofluides d'oxyde de cuivre-eau en micro-canal rectangulaire chauffe sont disponibles dans la litterature, cette recherche sert de contribution. Premierement, une validation avec la litterature a ete effectuee pour le cas d'un ecoulement d'eau entre plaques planes paralleles chauffees. Des essais hydrauliques ont ete realises pour une gamme du nombre de Reynolds allant jusqu'a Re=5000 a temperature constante. Par la suite des essais thermiques jusqu'a Re=2500 ont consiste en une elevation de temperature fixe (20.5°C a 30.5°C) a travers la longueur du micro-canal sous un regime stationnaire. Les resultats ont demontre une augmentation de la perte de pression et du coefficient de frottement des nanofluides sur l'eau pour un meme debit. Une telle augmentation de perte de pression etait de +70%, +25%, et +0 a 30% respectivement pour les concentrations 4.50%, 1.03%, et 0.24%. Concernant la transition laminaire a turbulent les comportements semblaient indiquer une valeur critique semblable entre l'eau et les differentes concentrations avec et sans chauffage a un nombre de Reynolds critique Rem 1000. Nous avons observe une legere augmentation du coefficient de convection thermique avec le debit massique pour les faibles concentrations (1.03% et 0.24%), alors que la concentration 4.5% demontre une nette diminution. En general la performance energetique globale definie par la chaleur transferee sur la puissance de pompage, reste inferieure compare a l'eau pour un meme Reynolds et un meme debit massique egalement. L'eau semble etre la meilleure solution en termes de performance energetique globale.

  6. Distribution and character of upper mesozoic subduction complexes along the west coast of North America

    USGS Publications Warehouse

    Jones, D.L.; Blake, M.C.; Bailey, E.H.; McLaughlin, R.J.

    1978-01-01

    Structurally complex sequences of sedimentary, volcanic, and intrusive igneous rocks characterize a nearly continuous narrow band along the Pacific coast of North America from Baja California, Mexico to southern Alaska. They occur in two modes: (1) as complexly folded but coherent sequences of graywacke and argillite that locally exhibit blueschist-grade metamorphism, and (2) as melanges containing large blocks of graywacke, chert, volcanic and plutonic rocks, high-grade schist, and limestone in a highly sheared pelitic, cherty, or sandstone matrix. Fossils from the coherent graywacke sequences range in age from late Jurassic to Eocene; fossils from limestone blocks in the melanges range in age from mid-Paleozoic to middle Cretaceous. Fossils from the matrix surrounding the blocks, however, are of Jurassic, Cretaceous, and rarely, Tertiary age, indicating that fossils from the blocks cannot be used to date the time of formation of the melanges. Both the deformation of the graywacke, with accompanying blueschist metamorphism, as well as the formation of the melanges, are believed to be the result of late Mesozoic and early Tertiary subduction. The origin of the melanges, particularly the emplacement of exotic tectonic blocks, is not understood. ?? 1978.

  7. Hurricane Mountain Formation melange: history of Cambro-Ordovician accretion of the Boundary Mountains terrane within the northern Appalachian orthotectonic zone

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

    Boone, G.M.; Boudette, E.L.

    1985-01-01

    The Hurricane Mountain Formation (HMF) melange and associated ophiolitic and volcanogenic formations of Cambrian and lowermost Ordovician age bound the SE margin of the Precambrian Y (Helikian) Chain Lakes Massif in western Maine. HMF melange matrix, though weakly metamorphosed, contains a wide variety of exotic greenschist to amphibolite facies blocks as components of its polymictic assemblage, but blocks of high-grade cratonal rocks such as those of Chain Lakes or Grenville affinity are lacking. Formations of melange exposed in structural culminations of Cambrian and Ordovician rocks NE of the HMF in Maine and in the Fournier Group in New Brunswick aremore » lithologically similar and probably tectonically correlative with the HMF; taken together, they may delineate a common pre-Middle Ordovician tectonic boundary. The authors infer that the Hurricane Mountain and St. Daniel melange belts define the SE and NW margins of the Boundary Mountains accreted terrane (BMT), which may consist of cratonal basement of Chain Lakes affinity extending from eastern Gaspe (deBroucker and St. Julien, 1985) to north-central New Hampshire. The Laurentian continental margin, underlain by Grenville basement, underplated the NW margin of this terrane, marked by the SDF suture zone, in late Cambrian to early Ordovician time, while terranes marked by Cambrian to Tremadocian (.) lithologies dissimilar to the Boundary Mountains terrane were accreted to its outboard margin penecontemporaneously. The docking of the Boundary Mountains terrane and the initiation of its peripheral melanges are equated to the Penobscottian disturbance.« less

  8. The use of radiolabelling techniques to measure substantivity to, and penetration into, hair of protein hydrolysates.

    PubMed

    Jones, R T; Chahal, S P

    1997-10-01

    The use of 14C-labelled amino acids enables the measurement of both the total substantivity to hair and the degree of penetration into the hair shaft of amino acid mixtures derived from complete hydrolysis of proteins. The technique utilizes the fact that direct measurement of 14C radioactivity of the treated hair detects only the surface substantivity. Total substantivity can be determined following solubilization of the hair. Data obtained for wheat amino acids show significant penetration when used to treat hair from a shampoo or conditioner formulation. A similar technique has been investigated for a wheat protein partial hydrolysate using 14CNO for radiolabelling purposes and shows that significant penetration into hair can occur. L'utilisation d'amino-acides marques au 14C permet la mesure a la fois de l'absorption totale par les cheveux et du degre de penetration dans la fibre du cheveu de melanges d'amino-acides obtenus a partir d'une hydrolyse totale de proteines. La technique utilise le fait que la mesure directe de la radioactivite du 14C des cheveux traites ne detecte que l'absorption en surface. L'absorption totale peut etre determinee apres solubilisation des cheveux. Les donnees obtenues a partir d'amino-acides de ble montrent une penetration significative lors d'une utilisation pour traiter des cheveux a partir d'une formulation de shampoing ou d'apres-shampoing. Une technique similaire a ete exploree vis-a-vis d'un hydrolysat partiel d'une proteine de ble utilisant 14CNO a des fins de marquage, et montre qu'une penetration significative dans les cheveux peut avoir lieu.

  9. Structure and metamorphism of the Franciscan Complex, Mt. Hamilton area, Northern California

    USGS Publications Warehouse

    Blake, M.C.; Wentworth, C.M.

    1999-01-01

    Truncation of metamorphic isograds and fold axes within coherent terranes of Franciscan metagraywacke by intervening zones of melange indicate that the melange is tectonic and formed after the subduction-related metamorphism and folding. These relations are expressed in two terranes of blueschist-facies rocks of the Franciscan Complex in the Mt. Hamilton area, northern California-the Jurassic Yolla Bolly terrane and the structurally underlying Cretaceous Burnt Hills terrane. Local preservation in both terranes of basal radiolarian chert and oceanic basalt beneath continent-derived metagraywacke and argillite demonstrates thrust repetition within the coherent terranes, although these relations are scarce near Mt. Hamilton. The metagraywackes range from albite-pumpellyite blueschists to those containing well-crystallized jadeitic pyroxene, and a jadeite-in isograd can be defined in parts of the area. Primary bedding defines locally coherent structural orientations and folds within the metagraywacke units. These units are crosscut by thin zones of tectonic melange containing blocks of high-grade blueschist, serpentinite, and other exotic rocks, and a broader, but otherwise identical melange zone marks the discordant boundary between the two terranes.

  10. Some contrasting biostratigraphic links between the Baker and Olds Ferry Terranes, eastern Oregon

    USGS Publications Warehouse

    Nestell, Merlynd K.; Blome, Charles D.

    2016-01-01

    New stratigraphic and paleontologic data indicate that ophiolitic melange windows in the Olds Ferry terrane of eastern Oregon contain limestone blocks and chert that are somewhat different in age than those present in the adjacent Baker terrane melange. The melange windows in the Olds Ferry terrane occur as inliers in the flyschoid Early and Middle Jurassic age Weatherby Formation, which depositionally overlies the contact between the melange-rich Devonian to Upper Triassic rocks of the Baker terrane on the north, and Upper Triassic and Early Jurassic volcanic arc rocks of the Huntington Formation on the south. The Baker terrane and Huntington Formation represent fragments of a subduction complex and related volcanic island arc, whereas the Weatherby Formation consists of forearc basin sedimentary deposits. The tectonic blocks in the melange windows of the Weatherby Formation (in the Olds Ferry terrane) are dated by scarce biostratigraphic evidence as Upper Pennsylvanian to Lower Permian and Upper Triassic. In contrast, tectonic blocks of limestone in theBaker terrane yield mostly fusulinids and small foraminifers of Middle Pennsylvanian Moscovian age at one locality.Middle Permian (Guadalupian) Tethyan fusulinids and smaller foraminifers (neoschwagerinids and other Middle Permian genera) are present at a few other localities. Late Triassic conodonts and bryozoans are also present in a few of the Baker terrane tectonic blocks. These limestone blocks are generally embedded in Permian and Triassic radiolarian bearing chert or argillite. Based on conodont, radiolarian and fusulinid data, the age limits of the meange blocks in the Weatherby Formation range from Pennsylvanian to Late Triassic.

  11. Structure of Franciscan complex in the Stanley Mountain window, Southern Coast ranges, California

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

    Korsch, R.J.

    1982-11-01

    Three sets of deformational events are recognized in the Franciscan Complex of the Stanley Mt. area, S. Coast ranges, California. First, in pre-melange time, shortening of the relatively cohesive sequence of interbedded graywacke and mudstone formed isoclinal folds and an axial-plane slaty cleavage. Second, fragmentation of the once cohesive sequence, probably over a considerable period of time, produced the configuration now considered a melange. Third, after the melange developed, the Franciscan Complex was deformed along with the surrounding upper Mesozoic Great Valley sequence into the Stanley Mt. antiform. In the cohesive Upper Cretaceous Carrie Creek Formation, macroscopic and mesoscopic foldsmore » have 2 predominant orientations. The less cohesive Franciscan Complex attempted to fold, as shown by the distribution of shear foliations on stereographic projections, but lack of lithologic continuity and slip along previously formed shear fractures prevents the recognition of macroscopic folds. Hence, in the Franciscan Complex of the Stanley Mt. window, several lines of evidence show that the melange structure is tectonic in origin, not just a tectonic imprint superimposed upon already chaotic rocks of sedimentary origin (olistostromes). 43 references.« less

  12. Geologic map of the Sauk River 30- by 60-minute quadrangle, Washington

    USGS Publications Warehouse

    Tabor, R.W.; Booth, D.B.; Vance, J.A.; Ford, A.B.

    2002-01-01

    Summary -- The north-south-trending regionally significant Straight Creek Fault roughly bisects the Sauk River quadrangle and defines the fundamental geologic framework of it. Within the quadrangle, the Fault mostly separates low-grade metamorphic rocks on the west from medium- to high-grade metamorphic rocks of the Cascade metamorphic core. On the west, the Helena-Haystack melange and roughly coincident Darrington-Devils Mountain Fault Zone separate the western and eastern melange belts to the southwest from the Easton Metamorphic Suite, the Bell Pass melange, and rocks of the Chilliwack Group, to the northeast. The tectonic melanges have mostly Mesozoic marine components whereas the Chilliwack is mostly composed of Late Paleozoic arc rocks. Unconformably overlying the melanges and associated rocks are Eocene volcanic and sedimentary rocks, mostly infaulted along the Darrington-Devils Mountain Fault Zone. These younger rocks and a few small Eocene granitic plutons represent an extensional tectonic episode. East of the Straight Creek Fault, medium to high-grade regional metamorphic rocks of the Nason, Chelan Mountains, and Swakane terranes have been intruded by deep seated, Late Cretaceous granodioritic to tonalitic plutons, mostly now orthogneisses. Unmetamorphosed mostly tonalitic intrusions on both sides of the Straight Creek fault range from 35 to 4 million years old and represent the roots of volcanoes of the Cascade Magmatic Arc. Arc volcanic rocks are sparsely preserved east of the Straight Creek fault, but dormant Glacier Peak volcano on the eastern margin of the quadrangle is the youngest member of the Arc. Deposits of the Canadian Ice Sheet are well represented on the west side of the quadrangle, whereas alpine glacial deposits are common to the east. Roughly 5000 years ago lahars from Glacier Peak flowed westward filling major valleys across the quadrangle.

  13. Study of the Tributyl Phosphate--30 Percent Dodecane Solvent; ETUDE DU SOLVANT PHOSPHATE TRIBUTYLIQUE 30 PERCENT--DODECANE (in French)

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

    Leroy, P.

    1967-07-01

    This study, originating mainly from a literature survey, gives the principal chemical and physical features of the tributyl-phosphate (TBP) agent diluted at 30 volumes per cent in dodecane. The mixture is a very commonly used extractant in nuclear fuel processing. In this paper, the main following points are reported: -) the components (TBP and diluents) -) the TBP-diluents systems (non-loaded), -) the TBP-diluents-water systems, -) TBP-diluents-water-nitric acid systems, and -) industrial solvents. (author) [French] Cette etude, d'origine bibliographique, regroupe les caracteristiques physico-chimiques essentielles du phosphate tributylique (TBP) dilue a 30% en volume dans du dodecane. Ce melange constitue un agentmore » d'extraction tres utilise dans le traitement des combustibles nucleaires. Les principaux points traites sont les suivants: -) les constituants (TBP et diluants), -) les systemes TBP-diluants non charges, -) les systemes TBP-diluants-eau, -) les systemes TBP-diluants-eau-acide nitrique, et -) les solvants industriels. (auteur)« less

  14. Kinematic analysis of melange fabrics: Examples and applications from the McHugh Complex, Kenai Peninsula, Alaska

    USGS Publications Warehouse

    Kusky, T.M.; Bradley, D.C.

    1999-01-01

    Permian to Cretaceous melange of the McHugh Complex on the Kenai Peninsula, south-central Alaska includes blocks and belts of graywacke, argillite, limestone, chert, basalt, gabbro, and ultramafic rocks, intruded by a variety of igneous rocks. An oceanic plate stratigraphy is repeated hundreds of times across the map area, but most structures at the outcrop scale extend lithological layering. Strong rheological units occur as blocks within a matrix that flowed around the competent blocks during deformation, forming broken formation and melange. Deformation was noncoaxial, and disruption of primary layering was a consequence of general strain driven by plate convergence in a relatively narrow zone between the overriding accretionary wedge and the downgoing, generally thinly sedimented oceanic plate. Soft-sediment deformation processes do not appear to have played a major role in the formation of the melange. A model for deformation at the toe of the wedge is proposed in which layers oriented at low angles to ??1 are contracted in both the brittle and ductile regimes, layers at 30-45??to ??1 are extended in the brittle regime and contracted in the ductile regime, and layers at angles greater than 45??to ??1 are extended in both the brittle and ductile regimes. Imbrication in thrust duplexes occurs at deeper levels within the wedge. Many structures within melange of the McHugh Complex are asymmetric and record kinematic information consistent with the inferred structural setting in an accretionary wedge. A displacement field for the McHugh Complex on the lower Kenai Peninsula includes three belts: an inboard belt of Late Triassic rocks records west-to-east-directed slip of hanging walls, a central belt of predominantly Early Jurassic rocks records north-south directed displacements, and Early Cretaceous rocks in an outboard belt preserve southwest-northeast directed slip vectors. Although precise ages of accretion are unknown, slip directions are compatible with inferred plate motions during the general time frame of accretion of the McHugh Complex. The slip vectors are interpreted to preserve the convergence directions between the overriding and underriding plates, which became more oblique with time. They are not considered indicative of strain partitioning into belts of orogen-parallel and orogen-perpendicular displacements, because the kinematic data are derived from the earliest preserved structures, whereas fabrics related to strain partitioning would be expected to be superimposed on earlier accretion-related fabrics.Permian to Cretaceous melange of the McHugh Complex on the Kenai Peninsula, south-central Alaska includes blocks and belts of graywacke, argillite, limestone, chert, basalt, gabbro, and ultramafic rocks, intruded by a variety of igneous rocks. An oceanic plate stratigraphy is repeated hundreds of times across the map area, but most structures at the outcrop scale extend lithological layering. Strong rheological units occur as blocks within a matrix that flowed around the competent blocks during deformation, forming broken formation and melange. Deformation was noncoaxial, and disruption of primary layering was a consequence of general strain driven by plate convergence in a relatively narrow zone between the overriding accretionary wedge and the downgoing, generally thinly sedimented oceanic plate. Soft-sediment deformation processes do not appear to have played a major role in the formation of the melange. A model for deformation at the toe of the wedge is proposed in which layers oriented at low angles to ??1 are contracted in both the brittle and ductile regimes, layers at 30-45?? to ??1 are extended in the brittle regime and contracted in the ductile regime, and layers at angles greater than 45?? to ??1 are extended in both the brittle and ductile regimes. Imbrication in thrust duplexes occurs at deeper levels within the wedge. Many structures within melange of the McHugh Complex are asymmetric and record

  15. Aeromagnetic map and interpretation of geophysical data from the Condrey Mountain Roadless Area, Siskiyou County, California

    USGS Publications Warehouse

    Jachens, R.C.; Elder, W.P.

    1983-01-01

    The western Paleozoic and Triassic belt that nearly surrounds the Condrey Mountain Schist is a melange of sedimentary, volcanic, and ultramafic rocks metamorphosed to amphibolite facies (Coleman and others, 1983). Only two samples of the metamorphic melange were collected near the Condrcy Mountain Road less Area, but extensive sampling of this unit southwest of the roadless area yielded an average sample density of 2.86±0.15 g/cm3 (112 samples) (Jachens and others, 1983).

  16. Contribution a l'etude et au developpement de nouvelles poudres de fonte

    NASA Astrophysics Data System (ADS)

    Boisvert, Mathieu

    L'obtention de graphite libre dans des pieces fabriquees par metallurgie des poudres (M/P) est un defi auquel plusieurs chercheurs se sont attardes. En effet, la presence de graphite apres frittage ameliore l'usinabilite des pieces, permettant donc de reduire les couts de production, et peut aussi engendrer une amelioration des proprietes tribologiques. L'approche utilisee dans cette these pour tenter d'obtenir du graphite libre apres frittage est par l'utilisation de nouvelles poudres de fontes atomisees a l'eau. L'atomisation a l'eau etant un procede de production de poudres relativement peu couteux qui permet de grandes capacites de production, le transfert des decouvertes de ce doctorat vers des applications industrielles sera donc economiquement plus favorable. En plus de l'objectif d'obtenir du graphite libre apres frittage, un autre aspect important des travaux est le controle de la morphologie du graphite libre apres frittage. En effet, il est connu dans la litterature des fontes coulees/moulees que la morphologie du graphite influencera les proprietes des fontes, ce qui est aussi vrai pour les pieces de M/P. Les fontes ductiles, pour lesquelles le graphite est sous forme de nodules spheroidaux isoles les uns des autres, possedent des proprietes mecaniques superieures aux fontes grises pour lesquelles le graphite est sous forme lamellaire et continu dans la matrice. Les resultats presentes dans cette these montrent qu'il est possible, dans des melanges contenant des poudres de fontes, d'avoir un controle sur la morphologie du graphite et donc sur les proprietes des pieces. Le controle de la morphologie du graphite a principalement ete realise par le type de frittage et le phenomene de diffusion " uphill " du carbone cause par des gradients en silicium. En effet, pour les frittages en phase solide, tous les nodules de graphite sont presents a l'interieur des grains de poudre apres frittage. Pour les frittages en phase liquide, l'intensite de la diffusion " uphill " permet de conserver plus ou moins de graphite nodulaire a l'interieur des regions riches en silicium, alors que le reste du graphite precipite sous forme lamellaire/vermiculaire dans les regions interparticulaires. L'etude des poudres de fontes et la recherche des mecanismes regissant la morphologie du graphite dans les fontes coulees/moulees nous ont amenes a produire des poudres de fontes traitees au magnesium avant l'atomisation. Plusieurs resultats fondamentaux ont ete obtenus de la caracterisation des poudres traitees au magnesium et de leur comparaison avec des poudres de chimies similaires non traitees au magnesium. D'abord, il a ete possible d'observer des bifilms d'oxyde de silicium dans la structure du graphite primaire d'une poudre de fonte grise hypereutectique. Il s'agit des premieres images montrant la structure double de ces defauts, venant ainsi appuyer la theorie elaboree par le professeur John Campbell. Ensuite, il a ete montre que le traitement au magnesium forme une atmosphere protectrice gazeuse autogeneree qui empeche l'oxydation de la surface du bain liquide et donc, la formation et l'entrainement des bifilms. Le role du magnesium sur la morphologie du graphite est de diminuer le soufre en solution en formant des precipites de sulfure de magnesium et ainsi d'augmenter l'energie d'interface graphite-liquide. En reponse a cette grande energie d'interface graphite-liquide, le graphite cherche a minimiser son ratio surface/volume, ce qui favorise la formation de graphite spheroidal. De plus, deux types de germination ont ete observes dans la poudre de fonte hypereutectique traitee au magnesium. Le premier type est une germination heterogene sur un nombre limite de particules faites de magnesium, d'aluminium, de silicium et d'oxygene. Le deuxieme type est une germination homogene des nodules dans certaines regions du liquide plus riches en silicium. L'observation du centre reel tridimensionnel, en microscopie electronique en transmission en haute resolution, d'un des nodules ayant subi une germination homogene a permis de confirmer que le mode de croissance du graphite spheroidal se produit selon le modele de la croissance en feuille de chou. (Abstract shortened by ProQuest.).

  17. Evolution of a Permo-Triassic sedimentary melange, Grindstone terrane, east-central Oregon

    USGS Publications Warehouse

    Blome, C.D.; Nestell, M.K.

    1991-01-01

    Perceives the Grindstone rocks to be a sedimentary melange composed of Paleozoic limestone slide and slump blocks that became detached from a carbonate shelf fringing a volcanic knoll or edifice in Late Permian to Middle Triassic time and were intermixed with Permian and Triassic slope to basinal clastic and volcaniclastic rocks in a forearc basin setting. Paleogeographic affinities of the Grindstone limestone faunas and volcaniclastic debris in the limestone and clastic rocks all indicate deposition in promixity to an island-arc system near the North American craton. -from Authors

  18. Fluid-rock reactions in an evaporitic melange, Permian Haselgebirge, Austrian Alps

    USGS Publications Warehouse

    Spotl, C.; Longstaffe, F.J.; Ramseyer, K.; Kunk, Michael J.; Wiesheu, R.

    1998-01-01

    Tectonically isolated blocks of carbonate rocks present within the anhydritic Haselgebirge melange of the Northern Calcareous Alps record a complex history of deformation and associated deep-burial diagenetic to very low-grade metamorphic reactions. Fluids were hot (up to ~ 250 ??C) and reducing brines charged with carbon dioxide. Individual carbonate outcrops within the melange record different regimes of brine-rock reactions, ranging from pervasive dolomite recrystallization to dedolomitization. Early diagenetic features in these carbonates were almost entirely obliterated. Matrix dolomite alteration was related to thermochemical sulphate reduction (TSR) recognized by the replacement of anhydrite by calcite + pyrite ?? native sulphur. Pyrite associated with TSR is coarsely crystalline and characterized by a small sulphur isotope fractionation relative to the precursor Permian anhydrite. Carbonates associated with TSR show low Fe/Mn ratios reflecting rapid reaction of ferrous iron during sulphide precipitation. As a result, TSR-related dolomite and calcite typically show bright Mn(II)-activated cathodoluminescence in contrast to the dull cathodoluminescence of many (ferroan) carbonate cements in other deep-burial settings. In addition to carbonates and sulphides, silicates formed closely related to TSR, including quartz, K-feldspar, albite and K-mica. 40Ar/39Ar analysis of authigenic K-feldspar yielded mostly disturbed step-heating spectra which suggest variable cooling through the argon retention interval for microcline during the Late Jurassic. This timing coincides with the recently recognized subduction and closure of the Meliata-Hallstatt ocean to the south of the Northern Calcareous Alps and strongly suggests that the observed deep-burial fluid-rock reactions were related to Jurassic deformation and melange formation of these Permian evaporites.

  19. Northern Papua New Guinea: Structure and sedimentation in a modern arc-continent collision

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

    Abbott, L.; Silver, E.

    Northern Papua New Guinea and the Solomon Sea are the site of a modern oblique, arc-continent collision, which is progressing from northwest to southeast. By combining offshore seismic data from the Solomon Sea with geologic mapping in the Markham Valley area of northern Papua New Guinea the authors are predicting the outcome of this collision. The Huon Gulf is the present site of initial collision. Seismic profiles show this area is dominated by thin thrust sheets. Onshore, the bulk of the uplifted accretionary wedge is a melange with exotic blocks of a variety of lithologies. Structurally below the melange liesmore » the Leron Formation composed of thick channelized sandstone and conglomerate. It dips north at approximately 40{degree} and is cut by several thrust fault with associated folds. Limestone blocks within the melange are reported to be 2 Ma, and Beryllium 10 anomalies from Bismarck arc volcanoes suggest that initial collision of the Finisterre block (375 km northwest of the present collision point) began no earlier than 3 Ma. This implies the collision is propagating laterally at about 125 km/m.y.. Large outcrops of basalt and gabbro within the melange suggest that segments of oceanic crust were incorporated into the accretionary wedge. Modern sedimentation within the collision zone grades from fluvial sediments in the Markham Valley to deep-water turbidites ponded behind a structural ridge near the point of incipient collision. The Markham submarine canyon occupies the collision front here, and efficiently erodes the accretionary wedge. This setting may serve as a modem analog for deposition of much of the Leron Formation which exhibits tremendous sediment reworking.« less

  20. Bulk rheology and simulated episodic tremor and slip within a numerically-modeled block-dominated subduction melange

    NASA Astrophysics Data System (ADS)

    Webber, S.; Ellis, S. M.; Fagereng, A.

    2015-12-01

    We investigate the influence of melange rheology in a subduction thrust interface on stress and slip cycling constrained by observations from an exhumed subduction complex at Chrystalls Beach, New Zealand. A two-phase mélange dominated by large, competent brittle-viscous blocks surrounded by a weak non-linear viscous matrix is numerically modeled, and the evolution of bulk stress are analysed as the domain deforms. The models produce stress cycling behaviour under constant shear strain rate boundary conditions for a wide range of physical conditions that roughly corresponds to depths and strain rates calculated for instrumentally observed episodic tremor and slip (ETS) in presently-deforming subduction thrust interfaces. Stress cycling is accompanied by mixed brittle plastic-viscous deformation, and occurs as a consequence of geometric reorganisation and the progressive development and breakdown of stress bridges as blocks mutually obstruct one another. We argue that periods of low differential stress correspond to periods of rapid mixed-mode deformation and ETS. Stress cycling episodicities are a function of shear strain rate and pressure/temperature conditions at depth. The time period of stress cycling is principally controlled by the geometry (block distribution and density through time) and stress cycling amplitudes are controlled by effective stress. The duration of stress cycling events in the models (months-years) and rapid strain rates are comparable to instrumentally observed ETS. Shear strain rates are 1 - 2 orders of magnitude slower between stress cycling events, suggesting episodic return times within a single model domain are long duration (> centennial timescales), assuming constant flow stress. Finally, we derive a bulk viscous flow law for block dominated subduction mélanges for conditions 300 - 500°C and elevated pore fluid pressures. Bulk flow laws calculated for block-dominated subduction mélanges are non-linear, owing to a combination of non-linear matrix viscosity and development of tensile fractures at rapid shear strain rates. Model behaviour, including the generation of mixed-mode deformation, is highly comparable to the exhumed block-dominated melange found within the Chrystalls Beach Complex.

  1. Formulation, caracterisation, modelisation et prevision du comportement thermomecanique des pieces plastiques et composites de fibres de bois : Application aux engrenages =

    NASA Astrophysics Data System (ADS)

    Mijiyawa, Faycal

    Cette etude permet d'adapter des materiaux composites thermoplastiques a fibres de bois aux engrenages, de fabriquer de nouvelles generations d'engrenages et de predire le comportement thermique de ces engrenages. Apres une large revue de la litterature sur les materiaux thermoplastiques (polyethylene et polypropylene) renforces par les fibres de bois (bouleau et tremble), sur la formulation et l'etude du comportement thermomecanique des engrenages en plastique-composite; une relation a ete etablie avec notre presente these de doctorat. En effet, beaucoup d'etudes sur la formulation et la caracterisation des materiaux composites a fibres de bois ont ete deja realisees, mais aucune ne s'est interessee a la fabrication des engrenages. Les differentes techniques de formulation tirees de la litterature ont facilite l'obtention d'un materiau composite ayant presque les memes proprietes que les materiaux plastiques (nylon, acetal...) utilises dans la conception des engrenages. La formulation des materiaux thermoplastiques renforces par les fibres de bois a ete effectuee au Centre de recherche en materiaux lignocellulosiques (CRML) de l'Universite du Quebec a Trois-Rivieres (UQTR), en collaboration avec le departement de Genie Mecanique, en melangeant les composites avec deux rouleaux sur une machine de type Thermotron-C.W. Brabender (modele T-303, Allemand) ; puis des pieces ont ete fabriquees par thermocompression. Les thermoplastiques utilises dans le cadre de cette these sont le polypropylene (PP) et le polyethylene haute densite (HDPE), avec comme renfort des fibres de bouleau et de tremble. A cause de l'incompatibilite entre la fibre de bois et le thermoplastique, un traitement chimique a l'aide d'un agent de couplage a ete realise pour augmenter les proprietes mecaniques des materiaux composites. Pour les composites polypropylene/bois : (1) Les modules elastiques et les contraintes a la rupture en traction des composites PP/bouleau et PP/tremble evoluent lineairement en fonction du taux de fibres, avec ou sans agent de couplage (Maleate de polypropylene MAPP). De plus, l'adherence entre les fibres de bois et le plastique est amelioree en utilisant seulement 3 % MAPP, entrainant donc une augmentation de la contrainte maximale bien qu'aucun effet significatif ne soit observe sur le module d'elasticite. (2) Les resultats obtenus montrent que, en general, les proprietes en traction des composites polypropylene/bouleau, polypropylene/tremble et polypropylene/bouleau/ tremble sont tres semblables. Les composites plastique-bois (WPCs), en particulier ceux contenant 30 % et 40 % de fibres, ont des modules elastiques plus eleves que certains plastiques utilises dans l'application des engrenages (ex. Nylon). Pour les composites polyethylene/bois, avec 3%Maleate de polyethylene (MAPE): (1) Tests de traction : le module elastique passe de 1.34 GPa a 4.19 GPa pour le composite HDPE/bouleau, alors qu'il passe de 1.34 GPa a 3.86 GPa pour le composite HDPE/tremble. La contrainte maximale passe de 22 MPa a 42.65 MPa pour le composite HDPE/bouleau, alors qu'elle passe de 22 MPa a 43.48 MPa pour le composite HDPE/tremble. (2) Tests de flexion : le module elastique passe de 1.04 GPa a 3.47 GPa pour le composite HDPE/bouleau et a 3.64 GPa pour le composite HDPE/tremble. La contrainte maximale passe de 23.90 MPa a 66.70 MPa pour le composite HDPE/bouleau, alors qu'elle passe a 59.51 MPa pour le composite HDPE/tremble. (3) Le coefficient de Poisson determine par impulsion acoustique est autour de 0.35 pour tous les composites HDPE/bois. (4) Le test de degradation thermique TGA nous revele que les materiaux composites presentent une stabilite thermique intermediaire entre les fibres de bois et la matrice HDPE. (5) Le test de mouillabilite (angle de contact) revele que l'ajout de fibres de bois ne diminue pas de facon significative les angles de contact avec de l'eau parce que les fibres de bois (bouleau ou tremble) semblent etre enveloppees par la matrice sur la surface des composites, comme le montrent des images prises au microscope electronique a balayage MEB. (6) Le modele de Lavengoof-Goettler predit mieux le module elastique du composite thermoplastique/bois. (7) Le HDPE renforce par 40 % de bouleau est mieux adapte pour la fabrication des engrenages, car le retrait est moins important lors du refroidissement au moulage. La simulation numerique semble mieux predire la temperature d'equilibre a la vitesse de 500 tr/min; alors qu'a 1000 tr/min, on remarque une divergence du modele. (Abstract shortened by ProQuest.). None None None None None None None None

  2. GAMMA IRRADIATION OF SALMONELLA SPECIES IN FROZEN WHOLE EGG

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

    Comer, A.G.; Anderson, G.W.; Garrard, E.H.

    1963-06-01

    A study was undertaken to establish the survival pattern of 18 Salmonella species in frozen whole egg exposed to gamma radiation from a Co/sup 60/ source as part of a program to investigate the possibilities of using radiation for the destruction of micro-organisms in foods. A definite variation in sensitivity to radiation was found among these 18 species commonly occurring in frozen egg. The dose levels, applied at a dose rate of 0.491 Mrad/hr, required for a 10/sup 7/-fold reduction of these species ranged from 0.36 to 0.54 Mrad. Variation in sensitivity to radiation was also detected with three culturesmore » of S. pullorum that appeared similar except in origin. Variation in sensitivity within all species of Salmonella studied apparently indicates that no one species can be considered most resistant. These studies reveal that a level of 0.54 Mrad of gamma radiation would reduce the salmonellae to a safe level in frozen egg. However, this is based on the supposition that 10/sup 5/ cells is a reasonable number to consider necessary for the initiation of salmonellosis. The most heavily contaminated frozen egg melange examined contained approximates 2 x 10/sup 5/ cells of salmonellae/ml. Of these, any process giving a 10/sup 7/-fold reduction would leave only 2 x 10/sup -2/ cells/ml, i.e., 2 cells/100 ml or about 10 cells per lb. Apparently it would be necessary to consume several tons of uncooked melange to obtain an infective dose and therefore the 10/sup 7/-fold reduction is adequate from the viewpoint of the public health hazard. Although off-flavors develop in frozen whole egg irradiated with 0.5 Mrad, they disappear on storage and the irradiated product was found acceptable for commercial use. Thus irradiation of frozen whole egg melange with 0.54 Mrad would not be expected to markedly increase the unfavorable alterations in the product, indicating that gamma radiation possesses a distinct potential for removing Salmonella from frozen whole egg melange. (BBB)« less

  3. Strong Matrix & Weak Blocks: Evolutionary Inversion of Mélange Rheological Relationships During Subduction and Its Implications for Seismogenesis

    NASA Astrophysics Data System (ADS)

    Clarke, A. P.; Vannucchi, P.; Ougier-Simonin, A.; Morgan, J. P.

    2017-12-01

    Subduction zone interface layers are often conceived to be heterogeneous, polyrheological zones analogous to exhumed mélanges. Mélanges typically contain mechanically strong blocks within a weaker matrix. However, our geomechanical study of the Osa Mélange, SW Costa Rica shows that this mélange contains blocks of altered basalt which are now weaker in friction than their surrounding indurated volcanoclastic matrix. Triaxial deformation experiments were conducted on samples of both the altered basalt blocks and the indurated volcanoclastic matrix at confining pressures of 60 and 120 MPa. These revealed that the volcanoclastic matrix has a strength 7.5 times that of the altered basalt at 60 MPa and 4 times at 120 MPa, with the altered basalt experiencing multi-stage failure. The inverted strength relationship between weaker blocks and stronger matrix evolved during subduction and diagenesis of the melange unit by dewatering, compaction and diagenesis of the matrix and cataclastic brecciation and hydrothermal alteration of the basalt blocks. During the evolution of this material, the matrix progressively indurated until its plastic yield stress became greater than the brittle yield stress of the blocks. At this point, the typical rheological relationship found within melanges inverts and melange blocks can fail seismically as the weakest links along the subduction plate interface. The Osa Melange is currently in the forearc of the erosive Middle America Trench and is being incorporated into the subduction zone interface at the updip limit of seismogenesis. The presence of altered basalt blocks acting as weak inclusions within this rock unit weakens the mélange as a whole rock mass. Seismic fractures can nucleate at or within these weak inclusions and the size of the block may limit the size of initial microseismic rock failure. However, when fractures are able to bridge across the matrix between blocks, significantly larger rupture areas may be possible. While this mechanism is a promising candidate for the updip limit of the unusually shallow seismogenic zone beneath Osa, it remains to be seen whether analogous evolutionary strength-inversions control the updip limit of other subduction seismogenic zones.

  4. Etude des proprietes de surface et des proprietes rheologiques des melanges polymeres thermotropes

    NASA Astrophysics Data System (ADS)

    Tovar Hernandez, Maria Gabriela

    We studied the surface and rheological properties of thermotropic liquid crystal polymers (TLCP) mixed with thermoplastics. We first investigated acid-base interactions in polymer component as a function of temperature, and could identified the many phase changes in TLCP. We found that acid-base interactions in TLCP decrease significantly with temperature, down to a point Tc where they become negligible. To our knowledge, it is the first time such observation is reported concerning TLCP. Acid-base interactions in the thermoplastics also vary with temperature, but they remain non-negligible, and reach a plateau at high temperature. In theory, one can obtain compatible blends between polymers A and B when their interaction parameters are both small and similar. The negligible acid-base parameter of TLCP at T > Tc should enhance the compatibility with thermoplastics. For that reason, we prepared the TLCP/thermoplastic blends at temperatures superior and inferior to Tc. We restricted our investigation to blends prepared in a Brabender Plasticorder in order to control the temperature in the mixing chamber and reduce the effects of TLCP domains deformation and reorientation. We prepared Vectra/polycarbonate blends, optimizing the drying conditions and the TLCP concentration. We optimized the drying conditions based on our previous results, finding that the transesterification reaction in presence of water happens at high temperature. Transesterification reaction was identified using infrared spectroscopy in the polymer components and in the blends. We found that this reaction occurring mainly between the ester groups in the polymer components. The product of this reaction, concentrated at the interfaces, has a remarkable effect on the blend morphology, similar to the one in compatible blend, and on its mechanical properties. To measure the effect of transesterification at the interfaces, we studied the linear viscoelasticity properties of Vectra/polycarbonate blend and their relation with their morphology. We found from the time variation of the elastic modulus at very low frequencies that the transesterification reaction was still occurring during rheological measurements. We observed coalescence of the dispersed phase droplets in all blends. Size of the droplets changed with the blend composition, the preparation temperature and the rheological characterization temperature. In addition, we compared Palierne (1990, 1991) and Lee-Park models when applied to Vectra/polycarbonate blends. We found that the Palierne model does not predict the rheological behavior of the blend, due to the mixture rule used in that model. Lee-Park model, using a different mixture rule, gives a good prediction of the linear viscoelastic properties. We succeeded in modeling the Vectra/polycarbonate rheological properties combining the characteristic relaxation times of the Palierne and Lee-Park models. Using this approach, we could clearly show that the decrease of the interfacial tension is due to the copolymer produced at the interface by transesterification reaction.

  5. Liberty Complex: polygenetic melange in the central Maryland Piedmont

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

    Muller, P.D.; Candela, P.A.; Wylie, A.G.

    1985-01-01

    A polydeformed, medium-grade assemblage of pelitic to psammitic flyschoid rocks with intercalated mafic and ultramafic ophiolitic rocks forms a major tectonic unit, the Liberty Complex (LC), within the central Maryland Piedmont. The LC outcrops in a NE-NNE-trending synformal belt bordered on the west by phyllonitic rocks of the Pleasant Grove zone, a regional tectonic boundary between eastern and western Piedmont terranes, and on the east by structurally lower basement-cored nappes of the lower Glenarm Supergroup. The LC is composed of two basic units, the Morgan Run melange (MRm) and the Skyesville Formation (SFm). The MRm is composed of metagreywacke andmore » micaschist with decimeter to tens of meter-thick lensoidal blocks of quartzite and amphibolite and a variety of ultramafic material ranging from thin sedimentary ultramafite lenses to kilometer-sized serpentine bodies. The SFm is schistose to massive metadiamictite containing granule to boulder-sized detritus of the same lithologies as comprise the MRm. Metamorphic foliation within many clasts is discordant to the matrix foliation. The LC is interpreted as a polygenetic melange which originated in a Cambro-Ordovician accretionary wedge and continued to develop during emplacement onto the continental margin of eastern North America. The MRm may represent underplated material deformed and metamorphosed in a subduction zone. Rapid uplift and erosion of the MRm during obduction supplied debris to the olistostromal SFm. Both units were complexly folded and cleaved, metamorphosed, and intruded by granitoids during medial (.) Ordovician suturing of an island arc to the continent.« less

  6. Middle Jurassic Radiolaria from a siliceous argillite block in a structural melange zone near Viqueque, Timor Leste: Paleogeographic implications

    NASA Astrophysics Data System (ADS)

    Haig, David W.; Bandini, Alexandre Nicolas

    2013-10-01

    Thin-bedded siliceous argillite forming a large block within a structural melange zone at Viqueque, Timor Leste, has yielded a Middle Jurassic (late Bathonian-early Callovian) radiolarian assemblage belonging to Unitary Association Zone 7. Fifty-five species are recognized and illustrated, forming the most diverse radiolarian fauna yet documented from the Jurassic of Timor. The fauna shows little similarity in species content to the few other assemblages previously listed from the Middle or Late Jurassic of Timor, and also has few species in common with faunas known elsewhere in the region from Rotti, Sumatra, South Kalimantan, and Sula. Based on lithofacies similarities and age, the siliceous argillite succession in the melange block at Viqueque is included in the Noni Group originally described as the lower part of the Palelo Series in West Timor. In terms of lithofacies, the Noni Group is distinct from other stratigraphic units known in Timor. It may be associated with volcanic rocks but age relationships are uncertain, although some of the radiolarian cherts in the Noni Group in West Timor have been reported to include tuffaceous sediment. The deep-water character of the siliceous hemipelagite-pelagite facies, the probable volcanic association, and an age close to that of continental breakup in the region suggest deposition in a newly rifted Indian Ocean. In Timor's tectonostratigraphic classification scheme, the Noni Group is here placed in the "Indian Ocean Megasequence".

  7. High-P metamorphic rocks from the Himalaya and their tectonic implication ? a review

    NASA Astrophysics Data System (ADS)

    Jan, M. Qasim

    The suture zones bordering the Indian subcontinent on the E, N and W are characterized in several places by the occurrence of ophiolitic complexes and tectonic melanges. High-P metamorphic rocks have recently been discovered in the melanges in Burma, Naga Hills, southern Tibet, eastern and western Ladakh, Kohistan (Jijal, Allai, Shangla) and Khost (Afghanistan). The development of these rocks has an important bearing on the plate tectonics of the Himalaya. The High-P metamorphic rocks belong to prehnite-pumpellyite, blueschist and high-P greenschist facies but extensive garnet-granulites have developed at 35 km depth in Jijal. In the Indus-Zangbo suture zone (IZS) the high-P metamorphism is complemented to the N by low- or medium-P metamorphism and calc-alkaline magmatism in Tibet, Ladakh as well as Kohistan. High-P metamorphism in Jijal has been dated at 104 Ma, in Shangla at 70-100 Ma and in western Ladakh during mid-Cretaceous. Elsewhere, the timing of the high-P metamorphism is not known but a Cretaceous age is inferred. Since collision along the IZS occurred during Eocene, the high-P metamorphism is therefore related to the northwards subduction of the neo-Tethyan lithosphere under Tibet or late Mesozoic magmatic arcs. The timing of high-P metamorphism coincides with the breakup of India from Gondwanaland and its rapid northwards movement, whereas the tectonic melanges may principally have formed during Eocene collision and obduction.

  8. Reconnaissance geologic map of the Dubakella Mountain 15 quadrangle, Trinity, Shasta, and Tehama Counties, California

    USGS Publications Warehouse

    Irwin, William P.; Yule, J. Douglas; Court, Bradford L.; Snoke, Arthur W.; Stern, Laura A.; Copeland, William B.

    2011-01-01

    The Dubakella Mountain 15' quadrangle is located just south of the Hayfork quadrangle and just east of the Pickett Peak quadrangle. It spans a sequence of four northwest-trending tectonostratigraphic terranes of the Klamath Mountains geologic province that includes, from east to west, the Eastern Hayfork, Western Hayfork, Rattlesnake Creek, and Western Jurassic terranes, as well as, in the southwest corner of the quadrangle, part of a fifth terrane, the Pickett Peak terrane of the Coast Ranges geologic province. The Eastern Hayfork terrane is a broken formation and melange of volcanic and sedimentary rocks that include blocks of limestone and chert. The limestone contains late Permian microfossils of Tethyan faunal affinity. The chert contains radiolarians of Mesozoic age, mostly Triassic, but none clearly Jurassic. The Western Hayfork terrane is an andesitic volcanic arc that consists mainly of agglomerate, tuff, argillite, and chert, and includes the Wildwood pluton. That pluton is related to the Middle Jurassic (about 170 Ma) Ironside Mountain batholith that is widely exposed farther north beyond the Dubakella Mountain quadrangle. The Rattlesnake Creek terrane is a highly disrupted ophiolitic melange of probable Late Triassic or Early Jurassic age. Although mainly ophiolitic, the melange includes blocks of plutonic rocks (about 200 Ma) of uncertain genetic relation. Some scattered areas of well-bedded mildly slaty detrital rocks of the melange appear similar to Galice Formation (unit Jg) and may be inliers of the nearby Western Jurassic terrane. The Western Jurassic terrane consists mainly of slaty to phyllitic argillite, graywacke, and stretched-pebble conglomerate and is correlative with the Late Jurassic Galice Formation of southwestern Oregon. The Pickett Peak terrane, the most westerly of the succession of terranes of the Dubakella Mountain quadrangle, is mostly fine-grained schist that includes the blueschist facies mineral lawsonite and is of Early Cretaceous (about 120 Ma) metamorphic age. Remnants of the Great Valley sequence of dominantly Cretaceous marine sedimentary strata, which once covered much of the southern fringe of the Klamath Mountains, are present at three places in the Dubakella Mountain quadrangle. Mineral production in the quadrangle has included small amounts of gold, chromite, and manganese. This map of the Dubakella Mountain 15' quadrangle is a digital rendition of U.S. Geological Survey Miscellaneous Field Studies Map MF-1808, with various improvements and additions.

  9. Carbon nano structures: Production and characterization

    NASA Astrophysics Data System (ADS)

    Beig Agha, Rosa

    L'objectif de ce memoire est de preparer et de caracteriser des nanostructures de carbone (CNS -- Carbon Nanostructures, en licence a l'Institut de recherche sur l'hydrogene, Quebec, Canada), un carbone avec un plus grand degre de graphitisation et une meilleure porosite. Le Chapitre 1 est une description generale des PEMFCs (PEMFC -- Polymer Electrolyte Membrane Fuel Cell) et plus particulierement des CNS comme support de catalyseurs, leur synthese et purification. Le Chapitre 2 decrit plus en details la methode de synthese et la purification des CNS, la theorie de formation des nanostructures et les differentes techniques de caracterisation que nous avons utilises telles que la diffraction aux rayons-X (XRD -- X-ray diffraction), la microscopie electronique a transmission (TEM -- transmission electron microscope ), la spectroscopie Raman, les isothermes d'adsorption d'azote a 77 K (analyse BET, t-plot, DFT), l'intrusion au mercure, et l'analyse thermogravimetrique (TGA -- thermogravimetric analysis). Le Chapitre 3 presente les resultats obtenus a chaque etape de la synthese des CNS et avec des echantillons produits a l'aide d'un broyeur de type SPEXRTM (SPEX/CertiPrep 8000D) et d'un broyeur de type planetaire (Fritsch Pulverisette 5). La difference essentielle entre ces deux types de broyeur est la facon avec laquelle les materiaux sont broyes. Le broyeur de type SPEX secoue le creuset contenant les materiaux et des billes d'acier selon 3 axes produisant ainsi des impacts de tres grande energie. Le broyeur planetaire quant a lui fait tourner et deplace le creuset contenant les materiaux et des billes d'acier selon 2 axes (plan). Les materiaux sont donc broyes differemment et l'objectif est de voir si les CNS produits ont les memes structures et proprietes. Lors de nos travaux nous avons ete confrontes a un probleme majeur. Nous n'arrivions pas a reproduire les CNS dont la methode de synthese a originellement ete developpee dans les laboratoires de l'Institut de recherche sur l'hydrogene (IRH). Nos echantillons presentaient toujours une grande quantite de carbure de fer au detriment de la formation de nanostructures de carbone. Apres plusieurs mois de recherche nous avons constate que les metaux de base, soit le fer et le cobalt, etaient contamines. Neanmoins, ces recherches nous ont enseigne beaucoup et les resultats sont presentes aux Appendices I a III. Le carbone de depart est du charbon active commercial (CNS201) qui a ete prealablement chauffe a 1,000°C sous vide pendant 90 minutes pour se debarrasser de toute humidite et autres impuretes. En premiere etape, dans un creuset d'acier durci du CNS201 pretraite fut melange a une certaine quantite de Fe et de Co (99.9 % purs). Des proportions typiques sont 50 pd. %, 44 pd. %, et 6 pd. % pour le C, le Fe, et le Co respectivement. Pour les echantillons prepares avec le broyeur SPEX, trois a six billes en acier durci furent utilisees pour le broyage, de masse relative echantillon/poudre de 35 a 1. Pour les echantillons prepares avec le broyeur planetaire, trente-six billes en acier durci furent utilisees pour le broyage, de masse relative echantillon/poudre de 10 a 1. L'hydrogene fut alors introduit dans le creuset pour les deux types de broyeur a une pression de 1.4 MPa, et l'echantillon fut broye pendant 12 h pour le SPEX et 24 h pour le planetaire. Le broyeur SPEX a un rendement de transfert d'energie mecanique plus grand qu'un broyeur planetaire, mais il a le desavantage de contaminer davantage l'echantillon en Fe par attrition. Cependant, ceci peut etre neglige vu que le Fe etait un des catalyseurs metalliques ajoutes au creuset. En deuxieme etape, l'echantillon broye est transfere sous gaz inerte (argon) dans un tube en quartz, qui est alors chauffe a 700°C pendant 90 minutes. Des mesures de patrons de diffraction a rayons-X sur poudre furent faites pour caracteriser les changements structurels des CNS lors des etapes de synthese. Ces mesures furent prises avec un diffractometre Bruker D8 FOCUS utilisant le rayonnement Cu Ka (lambda = 1.54054 A) et une geometrie Theta/2Theta. La Figure 3.1 montre le patron de diffraction de rayon-X du charbon active utilise comme precurseur pour produire les CNS. Le charbon active est prechauffe a haute temperature (1,000°C) pendant 1 h pour enlever l'humidite. La Figure 3.2 montre les patrons de diffraction de rayons-X des echantillons SPEX et planetaire apres broyage de 12 h et 24 h, respectivement. Les structures de charbon ne sont pas encore bien definies, mais un pic a 2theta ≈ 20°-30° correspond aux petites cristallites a caractere turbostatique et un pic correspondant au fer et au carbure de fer apparait a 2theta ≈ 45°. (Abstract shortened by UMI.)

  10. Foliated breccias in the active Portuguese Bend landslide complex, California: bearing on melange genesis

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

    Larue, D.K.; Hudleston, P.J.

    1987-05-01

    The active portion of the Portuguese Bend landslide complex is approximately 3 km/sup 2/ in area and 30-50 m thick. Measured displacement rates range from less than one to greater than 30 mm/day on different parts of the landslide, with total displacements over the last 30 yrs ranging from about 10 to greater than 150 m. Six types of breccia, each locally with a foliated matrix, were recognized in the active landslide complex and are absent outside the landslide complex. Slide-body breccias are of two types, the first formed by extensional fracturing during bulk pure shear at the top ofmore » the landslide (slide-top breccia) and the second by flow of tuffaceous shales and fracture of embedded siliceous shales during simple shear deep in the landslide to the basal decollement (slide-bottom breccias). Slide-margin breccias, also in simple shear, are produced on the lateral margins of individual slide blocks accompanying wrench-fault motion. Other breccias (fault-ramp breccias) are formed during motion over ramps. Colluvial deposits within tension gashes (crack-fill breccias) and at the toe of the slide (slide-toe breccias) represent a fifth breccia type. Diapirs originating from over-pressured zones at the slide base also contain breccia. Recognition of different breccia types in ancient rocks would be difficult, because fabrics in the different types are similar. Foliations are defined by: scaly cleavage, compositional banding and color banding (in shear zones), stretched mud clasts, and aligned hard grains. Foliated breccias are synonymous with melanges. The authors regard the six breccia types described herein as representing the principal types of melange that occur in ancient accretionary settings.« less

  11. Risk of stent thrombosis among bare-metal stents, first-generation drug-eluting stents, and second-generation drug-eluting stents: results from a registry of 18,334 patients.

    PubMed

    Tada, Tomohisa; Byrne, Robert A; Simunovic, Iva; King, Lamin A; Cassese, Salvatore; Joner, Michael; Fusaro, Massimiliano; Schneider, Simon; Schulz, Stefanie; Ibrahim, Tareq; Ott, Ilka; Massberg, Steffen; Laugwitz, Karl-Ludwig; Kastrati, Adnan

    2013-12-01

    This study sought to compare the risk of stent thrombosis among patients treated with bare-metal stents (BMS), first-generation drug-eluting stents (G1-DES), and second-generation drug-eluting stents (G2-DES) for a period of 3 years. In patients undergoing coronary stenting, there is a scarcity of long-term follow-up data on cohorts large enough to compare rates of stent thrombosis across the stent generations. A total of 18,334 patients undergoing successful coronary stent implantation from 1998 to 2011 at 2 centers in Munich, Germany, were included in this study. Patients were stratified into 3 groups according to treatment with BMS, G1-DES, and G2-DES. The cumulative incidence of definite stent thrombosis at 3 years was 1.5% with BMS, 2.2% with G1-DES, and 1.0% with G2-DES. On multivariate analysis, G1-DES compared with BMS showed a significantly higher risk of stent thrombosis (odds ratio [OR]: 2.05; 95% confidence interval [CI]: 1.47 to 2.86; p < 0.001). G2-DES were associated with a similar risk of stent thrombosis compared with BMS (OR: 0.82; 95% CI: 0.56 to 1.19; p = 0.30). Beyond 1 year, the risk of stent thrombosis was significantly increased with G1-DES compared with BMS (OR: 4.72; 95% CI: 2.01 to 11.1; p < 0.001), but not with G2-DES compared with BMS (OR: 1.01; 95% CI: 0.32 to 3.25; p = 0.98). In a large cohort of unselected patients undergoing coronary stenting, compared with BMS, there was a significant excess risk of stent thrombosis at 3 years with G1-DES, driven by an increased risk of stent thrombosis events beyond 1 year. G2-DES were associated with a similar risk of stent thrombosis compared with BMS. Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  12. Melanges Pedagogiques (Pedagogical Mixture), 1983.

    ERIC Educational Resources Information Center

    Melanges Pedagogiques, 1983

    1983-01-01

    The 1983 issue of the journal on second language teaching and learning contains six articles in French. These include the following: "E.A.O.: Expression avec ordinateur (E.A.O.: Computer-Aided Expression)" (Daniele Abe, Michele Cembalo); "Ou suis-je? De la relation apprenant/environnement (Where Am I? On the Learner/Environment…

  13. Structural Analyses of the Kahiltna Terrane: A Kinematic Record of the Collision of the Talkeetna Superterrane

    NASA Astrophysics Data System (ADS)

    Bier, S. E.; Fisher, D.

    2002-12-01

    Macro-, meso-, and microscale structural analyses from several localities across the ~1000 km Kahiltna Terrane provide valuable kinematic insights into the late Cretaceous collision between the Talkeetna superterrane and North America. The Kahiltna Terrane, a Jurassic-Cretaceous flysch basin inboard of the Talkeetna superterrane (Wrangellia, Peninsular, and Alexander terranes), contains incremental strain indicators that record a history of oblique collision and subsequent deformation in a strike-slip regime. A comparison of structural data from localities across the Kahiltna terrane suggests a unique history not yet described in previous work on south-central Alaskan tectonics. Data was collected from the Reindeer Hills area, the northwestern Talkeetna Mountains, Denali National Park, the Peters Hills, and the Tordrillo Mountains. In the Reindeer Hills, a melange zone occurs as a series of exposures dismembered by ongoing strike slip faulting between the flysch of the Kahiltna terrane and the precollisional edge of the North American continent. This melange is characterized by fault-bounded blocks of Paleozoic limestone and sandstone within an argillite matrix with a conspicuous scaly fabric. The blocks range in size from 10 cm to tens of meters; and melange fish indicate a south-directed shear sense. The melange is overlain by a red and green (Triassic-Jurassic?) conglomerate along an unconformity that likely marks the base of a perched slope basin near the toe of an accretionary wedge. The strike of bedding and cleavage in this area trends EW. The fold axes trend NW-SE and folds verge to the south. In the northwest corner of the Talkeetna Mountains, the structure is dominated by north vergent folds and faults. The strike of bedding trends ~025°; whereas the strike of the cleavage is ~060°. Both cleavage and bedding dip to the southeast. The fold axes trend roughly NE-SW. North of the Denali Fault System, in Denali National Park, strike of bedding is ~122° and the dip is to the southwest. Folds can be divided into two sets: 1) tight folds with axes trending E-W and 2) open folds with axes that trend N-S. Cleavage is axial planar to the first set of folds. Crenulation cleavage that trends E-W may also be associated with the first set of folds. In the Peters Hills, reversals in facing direction indicate the presence of multiple macroscale folds. The strike of bedding and cleavage trend ~240° and dip to the northwest. Outcrop observations of smaller scale north-vergent folds and larger scale south-vergent folds suggest multiple deformation events. Stretching lineations trend NE-SW, and incremental strain indicators record indicate a dextral shearing event. The Kahiltna terrane exposed in the vicinity of the Tordrillo Mountains consists of alternating volcaniclastic sandstones and turbidite sequences. The strike of bedding and cleavage is ~240°, and they dip steeply to the northwest. Small isoclinal folds and faults indicate northwestward transport and deformation overprinted by large-scale open folds that verge to the east. Observations of the melange indicate precollisional northward-dipping subduction beneath an accretionary assemblage of Triassic(?) material. Structural observations from multiple localities across the Kahiltna terrane indicate northward-directed thrusting related to dextral transpression and oblique collision of the Talkeetna superterrane, with varying amounts of obliquity along the margin.

  14. Impact of bioresorbable versus permanent polymer on longterm vessel wall inflammation and healing: a comparative drug-eluting stent experimental study.

    PubMed

    Wilson, Gregory J; McGregor, Jennifer; Conditt, Gerard; Shibuya, Masahiko; Sushkova, Natalia; Eppihimer, Michael J; Hawley, Steven P; Rouselle, Serge D; Huibregtse, Barbara A; Dawkins, Keith D; Granada, Juan F

    2018-02-20

    Drug-eluting stents (DES) have evolved to using bioresorbable polymers as a method of drug delivery. The impact of bioresorbable polymer on long-term neointimal formation, inflammation, and healing has not been fully characterised. This study aimed to evaluate the biological effect of polymer resorption on vascular healing and inflammation. A comparative DES study was performed in the familial hypercholesterolaemic swine model of coronary stenosis. Permanent polymer DES (zotarolimus-eluting [ZES] or everolimus-eluting [EES]) were compared to bioresorbable polymer everolimus-eluting stents (BP-EES) and BMS. Post implantation in 29 swine, stents were explanted and analysed up to 180 days. Area stenosis was reduced in all DES compared to BMS at 30 days. At 180 days, BP-EES had significantly lower area stenosis than EES or ZES. Severe inflammatory activity persisted in permanent polymer DES at 180 days compared to BP-EES or BMS. Qualitative para-strut inflammation areas (graded as none to severe) were elevated but similar in all groups at 30 days, peaked at 90 days in DES compared to BMS (p<0.05) and, at 180 days, were similar between BMS and BP-EES but were significantly greater in DES. BP-EES resulted in a lower net long-term reduction in neointimal formation and inflammation compared to permanent polymer DES in an animal model. Further study of the long-term neointima formation deserves study in human clinical trials.

  15. Very late stent thrombosis with second generation drug eluting stents compared to bare metal stents: Network meta-analysis of randomized primary percutaneous coronary intervention trials.

    PubMed

    Philip, Femi; Stewart, Susan; Southard, Jeffrey A

    2016-07-01

    The relative safety of drug-eluting stents (DES) and bare-metal stents (BMS) in primary percutaneous coronary intervention (PPCI) in ST elevation myocardial infarction (STEMI) continues to be debated. The long-term clinical outcomes between second generation DES and BMS for primary percutaneous coronary intervention (PCI) using network meta-analysis were compared. Randomized controlled trials comparing stent types (first generation DES, second generation DES, or BMS) were considered for inclusion. A search strategy used Medline, Embase, Cochrane databases, and proceedings of international meetings. Information about study design, inclusion criteria, and sample characteristics were extracted. Network meta-analysis was used to pool direct (comparison of second generation DES to BMS) and indirect evidence (first generation DES with BMS and second generation DES) from the randomized trials. Twelve trials comparing all stents types including 9,673 patients randomly assigned to treatment groups were analyzed. Second generation DES was associated with significantly lower incidence of definite or probable ST (OR 0.59, 95% CI 0.39-0.89), MI (OR 0.59, 95% CI 0.39-0.89), and TVR at 3 years (OR 0.50: 95% CI 0.31-0.81) compared with BMS. In addition, there was a significantly lower incidence of MACE with second generation DES versus BMS (OR 0.54, 95% CI 0.34-0.74) at 3 years. These were driven by a higher rate of TVR, MI and stent thrombosis in the BMS group at 3 years. There was a non-significant reduction in the overall and cardiac mortality [OR 0.83, 95% CI (0.60-1.14), OR 0.88, 95% CI (0.6-1.28)] with the use of second generation DES versus BMS at 3 years. Network meta-analysis of randomized trials of primary PCI demonstrated lower incidence of MACE, MI, TVR, and stent thrombosis with second generation DES compared with BMS. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  16. An empirical comparison of Markov cohort modeling and discrete event simulation in a capacity-constrained health care setting.

    PubMed

    Standfield, L B; Comans, T A; Scuffham, P A

    2017-01-01

    To empirically compare Markov cohort modeling (MM) and discrete event simulation (DES) with and without dynamic queuing (DQ) for cost-effectiveness (CE) analysis of a novel method of health services delivery where capacity constraints predominate. A common data-set comparing usual orthopedic care (UC) to an orthopedic physiotherapy screening clinic and multidisciplinary treatment service (OPSC) was used to develop a MM and a DES without (DES-no-DQ) and with DQ (DES-DQ). Model results were then compared in detail. The MM predicted an incremental CE ratio (ICER) of $495 per additional quality-adjusted life-year (QALY) for OPSC over UC. The DES-no-DQ showed OPSC dominating UC; the DES-DQ generated an ICER of $2342 per QALY. The MM and DES-no-DQ ICER estimates differed due to the MM having implicit delays built into its structure as a result of having fixed cycle lengths, which are not a feature of DES. The non-DQ models assume that queues are at a steady state. Conversely, queues in the DES-DQ develop flexibly with supply and demand for resources, in this case, leading to different estimates of resource use and CE. The choice of MM or DES (with or without DQ) would not alter the reimbursement of OPSC as it was highly cost-effective compared to UC in all analyses. However, the modeling method may influence decisions where ICERs are closer to the CE acceptability threshold, or where capacity constraints and DQ are important features of the system. In these cases, DES-DQ would be the preferred modeling technique to avoid incorrect resource allocation decisions.

  17. Impasses and Reversals in Foreign Language Instruction. Melanges Pedagogiques, 1971.

    ERIC Educational Resources Information Center

    Baskan, O.

    All proposed programs in foreign language instruction should be scrutinized and questioned in liberal-minded research centers, because this field seems to have arrived at an impasse. Two types of impasse are evident: "intrinsic" and "emergent.""Intrinsic" refers to built-in difficulties, those that are not artificially imposed on the…

  18. Diversity Trumps Freedom on Campus

    ERIC Educational Resources Information Center

    Talkington, Scott W.

    2006-01-01

    The tally of occurrences of a PC buzzword on academic and other websites seems to corroborate the suspicion that we're quickly abandoning "e pluribus unum" as the governing principle for treating individuals justly. In its place is the new image of America as a melange of competing interest groups. In this NAS research on comparative…

  19. Theorie Grammaticale et Enseignement de la Grammaire (Grammatical Theory and Grammar Instruction). Melanges Pedagogiques, 1970.

    ERIC Educational Resources Information Center

    Heddesheimer, C.

    This article discusses the problem of the relationship between scientific theory and teaching practice, between the linguist and the language teacher. Language instruction attempts more and more to approximate the mother tongue acquisition process, but the two processes remain distinct. However, good second language pedagogy will lead to…

  20. Melanges Pedagogiques (Pedagogical Mixture), 1986/87.

    ERIC Educational Resources Information Center

    Melanges Pedagogiques, 1987

    1987-01-01

    The 1986/87 issue of the journal on second language teaching and learning contains seven articles in French and four in English, including: "Learning How To Learn English"; "Socrate est-il un chat? Pratiquer le syllogisme pour apprendre a argumenter (Is Socrates a Cat? Practicing Syllogisms To Learn To Argue)"; "La production orale en francais des…

  1. Fonctions Discursives et Communication Ecrite (Discursive Functions and Written Communication). Melanges Pedagogiques, 1974.

    ERIC Educational Resources Information Center

    Duda, R.

    This article describes discursive functions in the three major areas of non-literary written communication: (1) official or personal correspondence; (2) technical reading or editing; and (3) the press. Illocutionary acts are examined under their three aspects: graphic, lexical, enunciative. This description is intended to result in training…

  2. Early Paleozoic magmatic events in the eastern Klamath Mountains, northern California

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

    Wallin, E.T.; Mattinson, J.M.; Potter, A.W.

    1988-02-01

    New U-Pb zircon ages for nine samples of tonalite and pegmatitic trondhjemite from the Trinity ophiolite and associated melange reveal a complex history of magmatic activity extending back into the earliest Cambrian, much older than previously believed. Earlier investigations, based on limited data, recognized lower Paleozoic crustal elements in the eastern Klamath terrane (EKT) ranging in age from Middle Ordovician to Early to Middle Devonian. The new work in the Yreka-Callahan area of the EKT confirms the Ordovician (440-475 Ma) and younger ages, but reveals for the first time the presence of tonalitic rocks that crystallized during a narrow timemore » interval at about 565-570 Ma. The authors also recognize younger, Late Silurian magmatism at 412 Ma. In the context of available mapping, these ages indicate that the Trinity ophiolite is broadly polygenetic because parts of it yield crystallization ages that span approximately 150 m.y. Superjacent dismembered units of probable early Paleozoic age may be tectonostratigraphically equivalent to the Sierra City melange in the northern Sierra Nevada.« less

  3. Mid-to-long term mortality following surgical versus percutaneous coronary revascularization stratified according to stent subtype: An analysis of 6,682 patients with multivessel disease

    PubMed Central

    Raja, Shahzad G.; Ilsley, Charles; De Robertis, Fabio; Lane, Rebecca; Kabir, Tito; Bahrami, Toufan; Simon, Andre; Popov, Aron; Dalby, Miles C.; Mason, Mark; Grocott-Mason, Richard; Smith, Robert D.

    2018-01-01

    Background Studies comparing coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI) have largely been performed in the bare-metal stent (BMS) and first-generation drug eluting stent (F-DES) era. Second-generation DES (S-DES) have shown improved outcomes when compared to F-DES, but data comparing CABG with PCI using S-DES is limited. We compared mortality following CABG versus PCI for patients with multivessel disease and analyzed different stent types. Methods A total of 6,682 patients underwent multivessel revascularization at Harefield Hospital, UK. We stratified CABG patients into single arterial graft (SAG) or multiple arterial grafts (MAG); and PCI patients into BMS, F-DES or S-DES groups. We analyzed all-cause mortality at 5 years. Results 4,388 patients had CABG (n[SAG] = 3,358; n[MAG] = 1,030) and 2,294 patients had PCI (n[BMS] = 416; n[F-DES] = 752; n[S-DES] = 1,126). PCI had higher 5-year mortality with BMS (HR = 2.27, 95% CI:1.70–3.05, p<0.001); F-DES (HR = 1.52, 95% CI:1.14–2.01, p = 0.003); and S-DES (HR = 1.84, 95% CI:1.42–2.38, p<0.001). This was confirmed in inverse probability treatment weighted analyses. When adjusting for both measured and unmeasured factors using instrumental variable analyses, PCI had higher 5-year mortality with BMS (Δ = 15.5, 95% CI:3.6,27.5, p = 0.011) and FDES (Δ = 16.5, 95% CI:6.6,26.4, p<0.001), but had comparable mortality with CABG for PCI with SDES (Δ = 0.9, 95% CI: -9.6,7.9, p = 0.844), and when exclusively compared to CABG patients with SAG (Δ = 0.4, 95% CI: -8.0,8.7, p = 0.931) or MAG (Δ = 4.6, 95% CI: -0.4,9.6, p = 0.931). Conclusions In this real-world analysis, when adjusting for measured and unmeasured confounding, PCI with SDES had comparable 5-year mortality when compared to CABG. This warrants evaluation in adequately-powered randomized controlled trials. PMID:29408926

  4. Authigenic potassium feldspar: a tracer for the timing of palaeofluid flow in carbonate rocks, Northern Calcareous Alps, Austria

    USGS Publications Warehouse

    Spotl, C.; Kunk, Michael J.; Ramseyer, K.; Longstaffe, F.J.

    1998-01-01

    This paper is included in the Special Publication entitled 'Dating and duration of fluid flow and fluid-rock interaction', edited by J. Parnell. Feldspar is a common authigenic constituent in Permian carbonate rocks which occur as tectonically isolated blocks within the evaporitic Haselgebirge melange in the Northern Calcareous Alps (NCA). Coexisting with pyrite, anhydrite, (saddle) dolomite, magnesite, fluorite and calcite, K-feldspar and minor albite record an event of regionally extensive interaction of hot brines with carbonate rocks. Detailed petrographic, crystallographic and geochemical studies reveal a variability in crystal size and shape, Al-Si ordering, elemental and stable isotopic compositions of the K-feldspar, which is only partially consistent with the traditional view of authigenic feldspar as a well-ordered, compositionally pure mineral. 40Ar-39Ar step- heating measurements of authigenic potassium feldspar from several localities yield two age populations, an older one of 145-154 Ma, and a younger one of c.90-97 Ma. Most age spectra reflect cooling through the argon retention temperature interval, which was rapid in some localities (as indicated by plateau ages) and slower in others. Rb-Sr isotope data are more difficult to interpret, because in many K-feldspar samples they are controlled largely by Sr-bearing inclusions. The Jurassic 40Ar-39Ar dates are interpreted as minimum ages of feldspar growth and hence imply that fluid-rock interaction is likely to be simultaneous with or to slightly predate melange formation. Deformation associated with the closure and subduction of the Meliata-Hallstatt ocean south of the NCA during the Upper Jurassic is regarded as the principal geodynamic driving force for both enhanced fluid circulation and melange formation. Some localities were reheated beyond the argon retention temperature for microcline during mid-Cretaceous nappe stacking of the NCA, thus obliterating the older signal.

  5. Metasomatism, Fluid Overpressure and Brecciation at the Slab-Mantle Interface: Insights from the Livingstone Fault, New Zealand

    NASA Astrophysics Data System (ADS)

    Tarling, M.; Smith, S. A. F.; Scott, J.

    2017-12-01

    Juxtaposition of mantle peridotite and serpentinite against quartzofeldspathic and mafic schists occurs along the shallow slab-mantle interface in some subduction zones. This part of the subduction interface has been invoked as a possible source region of episodic tremor and slow slip, yet geological observations of fault zone structures and chemical reactions pertinent to this region are quite rare. The >1000 km long Livingstone Fault in New Zealand is a superbly exposed fault zone that provides a suitable analogue (both in terms of scale and the rock types involved) for the shallow slab-mantle interface. The fault is characterized by a foliated and highly sheared serpentinite mélange tens to several hundreds of meters wide that separates (partially serpentinised) peridotites from quartzofeldspathic schists. Talc- and tremolite-forming metasomatic reactions occurred along the margins of the mélange and around entrained pods due to mixing of serpentinite with silica- and calcium-rich fluids derived from the adjacent quartzofeldspathic schist. The metasomatic reactions generated significant volumes of water at the melange-schist contact that became trapped between the two relatively impermeable fault zone lithologies. On the schist side of the contact, brittle faulting was promoted by the formation of a laterally-continuous silicified zone up to tens of metres wide. On the melange side, a zone up to tens of metres wide of `crackle-breccias' containing veined stockworks of tremolite indicates periodic increases of pore pressure sufficient to cause hydraulic fracture of serpentinite. The crackle-breccias are multi-generational indicating that this process was episodic. Sr and Nd isotope data and permeability calculations suggest that the episodic brecciation process was critical to the transfer of fluids across the melange. Our observations suggest that fluid-producing metasomatic reactions along the shallow slab-mantle interface may contribute to the tremor signal by triggering brecciation events and promoting brittle failure in serpentinite and schist.

  6. Implications of Late Cretaceous U-Pb zircon ages of granitic intrusions cutting ophiolitic and volcanogenic rocks for the assembly of the Tauride allochthon in SE Anatolia (Helete area, Kahramanmaraş Region, SE Turkey)

    NASA Astrophysics Data System (ADS)

    Nurlu, Nusret; Parlak, Osman; Robertson, Alastair; von Quadt, Albrecht

    2016-01-01

    An assemblage of NE-SW-trending, imbricate thrust slices (c. 26 km E-W long × 6.3 km N-S) of granitic rocks, basic-felsic volcanogenic rocks (Helete volcanics), ophiolitic rocks (Meydan ophiolite) and melange (Meydan melange) is exposed near the Tauride thrust front in SE Anatolia. The volcanogenic rocks were previously assumed to be Eocene because of associated Nummulitic limestones. However, ion probe U-Pb dating of zircons extracted from the intrusive granitic rocks yielded ages of 92.9 ± 2.2-83.1 ± 1.5 Ma (Cenomanian-Campanian). The Helete volcanic unit and the overlying Meydan ophiolitic rocks both are intruded by granitic rocks of similar age and composition. Structurally underlying ophiolite-related melange includes similar-aged, but fragmented granitic intrusions. Major, trace element and rare earth element analyses coupled with electron microprobe analysis of the granitic rocks show that they are metaluminus to peraluminus and calc-alkaline in composition. A magmatic arc setting is inferred from a combination of tectonomagmatic discrimination, ocean ridge granite-normalized multi-element patterns and biotite geochemistry. Sr-Nd-Pb isotope data further suggest that the granitoid rocks were derived from variably mixed mantle and crustal sources. Granitic rocks cutting the intrusive rocks are inferred to have crystallized at ~5-16 km depth. The volcanogenic rocks and granitic rocks originated in a supra-subduction zone setting that was widely developed throughout SE Anatolia. Initial tectonic assembly took place during the Late Cretaceous probably related to northward subduction and accretion beneath the Tauride continent (Keban and Malatya platforms). Initial tectonic assembly was followed by exhumation and then transgression by shelf-depth Nummulitic limestones during Mid-Eocene, as documented in several key outcrops. Final emplacement onto the Arabian continental margin took place during the Early Miocene.

  7. Étude comparative des techniques d'analyse par fluorescence X à dispersion d'énergie (ED-XRF) et à dispersion de longueur d'onde (WD-XRF), et par spectrométrie d'émission atomique à source plasma couplée par induction (ICP-AES)

    NASA Astrophysics Data System (ADS)

    Rahmani, A.; Benyaïch, F.; Bounakhla, M.; Bilal, E.; Moutte, J.; Gruffat, J. J.; Zahry, F.

    2004-11-01

    Dans ce travail, nous présentons une étude comparative des techniques d'analyse par fluorescence X à dispersion d'énergie (ED-XRF) et à dispersion de longueur d'onde (WD-XRF), et par spectrométrie d'émission atomique à source plasma couplée par induction (ICP-AES). Les résultats de la calibration des spectromètres à dispersion d'énergie, à excitation par sources radioactives (55Fe, 109Cd et 241Am) et à excitation secondaire (cible secondaire Mo et Cu) du Centre National pour l'Energie, les Sciences et les Techniques Nucléaires (CNESTEN, Rabat, Maroc) sur des échantillons étalons de références de l'Agence International de l'Energie Atomique (AIEA) et du Community Bureau of Référence (BCR) ont été comparés aux résultats d'analyse des mêmes échantillons étalons par la spectrométrie X à dispersion de longueur d'onde (WD-XRF) et par spectrométrie d'émission atomique à source plasma couplé par induction (ICP-AES) au département GENERIC du centre SPIN à l'Ecole des Mines de Saint-Etienne (France). Les trois techniques d'analyse utilisées donnent des résultats comparables pour le dosage des éléments majeurs, alors que pour les traces on note des déviations importantes à cause des effets de matrice qui sont difficiles à corriger dans le cas de la fluorescence X.

  8. Cost-effectiveness analysis of biodegradable polymer versus durable polymer drug-eluting stents incorporating real-world evidence.

    PubMed

    Teng, Monica; Zhao, Ying Jiao; Khoo, Ai Leng; Ananthakrishna, Rajiv; Yeo, Tiong Cheng; Lim, Boon Peng; Chan, Mark Y; Loh, Joshua P

    2018-06-05

    Compared with second-generation durable polymer drug-eluting stents (DP-DES), the cost-effectiveness of biodegradable polymer drug-eluting stents (BP-DES) remains unclear in the real-world setting. We assessed the cost-effectiveness of BP-DES in patients with coronary artery disease undergoing percutaneous coronary intervention (PCI). We developed a decision-analytic model to compare the cost-effectiveness of BP-DES to DP-DES over one year and five years from healthcare payer perspective. Relative treatment effects during the first year post-PCI were obtained from a real-world population analysis while clinical event risks in the subsequent four years were derived from a meta-analysis of published studies. At one year, based on the clinical data analysis of 497 propensity-score matched pairs of patients, BP-DES were associated with an incremental cost-effectiveness ratio (ICER) of USD20,503 per quality-adjusted life-year (QALY) gained. At five years, BP-DES yielded an ICER of USD4,062 per QALY gained. At the willingness-to-pay threshold of USD50,400 (one gross domestic product per capita in Singapore in 2015), BP-DES were cost-effective. Sensitivity analysis showed that the cost of stents had a significant impact on the cost-effectiveness of BP-DES. Threshold analysis demonstrated that if the cost difference between BP-DES and DP-DES exceeded USD493, BP-DES would not be cost-effective in patients with one-year of follow-up. BP-DES were cost-effective compared with DP-DES in patients with coronary artery disease at one year and five years after PCI. It is worth noting that the cost of stents had a significant impact on the findings. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  9. Comparison of newer-generation drug-eluting with bare-metal stents in patients with acute ST-segment elevation myocardial infarction: a pooled analysis of the EXAMINATION (clinical Evaluation of the Xience-V stent in Acute Myocardial INfArcTION) and COMFORTABLE-AMI (Comparison of Biolimus Eluted From an Erodible Stent Coating With Bare Metal Stents in Acute ST-Elevation Myocardial Infarction) trials.

    PubMed

    Sabaté, Manel; Räber, Lorenz; Heg, Dik; Brugaletta, Salvatore; Kelbaek, Henning; Cequier, Angel; Ostojic, Miodrag; Iñiguez, Andrés; Tüller, David; Serra, Antonio; Baumbach, Andreas; von Birgelen, Clemens; Hernandez-Antolin, Rosana; Roffi, Marco; Mainar, Vicente; Valgimigli, Marco; Serruys, Patrick W; Jüni, Peter; Windecker, Stephan

    2014-01-01

    This study sought to study the efficacy and safety of newer-generation drug-eluting stents (DES) compared with bare-metal stents (BMS) in an appropriately powered population of patients with ST-segment elevation myocardial infarction (STEMI). Among patients with STEMI, early generation DES improved efficacy but not safety compared with BMS. Newer-generation DES, everolimus-eluting stents, and biolimus A9-eluting stents, have been shown to improve clinical outcomes compared with early generation DES. Individual patient data for 2,665 STEMI patients enrolled in 2 large-scale randomized clinical trials comparing newer-generation DES with BMS were pooled: 1,326 patients received a newer-generation DES (everolimus-eluting stent or biolimus A9-eluting stent), whereas the remaining 1,329 patients received a BMS. Random-effects models were used to assess differences between the 2 groups for the device-oriented composite endpoint of cardiac death, target-vessel reinfarction, and target-lesion revascularization and the patient-oriented composite endpoint of all-cause death, any infarction, and any revascularization at 1 year. Newer-generation DES substantially reduce the risk of the device-oriented composite endpoint compared with BMS at 1 year (relative risk [RR]: 0.58; 95% confidence interval [CI]: 0.43 to 0.79; p = 0.0004). Similarly, the risk of the patient-oriented composite endpoint was lower with newer-generation DES than BMS (RR: 0.78; 95% CI: 0.63 to 0.96; p = 0.02). Differences in favor of newer-generation DES were driven by both a lower risk of repeat revascularization of the target lesion (RR: 0.33; 95% CI: 0.20 to 0.52; p < 0.0001) and a lower risk of target-vessel infarction (RR: 0.36; 95% CI: 0.14 to 0.92; p = 0.03). Newer-generation DES also reduced the risk of definite stent thrombosis (RR: 0.35; 95% CI: 0.16 to 0.75; p = 0.006) compared with BMS. Among patients with STEMI, newer-generation DES improve safety and efficacy compared with BMS throughout 1 year. It remains to be determined whether the differences in favor of newer-generation DES are sustained during long-term follow-up. Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  10. The Sound and Video Library: An Interim Report on an Experiment. Melanges Pedagogiques, 1976.

    ERIC Educational Resources Information Center

    Riley, P.; Zoppis, C.

    An experimental sound- and video-library has recently been established by the Centre de Recherches et d'Applications Pedagogiques en Langues at the University of Nancy II. This article describes the functioning of the library system and gives a brief explanation of the underlying pedagogical principles which have guided the design, choice of…

  11. How firms set prices for medical materials: a multi-country study.

    PubMed

    Ide, Hiroo; Mollahaliloglu, Salih

    2009-09-01

    This study presents a comparison of medical material prices, discusses why differences exist, and examines methods for comparing prices. Market prices for drug-eluting stents (DES), non-drug-eluting stents (non-DES), and percutaneous transluminal coronary angioplasty (PTCA) catheters were collected from five countries: the United States, Japan, Korea, Turkey, and Thailand. To compare prices, three adjustment methods were used: currency exchange rates, purchasing power parity (PPP), and gross domestic product (GDP) per capita. The ratios of medical material prices compared with those in the United States were higher in Japan (from 1.4 for DES to 5.0 for PTCA catheters) and Korea (from 1.2 for DES to 4.0 for PTCA catheters), and lower in Turkey (from 0.8 for non-DES to 1.4 for DES) and Thailand (from 0.5 for non-DES to 1.3 for PTCA catheters). The PPP-adjusted ratios changed slightly for Japan, Korea, and Turkey. When the prices were adjusted by GDP per capita, the ratios were much higher. Comparing prices using currency exchange rates or PPP is applicable only between countries with stable economic relations; adjustment by GDP per capita reflects the actual burden. Further study is needed to fully elucidate the factors influencing the global medical material market.

  12. Cost effectiveness of drug-eluting stents in acute myocardial infarction patients in Germany: results from administrative data using a propensity score-matching approach.

    PubMed

    Bäumler, Michael; Stargardt, Tom; Schreyögg, Jonas; Busse, Reinhard

    2012-07-01

    The high number of patients with acute myocardial infarction (AMI) has facilitated greater research, resulting in the development of innovative medical devices. So far, results from economic evaluations that compared drug-eluting stents (DES) and bare-metal stents (BMS) have not shown clear evidence that one intervention is more cost effective than the other. The aim of this study was to measure the cost effectiveness of DES compared with BMS in routine care. We used administrative data from a large German sickness fund to compare the costs and effectiveness of DES and BMS in patients with AMI. Patients with hospital admission after AMI in 2004 and 2005 were followed up for 1 year after hospital discharge. The cost of treatment and survival after 365 days were compared for patients treated with DES and BMS. We adjusted for covariates defined according to the Ontario Acute Myocardial Infarction Mortality Prediction Rules using propensity score matching. After matching, we calculated incremental cost-effectiveness ratios (ICERs) by (i) using sample means based on bootstrapping procedures and (ii) estimating generalized linear mixed models for costs and survival. After propensity score matching, the sample included 719 patients treated with DES and 719 patients treated with BMS. A comparison of sample means resulted in average costs of € 12 714 and € 11 714 for DES and BMS, respectively, in 2005 German euros. Difference in 365-day survival was not statistically significant (700 patients with DES and 701 with BMS). The ICER of DES versus BMS was -€ 718 709 per life saved. Bootstrapping resulted in DES being dominated by BMS in 54.5% of replications and DES being a dominant strategy in 2.7% of replications. Results from regression models and sensitivity analyses confirm these results. Treatment with DES after admission with AMI is less cost effective than treatment with BMS. Our results are in line with other cost-effectiveness analyses that used administrative data, i.e. under routine care conditions. However, our results do not preclude that DES may be cost effective in specific patient subgroups.

  13. Mechanisms and Patterns of Intravascular Ultrasound In-Stent Restenosis Among Bare Metal Stents and First- and Second-Generation Drug-Eluting Stents.

    PubMed

    Goto, Kosaku; Zhao, Zhijing; Matsumura, Mitsuaki; Dohi, Tomotaka; Kobayashi, Nobuaki; Kirtane, Ajay J; Rabbani, LeRoy E; Collins, Michael B; Parikh, Manish A; Kodali, Susheel K; Leon, Martin B; Moses, Jeffrey W; Mintz, Gary S; Maehara, Akiko

    2015-11-01

    The most common causes of in-stent restenosis (ISR) are intimal hyperplasia and stent under expansion. The purpose of this study was to use intravascular ultrasound (IVUS) to compare the ISR mechanisms of bare metal stents (BMS), first-generation drug-eluting stents (DES), and second-generation DES. There were 298 ISR lesions including 52 BMS, 73 sirolimus-eluting stents, 52 paclitaxel-eluting stents, 16 zotarolimus-eluting stents, and 105 everolimus-eluting stent. Mean patient age was 66.6 ± 1.1 years, 74.2% were men, and 48.3% had diabetes mellitus. BMS restenosis presented later (70.0 ± 66.7 months) with more intimal hyperplasia compared with DES (BMS 58.6 ± 15.5%, first-generation DES 52.6 ± 20.9%, second-generation DES 48.2 ± 22.2%, p = 0.02). Although reference lumen areas were similar in BMS and first- and second-generation DES, restenotic DES were longer (BMS 21.8 ± 13.5 mm, first-generation DES 29.4 ± 16.1 mm, second-generation DES 32.1 ± 18.7 mm, p = 0.003), and stent areas were smaller (BMS 7.2 ± 2.4 mm(2), first-generation DES 6.1 ± 2.1 mm(2), second-generation DES 5.7 ± 2.0 mm(2), p <0.001). Stent fracture was seen only in DES (first-generation DES 7 [5.0%], second-generation DES 8 [7.4%], p = 0.13). In conclusion, restenotic first- and second-generation DES were characterized by less neointimal hyperplasia, smaller stent areas, longer stent lengths, and more stent fractures than restenotic BMS. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Drug-Eluting Stents versus Bare-Metal Stents in Taiwanese Patients with Acute Coronary Syndrome: An Outcome Report of a Multicenter Registry

    PubMed Central

    Lai, Chi-Cheng; Yip, Hon-Kan; Lin, Tsung-Hsien; Wu, Chiung-Jen; Lai, Wen-Ter; Liu, Chun-Peng; Chang, Shu-Chen; Mar, Guang-Yuan

    2014-01-01

    Background The study aims to compare cardiovascular outcomes of using bare-metal stents (BMS) and drug-eluting stents (DES) in patients with acute coronary syndrome (ACS) through analysis of the database from the Taiwan ACS registry. Large domestic studies comparing outcomes of interventional strategies using DES and BMS in a Taiwanese population with ACS are limited. Methods and Results Collected data regarding characteristics and cardiovascular outcomes from the registry database were compared between the BMS and DES groups. A Cox regression model was used in an unadjusted or adjusted manner for analysis. Baseline characteristics apparently varied between DES group (n = 650) and BMS group (n = 1672) such as ACS types, Killip’s classifications, or coronary blood flows. Compared with the BMS group, the DES group was associated with significantly lower cumulative incidence of all-cause mortality (3.4% vs. 5.8%, p = 0.008), target vessel revascularization (TVR) (5.2% vs. 7.4%, p = 0.035), or major adverse cardiac events (MACE) (10.2% vs. 15.6%, p < 0.001) at 1 year in a real-world setting. Cox regression analysis showed the BMS group referenced as the DES group had significantly higher risk-adjusted total mortality [hazard ratio (HR) = 1.85, p = 0.026], target vessel revascularization (TVR) (HR = 1.59, p = 0.035), and MACE (HR = 1.68, p = 0.001). Conclusions The data show use of DES over BMS provided advantages to patients with ACS in terms of lower 1-year mortality, TVR, and MACE. The study suggests implantation of DES compared with BMS in Taiwanese patients with ACS is safe and beneficial in the real-world setting. PMID:27122834

  15. Evaluation in an Autonomous Learning Scheme. Melanges Pedagogiques, 1977.

    ERIC Educational Resources Information Center

    Henner-Stanchina, C.; Holec, H.

    This document consists of a discussion of the place and nature of evaluation within the autonomous learning scheme developed by the Centre de Recherches et d'Applications Pedagogiques en Langues (C.R.A.P.E.L.). The center's commitment to the development of an autonomous learning scheme dates back several years. It is the outcome of an attempt to…

  16. Documents Non Didactiques et Formation en Langues (Non-Didactic Documents and Language Training). Melanges Pedagogiques, 1972.

    ERIC Educational Resources Information Center

    Duda, R.; And Others

    In second language learning, it is often the case that a discrepancy exists between the language of the pedagogical materials and that of the media or of the native speaker. This article discusses the advantages and problems involved in using authentic, non-didactic materials in post-introductory second language instruction, as found in an…

  17. Autonomie de l'Apprentissage: Realites et Perspectives (Autoinstruction: Realities and Perspectives). Melanges Pedagogiques, 1974.

    ERIC Educational Resources Information Center

    Cembalo, M.; Gremmo, M.-J.

    This article describes an attempt at organizing a continuing, self-instructional language program designed at the request of a commercial enterprise. The program was to be over a three-year period, and was originally aimed at producing reading comprehension in English, but at the request of the students the program was expanded to add listening…

  18. Hydrocarbon gas seeps of the convergent Hikurangi margin, North Island, New Zealand

    USGS Publications Warehouse

    Kvenvolden, K.A.; Pettinga, J.R.

    1989-01-01

    Two hydrocarbon gas seeps, located about 13 km apart, have distinctive molecular and isotopic compositions. These seeps occur within separate tectonic melange units of narrow parallel trending and structurally complex zones with incorporated upper Cretaceous and Palaeogene passive continental margin deposits which are now compressively deformed and imbricated along the convergent Hikurangi margin of North Island, New Zealand. At Brookby Station within the Coastal High, the seeping hydrocarbon gas has a methane/ethane ratio of 48 and ??13C and ??D values of methane of -45.7 and -188???, respectively (relative to the PDB and SMOW standards). Within the complex core of the Elsthorpe Anticline at Campbell Station seep, gas has a methane/ethane ratio of about 12000, and the methane has ??13C and ??D values of -37.4 and -170???, respectively. The source of the gases cannot be positively identified, but the gases probably originate from the thermal decomposition of organic matter in tectonically disturbed upper Cretaceous and/or lower Tertiary sedimentary rocks of passive margin affinity and reach the surface by migration along thrust faults associated with tectonic melange. The geochemical differences between the two gases may result from differences in burial depths of similar source sediment. ?? 1989.

  19. Impact of stent diameter and length on in-stent restenosis after DES vs BMS implantation in patients needing large coronary stents-A clinical and health-economic evaluation.

    PubMed

    Zbinden, Rainer; von Felten, Stefanie; Wein, Bastian; Tueller, David; Kurz, David J; Reho, Ivano; Galatius, Soren; Alber, Hannes; Conen, David; Pfisterer, Matthias; Kaiser, Christoph; Eberli, Franz R

    2017-02-01

    The British National Institute of Clinical Excellence (NICE) guidelines recommend to use drug-eluting stents (DES) instead of bare-metal stents (BMS) only in lesions >15 mm in length or in vessels <3 mm in diameter. We analyzed the impact of stent length and stent diameter on in-stent restenosis (ISR) in the BASKET-PROVE study population and evaluated the cost-effectiveness of DES compared to BMS. The BASKET-PROVE trial compared DES vs BMS in large coronary arteries (≥3 mm). We calculated incremental cost-effectiveness ratios (ICERs) and cost-effectiveness acceptability curves with regard to quality-adjusted life years (QALYs) gained and target lesion revascularizations (TLRs) avoided. A total of 2278 patients were included in the analysis. A total of 74 ISR in 63 patients were observed. In-stent restenosis was significantly more frequent in segments treated with a BMS compared to segments treated with a DES (5.4% vs 0.76%; P<.001). The benefit of a DES compared to a BMS regarding ISR was consistent among the subgroups of stent length >15 mm and ≤15 mm, respectively. With the use of DES in short lesions, there was only a minimal gain of 0.005 in QALYs. At a threshold of 10 000 CHF per TLR avoided, DES had a high probability of being cost-effective. In the BASKET-PROVE study population, the strongest predictor of ISR is the use of a BMS, even in patients in need of stents ≥3.0 mm and ≤15 mm lesion length and DES were cost-effective. This should prompt the NICE to reevaluate its recommendation to use DES instead of BMS only in vessels <3.0 mm and lesions >15 mm length. © 2016 John Wiley & Sons Ltd.

  20. Efficacy and safety of a biodegradable polymer sirolimus-eluting stent in primary percutaneous coronary intervention: a randomized controlled trial

    PubMed Central

    Li, Qiang; Tong, Zichuan; Wang, Lefeng; Zhang, Jianjun; Ge, Yonggui; Wang, Hongshi; Li, Weiming; Xu, Li; Ni, Zhuhua

    2013-01-01

    Introduction With long-term follow-up, whether biodegradable polymer drug-eluting stents (DES) is efficient and safe in primary percutaneous coronary intervention (PCI) remains a controversial issue. This study aims to assess the long-term efficacy and safety of DES in PCI for ST-segment elevation myocardial infarction (STEMI). Material and methods A prospective, randomized single-blind study with 3-year follow-up was performed to compare biodegradable polymer DES with durable polymer DES in 332 STEMI patients treated with primary PCI. The primary end point was major adverse cardiac events (MACE) at 3 years after the procedure, defined as the composite of cardiac death, recurrent infarction, and target vessel revascularization. The secondary end points included in-segment late luminal loss (LLL) and binary restenosis at 9 months and cumulative stent thrombosis (ST) event rates up to 3 years. Results The rate of the primary end points and the secondary end points including major adverse cardiac events, in-segment late luminal loss, binary restenosis, and cumulative thrombotic event rates were comparable between biodegradable polymer DES and durable polymer DES in these 332 STEMI patients treated with primary PCI at 3 years. Conclusions Biodegradable polymer DES has similar efficacy and safety profiles at 3 years compared with durable polymer DES in STEMI patients treated with primary PCI. PMID:24482648

  1. "Complex" Posttraumatic Stress Disorder/Disorders of Extreme Stress (CP/DES) in Sexually Abused Children: An Exloratory Study.

    ERIC Educational Resources Information Center

    Hall, Darlene Kordich

    1999-01-01

    Compares three groups of young sexually abused children on seven "Complex" Posttraumatic Stress Disorder/Disorders of Extreme Stress (CP/DES) indices. As cumulative number of types of trauma increased, the number of CP/DES symptoms rose. Results suggest that CP/DES also characterizes sexually abused children, especially those who have…

  2. The Misis-Andırın Complex: a Mid-Tertiary melange related to late-stage subduction of the Southern Neotethys in S Turkey

    NASA Astrophysics Data System (ADS)

    Robertson, Alastair; Unlügenç, Ülvi Can; İnan, Nurdan; Ta ṡli, Kemal

    2004-01-01

    The Mid-Tertiary (Mid-Eocene to earliest Miocene) Misis-Andırın Complex documents tectonic-sedimentary processes affecting the northerly, active margin of the South Tethys (Neotethys) in the easternmost Mediterranean region. Each of three orogenic segments, Misis (in the SW), Andırın (central) and Engizek (in the NE) represent parts of an originally continuous active continental margin. A structurally lower Volcanic-Sedimentary Unit includes Late Cretaceous arc-related extrusives and their Lower Tertiary pelagic cover. This unit is interpreted as an Early Tertiary remnant of the Mesozoic South Tethys. The overlying melange unit is dominated by tectonically brecciated blocks (>100 m across) of Mesozoic neritic limestone that were derived from the Tauride carbonate platform to the north, together with accreted ophiolitic material. The melange matrix comprises polymict debris flows, high- to low-density turbidites and minor hemipelagic sediments. The Misis-Andırın Complex is interpreted as an accretionary prism related to the latest stages of northward subduction of the South Tethys and diachronous continental collision of the Tauride (Eurasian) and Arabian (African) plates during Mid-Eocene to earliest Miocene time. Slivers of Upper Cretaceous oceanic crust and its Early Tertiary pelagic cover were accreted, while blocks of Mesozoic platform carbonates slid from the overriding plate. Tectonic mixing and sedimentary recycling took place within a trench. Subduction culminated in large-scale collapse of the overriding (northern) margin and foundering of vast blocks of neritic carbonate into the trench. A possible cause was rapid roll back of dense downgoing Mesozoic oceanic crust, such that the accretionary wedge taper was extended leading to gravity collapse. Melange formation was terminated by underthrusting of the Arabian plate from the south during earliest Miocene time. Collision was diachronous. In the east (Engizek Range and SE Anatolia) collision generated a Lower Miocene flexural basin infilled with turbidites and a flexural bulge to the south. Miocene turbiditic sediments also covered the former accretionary prism. Further west (Misis Range) the easternmost Mediterranean remained in a pre-collisional setting with northward underthrusting (incipient subduction) along the Cyprus arc. The Lower Miocene basins to the north (Misis and Adana) indicate an extensional (to transtensional) setting. The NE-SW linking segment (Andırın) probably originated as a Mesozoic palaeogeographic offset of the Tauride margin. This was reactivated by strike-slip (and transtension) during Later Tertiary diachronous collision. Related to on-going plate convergence the former accretionary wedge (upper plate) was thrust over the Lower Miocene turbiditic basins in Mid-Late Miocene time. The Plio-Quaternary was dominated by left-lateral strike-slip along the East Anatolian transform fault and also along fault strands cutting the Misis-Andırın Complex.

  3. Strongly foliated garnetiferous amphibolite clasts in ophiolitic melanges, Yarlung Zangbo Suture Zone, Tibet; Early Cretaceous disruption of a back-arc basin?

    NASA Astrophysics Data System (ADS)

    Guilmette, C.; Hebert, R.; Wang, C.; Indares, A. D.; Ullrich, T. D.; Dostal, J.; Bedard, E.

    2007-12-01

    Metre to decameter-size clasts of amphibolite are found embedded in ophiolitic melanges underlying the Yarlung Zangbo Suture Zone Ophiolites, South Tibet, China. These ophiolites and melanges occur at the limit between Indian and Tibetan-derived rocks and represent remnants of an Early Cretaceous intraoceanic supra-subduction zone domain, the Neo-Tethys. In the Saga-Dazuka segment (500 km along-strike), we discovered new occurrences of strongly foliated amphibolites found as clasts in the ophiolitic melange. In garnet-free samples, hornblende is green-blue magnesio-hornblende and cpx is low-Al diopside. In garnet- bearing samples, garnet is almandine with a strong pyrope component (up to 30 mol%) whereas coexisting hornblende is brown Ti-rich tschermakite and clinopyroxene is Al-diopside. Plagioclase composition was ubiquitously shifted to albite during a late metasomatic event. Geochemistry of these rocks indicates that their igneous protoliths crystallized from a slightly differentiated tholeiitic basaltic liquid that did not undergo major fractionation. Trace element patterns reveal geochemical characteristics identical to those of the overlying ophiolitic crust. These are 1) trace element abundances similar to that of N-MORBs or BABBs, 2) a slight depletion of LREE and 3) a moderate to strong Ta-Nb negative anomaly and a slight Ti anomaly. Such characteristics suggest genesis over a spreading center close to a subduction zone, possibly a back-arc basin. Step-heating Ar/Ar plateau ages were obtained from hornblende separates. All ages fall in the range of 123-128 Ma, overlapping the crystallization ages from the overlying ophiolite (126-131 Ma). Pseudosections were built with the THERMOCALC software in the system NCFMASH. Results indicate that the observed assemblage Hb+Pl+Gt+Cpx is stable over a wide range of P-T conditions, between 10-18 kbars and at more than 800°C. Measured mineral modes and solid solution compositions were successfully modeled, indicating equilibrium between 11-13 kbars and 825-850°C, corresponding to high-P granulite facies conditions. In a general way, the geochemistry of the strongly foliated amphibolite clasts suggests that their igneous protolith probably crystallized within the same supra-subduction zone as the crustal rocks from the overlying ophiolite. Then some of these rocks were entrained to mantle depth and were rapidly exhumed, most likely along a lithospheric scale thrust fault underneath the ophiolite. This event corresponds with the end of magmatic activity within the ophiolitic crust and mantle and could be regarded as the inception of a subduction plane at the spreading ridge of a back-arc basin. The whole package was later on obducted over the Indian passive margin, at about 70 Ma. Such a model suggests that closure of the oceanic domain separating India from Eurasia implied disruption of at least one arc-back-arc system, thus requiring at least one early intraoceanic collision or major plate movement reorganization prior to the Late Cretaceous obduction.

  4. Percutaneous coronary intervention with oral sirolimus and bare metal stents has comparable safety and efficacy to treatment with drug eluting stents, but with significant cost saving: long-term follow-up results from the randomised, controlled ORAR III (Oral Rapamycin in ARgentina) study.

    PubMed

    Rodriguez, Alfredo E; Maree, Andrew; Tarragona, Sonia; Fernandez-Pereira, Carlos; Santaera, Omar; Rodriguez Granillo, Alfredo M; Rodriguez-Granillo, Gaston A; Russo-Felssen, Miguel; Kukreja, Neville; Antoniucci, David; Palacios, Igor F; Serruys, Patrick W

    2009-06-01

    Previous randomised studies have shown a significant reduction in restenosis when oral rapamycin (OR) is administered to patients undergoing bare metal stent (BMS) implantation. How this regimen compares to drug eluting stents (DES) is unknown. Two-hundred patients with de novo coronary lesions were randomised to treatment with OR plus BMS (100 pts) or with DES (100 pts). OR was given as a bolus of 10 mg per day before PCI followed by daily doses of 3 mg during following 13 days. Primary endpoints were to compare hospital, follow-up and overall cost at one, two, three and five years of follow-up. The secondary endpoints included death, myocardial infarction (MI) and stroke and were analysed as major adverse cardiovascular events (MACCE). Target vessel (TVR) and target lesion revascularisation (TLR) were independently analysed. Costs included procedural resources, hospitalisation, medications, repeat revascularisation procedures and professional fees. Baseline demographic, clinical and angiographic characteristics were similar. At 18.3 +/- 7 months of follow-up, the initial strategy of OR plus BMS resulted in significant cost saving when compared to DES (p=0.0001). TLR rate was 8.2% with DES and 7.0% with OR plus BMS (p=0.84), similarly no differences in TVR rate in both groups was seen (10.6% and 10.5% in OR and DES group respectively, p=0.86). Non-inferiority testing, determined that DES therapy failed to be cost saving compared to OR in all possible cost scenarios. A strategy of OR plus BMS is cost saving compared to DES in patients undergoing PCI for de novo coronary lesions.

  5. Comparaison de méthodes d'identification des paramètres d'une machine asynchrone

    NASA Astrophysics Data System (ADS)

    Bellaaj-Mrabet, N.; Jelassi, K.

    1998-07-01

    Interests, in Genetic Algorithms (G.A.) expands rapidly. This paper consists initially to apply G.A. for identifying induction motor parameters. Next, we compare the performances with classical methods like Maximum Likelihood and classical electrotechnical methods. These methods are applied on three induction motors of different powers to compare results following a set of criteria. Les algorithmes génétiques sont des méthodes adaptatives de plus en plus utilisée pour la résolution de certains problèmes d'optimisation. Le présent travail consiste d'une part, à mettre en œuvre un A.G sur des problèmes d'identification des machines électriques, et d'autre part à comparer ses performances avec les méthodes classiques tels que la méthode du maximum de vraisemblance et la méthode électrotechnique basée sur des essais à vides et en court-circuit. Ces méthodes sont appliquées sur des machines asynchrones de différentes puissances. Les résultats obtenus sont comparés selon certains critères, permettant de conclure sur la validité et la performance de chaque méthode.

  6. Preparation a l'Autonomie en Expression Orale. (Preparation for Autonomy in Oral Communication). Melanges Pedagogiques, 1972.

    ERIC Educational Resources Information Center

    Boulanger, C.

    This article deals with the issue of gaining proficiency in oral expression in a second language. A functional approach to teaching oral proficiency is outlined, an approach which focuses on the audience as a determining factor in the speaker's linguistic output. Claims in the article are based on an experiment in the teaching of oral proficiency…

  7. Randomized comparison of cost-saving and effectiveness of oral rapamycin plus bare-metal stents with drug-eluting stents: three-year outcome from the randomized oral rapamycin in Argentina (ORAR) III trial.

    PubMed

    Rodriguez, Alfredo E; Rodriguez-Granillo, Alfredo M; Antoniucci, David; Mieres, Juan; Fernandez-Pereira, Carlos; Rodriguez-Granillo, Gaston A; Santaera, Omar; Rubilar, Bibiana; Palacios, Igor F; Serruys, Patrick W

    2012-09-01

    The Oral Rapamycin in ARgentina (ORAR) III trial is a randomized study comparing a strategy of oral rapamycin (OR) plus bare-metal stent (BMS) versus a strategy of drug-eluting stents (DES) in patients with de novo coronary lesions. The purpose of this study was to assess the 3 years cost-effectiveness outcome of each strategy. OR after BMS has been associated with reduction of target vessel revascularization (TVR) although its value in long-term efficacy in comparison with DES is unknown. In three hospitals in Buenos Aires, Argentina, 200 patients were randomized to OR plus BMS (n = 100) or DES (n = 100). Primary objectives were costs and effectiveness. Cost analysis included in-hospital and follow-up costs. Safety was defined as the composite of death, myocardial infarction (MI), and stroke. Efficacy was defined as TVR. Baseline characteristics between groups were similar. The 3-year follow-up rate was 99%. Cardiac mortality was 2% and 5% in OR group and DES group, respectively (P = 0.44). The composite of death, MI and stroke rate was 11% in OR group and 20% in DES group (P = 0.078). TVR rate was 14.5% in OR group and 17.6% in DES group (P = 0.50), respectively. Three year cumulative costs were significantly lower in the OR arm as compared to the DES arm (P = 0.0001) and DES strategy did not result cost-effective according to the non-inferiority test. At 3 years follow-up, there were no differences in effectiveness between the two strategies, and DES strategy was not more cost-effective as compared to OR plus BMS. Copyright © 2011 Wiley Periodicals, Inc.

  8. Effect of in-utero diethylstilboestrol exposure on human oocyte quality and fertilization in a programme of in-vitro fertilization.

    PubMed

    Kerjean, A; Poirot, C; Epelboin, S; Jouannet, P

    1999-06-01

    Genital tract abnormalities and adverse pregnancy outcome are well known in women exposed in utero to diethylstilboestrol (DES). Data about adverse reproductive performance in women exposed to DES have been published, including controversial reports of menstrual dysfunction, poor responses after ovarian stimulation, oocyte maturation and fertilization abnormalities. We compared oocyte quality, in-vitro fertilization results and embryo quality for women exposed in utero to DES with a control group. Between 1989 and 1996, 56 DES-exposed women who had 125 in-vitro fertilization (IVF) attempts were retrospectively compared to a control group of 45 women with tubal disease, who underwent 73 IVF attempts. Couples suffering from male infertility were excluded. The parameters compared were oocyte quality (maturation abnormalities, immature oocyte, mature oocyte), fertilization and cleavage rate (per treated and metaphase II oocytes), and embryo quality (number and grade). We found no significant difference in oocyte maturational status, fertilization rates, cleavage rates, embryo quality and development between DES-exposed subjects and control subjects. These results suggest that in-utero exposure to DES has no significant influence on oocyte quality and fertilization ability as judged during IVF attempts.

  9. Didactique et authentique: Du document a la pedagogie (Didactic and Authentic: From Document to Method). Melanges pedagogiques, No. 10.

    ERIC Educational Resources Information Center

    Abe, D.; And Others

    This discussion shows that "authentic documents" are a basic tool for the acquisition of communicative competence in a second language. An authentic document is a sort of photograph of discourse produced at a given time and in a given place. Like a cliche, it has its own existence. Two reasons for choosing authentic documents in second language…

  10. Rereading "The Jack-Roller:" Hidden Histories in Sociology and Social Work

    ERIC Educational Resources Information Center

    Shaw, Ian

    2009-01-01

    I revisit one of the iconic Chicago School studies, Clifford Shaw's "The Jack-Roller". A naive reading of Shaw's book leaves the reader with a sense of having been inducted into a melange of what we now know as "sociology" and "social work," but which to Shaw seems a coherent stance. I suggest that this is close to the heart of how things were,…

  11. Le Facteur d'Adaptation dans la Comprehension de l'Anglais Oral (The Adaptation Factor in the Understanding of Spoken English). Melanges Pedagogiques, 1972.

    ERIC Educational Resources Information Center

    Roussel, F.

    Progress in the teaching of oral comprehension depends partly on the isolation of factors which block comprehension. Research in conjunction with an experimental course in English as a second language led to the definition of errors due to: (1) insufficient knowledge of the language and the cultural context of its use, and (2) a failure to…

  12. Vers une Redefinition de la Comprehension Ecrite en Langue Etrangere (Towards a Redefinition of Reading Comprehension in a Foreign Language). Melanges Pedagogiques, 1975.

    ERIC Educational Resources Information Center

    Abe, D.; And Others

    Up to the present, the Centre de Recherches et d'Applications Pedagogiques en Langues has approached the development of reading comprehension skills in English as a second language in terms of morpho-syntactic development. This article proposes to examine difficulties in reading comprehension based not on morpho-syntax but on the textual and…

  13. Markov modeling and discrete event simulation in health care: a systematic comparison.

    PubMed

    Standfield, Lachlan; Comans, Tracy; Scuffham, Paul

    2014-04-01

    The aim of this study was to assess if the use of Markov modeling (MM) or discrete event simulation (DES) for cost-effectiveness analysis (CEA) may alter healthcare resource allocation decisions. A systematic literature search and review of empirical and non-empirical studies comparing MM and DES techniques used in the CEA of healthcare technologies was conducted. Twenty-two pertinent publications were identified. Two publications compared MM and DES models empirically, one presented a conceptual DES and MM, two described a DES consensus guideline, and seventeen drew comparisons between MM and DES through the authors' experience. The primary advantages described for DES over MM were the ability to model queuing for limited resources, capture individual patient histories, accommodate complexity and uncertainty, represent time flexibly, model competing risks, and accommodate multiple events simultaneously. The disadvantages of DES over MM were the potential for model overspecification, increased data requirements, specialized expensive software, and increased model development, validation, and computational time. Where individual patient history is an important driver of future events an individual patient simulation technique like DES may be preferred over MM. Where supply shortages, subsequent queuing, and diversion of patients through other pathways in the healthcare system are likely to be drivers of cost-effectiveness, DES modeling methods may provide decision makers with more accurate information on which to base resource allocation decisions. Where these are not major features of the cost-effectiveness question, MM remains an efficient, easily validated, parsimonious, and accurate method of determining the cost-effectiveness of new healthcare interventions.

  14. Stent Polymers: Do They Make a Difference?

    PubMed

    Rizas, Konstantinos D; Mehilli, Julinda

    2016-06-01

    The necessity of polymers on drug-eluting stent (DES) platforms is dictated by the need of an adequate amount and optimal release kinetic of the antiproliferative drugs for achieving ideal DES performance. However, the chronic vessel wall inflammation related to permanent polymer persistence after the drug has been eluted might trigger late restenosis and stent thrombosis. Biodegradable polymers have the potential to avoid these adverse events. A variety of biodegradable polymer DES platforms have been clinically tested, showing equal outcomes with the standard-bearer permanent polymer DES within the first year of implantation. At longer-term follow-up, promising lower rates of stent thrombosis have been observed with the early generation biodegradable polymer DES platforms compared to first-generation DES. Whether this safety benefit still persists with newer biodegradable polymer DES generations against second-generation permanent polymer DES needs to be explored. © 2016 American Heart Association, Inc.

  15. Comparison between Exclusive and Selective Drug-Eluting Stent Strategies in Treating Patients with Multivessel Coronary Artery Disease.

    PubMed

    Tung, Ying-Chang; Hsiao, Ping-Gune; Hsu, Lung-An; Kuo, Chi-Tai; Chang, Chi-Jen

    2014-05-01

    The expanded usage of drug-eluting stents (DES) in treating patients with multivessel coronary artery disease (CAD) may sometimes be limited in real-world practice due to cost concerns. We compared the clinical outcomes of exclusive and selective DES use in treating patients with multivessel CAD. From November 2004 to December 2011, 110 patients with multivessel CAD who received four or more stents were enrolled into this study, and divided into two groups according to the DES strategy employed: exclusive DES (n = 52), or selective DES (n = 58). In the selective DES group, DES was reserved for complex lesions only, such that the incidence and predictors of clinical events were assessed. At a mean follow-up of 41.4 ± 26.5 months, there were no significant differences between the two strategies in terms of baseline characteristics, all-cause mortality (exclusive vs. selective: 1.9% vs. 6.9%, p = 0.21), cardiac death (1.9% vs. 1.7%, p = 0.94) and nonfatal myocardial infarction (3.8% vs. 5.2%, p = 0.74). Despite the presence of more ostial lesions in the exclusive DES group, there was a trend such that major adverse cardiac events (MACE) and target lesion revascularization (TLR) rates were higher in the selective DES group (MACE: 17.3% vs. 31%, p = 0.16; TLR: 11.5% vs. 24.1%, p = 0.08). The higher MACE rate in the selective DES group was mainly driven by a higher target vessel revascularization (TVR) rate (15.4% vs. 29.3%, p = 0.08). In the exclusive DES group, SYNTAX score was an independent predictor of MACE [Haxard ratio (HR): 1.09, 95% confidence internal (CI): 1.02-1.16, p = 0.01] and TVR (HR 1.08, 95% CI 1.01-1.15, p = 0.04). Compared to the exclusive DES strategy, the selective DES strategy with reservation of DES for complex lesions is associated with numerically higher, but not statistically significant, rates of MACE and all-cause mortality in this small group of patients with multivessel CAD receiving four or more stents. Bare metal stent; Drug-eluting stent; Multivessel coronary artery disease.

  16. Comparison between Exclusive and Selective Drug-Eluting Stent Strategies in Treating Patients with Multivessel Coronary Artery Disease

    PubMed Central

    Tung, Ying-Chang; Hsiao, Ping-Gune; Hsu, Lung-An; Kuo, Chi-Tai; Chang, Chi-Jen

    2014-01-01

    Background The expanded usage of drug-eluting stents (DES) in treating patients with multivessel coronary artery disease (CAD) may sometimes be limited in real-world practice due to cost concerns. We compared the clinical outcomes of exclusive and selective DES use in treating patients with multivessel CAD. Methods From November 2004 to December 2011, 110 patients with multivessel CAD who received four or more stents were enrolled into this study, and divided into two groups according to the DES strategy employed: exclusive DES (n = 52), or selective DES (n = 58). In the selective DES group, DES was reserved for complex lesions only, such that the incidence and predictors of clinical events were assessed. Results At a mean follow-up of 41.4 ± 26.5 months, there were no significant differences between the two strategies in terms of baseline characteristics, all-cause mortality (exclusive vs. selective: 1.9% vs. 6.9%, p = 0.21), cardiac death (1.9% vs. 1.7%, p = 0.94) and nonfatal myocardial infarction (3.8% vs. 5.2%, p = 0.74). Despite the presence of more ostial lesions in the exclusive DES group, there was a trend such that major adverse cardiac events (MACE) and target lesion revascularization (TLR) rates were higher in the selective DES group (MACE: 17.3% vs. 31%, p = 0.16; TLR: 11.5% vs. 24.1%, p = 0.08). The higher MACE rate in the selective DES group was mainly driven by a higher target vessel revascularization (TVR) rate (15.4% vs. 29.3%, p = 0.08). In the exclusive DES group, SYNTAX score was an independent predictor of MACE [Haxard ratio (HR): 1.09, 95% confidence internal (CI): 1.02-1.16, p = 0.01] and TVR (HR 1.08, 95% CI 1.01-1.15, p = 0.04). Conclusions Compared to the exclusive DES strategy, the selective DES strategy with reservation of DES for complex lesions is associated with numerically higher, but not statistically significant, rates of MACE and all-cause mortality in this small group of patients with multivessel CAD receiving four or more stents. PMID:27122787

  17. Safety and efficacy of the next generation Resolute Onyx zotarolimus-eluting stent: Primary outcome of the RESOLUTE ONYX core trial.

    PubMed

    Price, Matthew J; Shlofmitz, Richard A; Spriggs, Douglas J; Haldis, Thomas A; Myers, Paul; Popma Almonacid, Alexandra; Maehara, Akiko; Dauler, Michelle; Peng, Yun; Mehran, Roxana

    2017-09-23

    To assess the safety and efficacy of the novel Resolute (R-) Onyx drug-eluting stent (DES). The R-Onyx DES consists of a composite wire with an outer shell of cobalt chromium alloy and a platinum-iridium inner core to enhance radiopacity, with thinner, swaged struts and modified stent geometry compared with the predicate Resolute DES, resulting in a slightly lower total drug load in most sizes. This was a prospective, single-arm non-inferiority trial compared with a historical control. Patients with stable angina/ischemia and up to 2 de novo target lesions ≤35 mm long with reference vessel diameter (RVD) of 2.25-4.2 mm were enrolled. The primary endpoint was late lumen loss at 8-month follow-up. Propensity-score adjusted outcomes from the single-arm RESOLUTE-US trial served as the control. Seventy-five patients (85 lesions) were enrolled. Mean patient age was 66 ± 9 years, 73% were male, and 32% had diabetes. Mean lesion length was 14.28 ± 6.68 mm, mean RVD was 2.57 ± 0.48 mm, and 86% of lesions were class B2/C. In-stent late lumen loss at 8 months was 0.24 ± 0.39 mm with R-Onyx DES compared with 0.36 ± 0.52 mm with Resolute DES (P < 0.001 for noninferiority, P = 0.029 for superiority). At 8 months, clinically driven target lesion revascularization occurred in 3 patients (4.0%) and target lesion failure occurred in 5 patients (6.7%). In-stent late lumen loss is non-inferior, and appears to be superior, with the thin-strut novel composite wire R-Onyx DES compared with Resolute DES. Continued evolution of stent design can improve angiographic outcomes in complex lesions, even in the current era of next-generation DES. © 2017 Wiley Periodicals, Inc.

  18. A multicenter, randomized study to test immunosuppressive therapy with oral prednisone for the prevention of restenosis after percutaneous coronary interventions: cortisone plus BMS or DES versus BMS alone to eliminate restenosis (CEREA-DES) - study design and rationale.

    PubMed

    Ribichini, Flavio; Tomai, Fabrizio; De Luca, Giuseppe; Boccuzzi, Giacomo; Presbitero, Patrizia; Pesarini, Gabriele; Ferrero, Valeria; Ghini, Anna S; Pastori, Francesca; De Luca, Leonardo; Zavalloni, Denis; Soregaroli, Daniela; Garbo, Roberto; Franchi, Elena; Marino, Paolo; Minelli, Massimo; Vassanelli, Corrado

    2009-02-01

    Several randomized trials and registries have shown a reduction of restenosis after coronary angioplasty with drug-eluting stents (DESs) compared with bare metal stents (BMSs). However, cost-efficacy analysis and long-term outcome of DESs compared to BMSs deserve further assessment. Moreover, concern has been raised regarding adverse clinical events occurring late after DES implantation, in particular, late stent thrombosis related to the suspension of dual antiplatelet therapy. The use of a short-cycle oral treatment with prednisone at immunosuppressive dose after BMS implantation has shown remarkable efficacy in reducing restenosis in nondiabetic patients, with very low additional cost and without the need for long-term dual antiplatelet therapy. Such results are however limited by small sample size. Cortisone plus BMS or DES versus BMS alone to Eliminate Restenosis is an independent, prospective, multicenter, randomized study. It will randomize 375 nondiabetic patients with coronary artery disease in three different arms to BMS (control group), DES (DES group) or BMS followed by a 40-day prednisone treatment (prednisone group). The DES and the prednisone groups will be compared to the control group to investigate the expected clinical advantage. The primary endpoint of the study is the event-free survival of cardiovascular death, myocardial infarction and recurrence of ischemia-needing repeated target vessel revascularization at 1 year. Secondary endpoints are the event-free survival analysis at 2 and 3 years, the restenosis rate at 9 months, and cost-effectiveness at 1, 2 and 3 years. The expected primary endpoint rates are 90% for DESs and for prednisone-treated patients and 77% for BMSs. The study was designed as a superiority trial, to compare DES, and BMS and prednisone, with BMS alone. A sample size of 118 patients per group provides an 80% power, assuming a complete 12-month follow-up information available for each patient. To obviate for cases of drop out, the sample size was increased to 375 patients to be enrolled in five Italian hospitals. This study will provide a magnitude of the net clinical and economic benefits of DES and of the safety and efficacy of BMS and cortisone compared to the standard use of BMS alone in nondiabetic patients with coronary artery disease.

  19. Comparison of cost-effectiveness of oral rapamycin plus bare-metal stents versus first generation of drug-eluting stents (from the Randomized Oral Rapamycin in Argentina [ORAR] 3 trial).

    PubMed

    Rodriguez, Alfredo E; Palacios, Igor; Rodriguez-Granillo, Alfredo M; Mieres, Juan R; Tarragona, Sonia; Fernandez-Pereira, Carlos; Solorzano, Leonardo; Pauletto, Ricardo; Serruys, Patrick W; Antoniucci, David

    2014-03-01

    The aim of this study was to compare 5-year cost-effectiveness and clinical outcomes of patients with oral rapamycin (OR) plus bare-metal stent versus the drug-eluting stent (DES) strategy. During 2006 to 2007, a total of 200 patients were randomized to OR (n = 100) and DES (n = 100). Primary end point was to compare costs of initial procedure and cost-effectiveness of both revascularization strategies. Safety was evaluated by the composite of death, myocardial infarction, and cerebrovascular accident. Efficacy was assessed by target vessel and target lesion revascularizations. The 2 groups had similar baseline demographic, clinical, and angiographic characteristics. In the DES group, paclitaxel-, zotarolimus-, and sirolimus-eluting stents were used. Five-year clinical follow-up was accomplished in 99% patients. The DES group had significantly higher procedural (p <0.001), discharge to first-year (p = 0.02), and 1- to 5-year costs (p <0.001) compared with the OR group. At 5 years, the composite end point of death, myocardial infarction, and cerebrovascular accident (12% in the OR group vs 25% in the DES group, p = 0.01) was significantly less in the OR group. Target vessel revascularization (14.5% in the OR group vs 21% in the DES group, p = 0.16) and target lesion revascularization (10% in the OR group vs 17.6% in the DES group, p = 0.05) were not significantly different. In conclusion, a strategy of OR plus bare-metal stent was cost saving than a first-generation DES. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. Drug-Eluting Versus Bare-Metal Stents During PCI in Patients With End-Stage Renal Disease on Dialysis

    PubMed Central

    Chang, Tara I.; Montez-Rath, Maria E.; Tsai, Thomas T.; Hlatky, Mark A.; Winkelmayer, Wolfgang C.

    2016-01-01

    BACKGROUND In patients undergoing percutaneous coronary intervention (PCI), drug-eluting stents (DES) reduce repeat revascularizations compared with bare metal stents (BMS), but their effects on death and myocardial infarction (MI) are mixed. Few studies have focused on patients with end-stage renal disease (ESRD). OBJECTIVES We compared mortality and cardiovascular morbidity during PCI with DES and with BMS in dialysis patients. METHODS We identified 36,117 dialysis patients from the U.S. Renal Data System who had coronary stenting in the U.S. between 4/23/03 and 12/31/10, and examined the association of DES versus BMS with 1-year outcomes: death; death or MI; and death, MI or repeat revascularization. We conducted a temporal analysis by dividing the study period into 3 DES eras: Transitional (4/23/03 – 6/30/04); Liberal (7/1/04 – 12/31/06); and Selective (1/1/07 – 12/31/10). RESULTS One-year event rates were high, with 38 deaths, 55 death or MI events and 71 death, MI or repeat revascularization events per 100 person-years. DES was associated with a significant 18% lower risk of death, 16% lower risk of death or MI, and 13% lower risk of death, MI or repeat revascularization, compared with BMS. DES use varied, from 56% in the Transitional era to 85% in the Liberal era and 62% in the Selective era. DES outcomes in the Liberal era were significantly better than in the Transitional Era, but not significantly better than in the Selective Era. CONCLUSIONS DES for PCI appears safe in U.S. dialysis patients, and is associated with lower rates of death, MI and repeat revascularization. PMID:27012407

  1. Angiographic patterns of restenosis with 2nd generation drug-eluting stent: comparative analysis from a 10-year single-center experience .

    PubMed

    Lee, Sahmin; Yoon, Chang-Hwan; Oh, Il-Young; Suh, Jung-Won; Cho, Young-Seok; Cho, Goo-Yeong; Chae, In-Ho; Choi, Dong-Ju; Youn, Tae-Jin

    2015-01-01

    The angiographic features of restenosis contain prognostic information. However, restenosis patterns of the new generation drug-eluting stents (DES), everolimus-(EES) and resolute zotarolimus-eluting stent (ZES) have not been described.A total of 210 consecutive patients with DES restenosis were enrolled from 2003 to 2012. We analyzed 217 restenotic lesions after DES implantation, and compared the morphologic characteristics of the 2nd generation DES restenosis to those of restenosis with 2 first generation DES, sirolimus-(SES) and paclitaxel-eluting stent (PES).Baseline characteristics were comparable between the different stent groups. The incidence of focal restenosis was significantly lower for PES than the other stents (49.5% versus 87.0%, 76.2%, and 82.1% for PES versus SES, EES, and ZES, respectively, P < 0.001). When considering the pattern of restenosis solely within the stent margins, a further clear distinction between PES and other stents was observed (40.0% versus 92.9%, 88.9%, and 81.2% in PES versus SES, EES, and ZES, respectively, P < 0.001). There were no significant differences in restenosis patterns among SES, EES, and ZES. In multivariate analysis, PES implantation, hypertension, and age were associated with non-focal type of restenosis after DES implantation. After the introduction of EES and ZES into routine clinical practice in 2008, focal restenosis significantly increased from 63.9% to 76.7% and diffuse restenosis significantly decreased from 26.4% to 11.0% (P = 0.045).Focal restenosis was the most common pattern of restenosis in the new generation DES and the incidence of diffuse restenosis significantly decreased with the introduction of the 2nd generation DES.

  2. Apprentissage de l'expression orale en autonomie. Implications de l'approche fonctionelle (Learning Oral Expression in Independent Study. Implications of the Functional Approach). Melanges pedagogiques.

    ERIC Educational Resources Information Center

    Abe, D.; And Others

    Within the CRAPEL autonomous learning scheme, modular material is being developed for communicative oral expression. The purpose of this material is twofold: (1) to enable the learner to define his or her own needs in communicative terms, that is, to analyse a situation in terms of communicative acts needed in a given situation, the relationships…

  3. Analyse Factorielle d'une Batterie de Tests de Comprehension Orale et Ecrite (Factor Analysis of a Battery of Tests of Listening and Reading Comprehension). Melanges Pedagogiques, 1971.

    ERIC Educational Resources Information Center

    Lonchamp, F.

    This is a presentation of the results of a factor analysis of a battery of tests intended to measure listening and reading comprehension in English as a second language. The analysis sought to answer the following questions: (1) whether the factor analysis method yields results when applied to tests which are not specifically designed for this…

  4. Biodiesel production from ethanolysis of palm oil using deep eutectic solvent (DES) as co-solvent

    NASA Astrophysics Data System (ADS)

    Manurung, R.; Winarta, A.; Taslim; Indra, L.

    2017-06-01

    Biodiesel produced from ethanolysis is more renewable and have better properties (higher oxidation stability, lower cloud and pour point) compared to methanolysis, but it has a disadvantage such as complicated purification. To improve ethanolysis process, deep eutectic solvent (DES) can be prepared from choline chloride and glycerol and used as co-solvent in ethanolysis. The deep eutectic solvent is formed from a quaternary ammonium salt (choline chloride) and a hydrogen bond donor (Glycerol), it is a non-toxic, biodegradable solvent compared to a conventional volatile organic solvent such as hexane. The deep eutectic solvent is prepared by mixing choline chloride and glycerol with molar ratio 1:2 at temperature 80 °C, stirring speed 300 rpm for 1 hour. The DES is characterized by its density and viscosity. The ethanolysis is performed at a reaction temperature of 70 °C, ethanol to oil molar ratio of 9:1, potassium hydroxide as catalyst concentration of 1.2 wt. DES as co-solvent with concentration 0.5 to 3 wt. stirring speed 400 rpm, and a reaction time 1 hour. The obtained biodiesel is then characterized by its density, viscosity, and ester content. The oil - ethanol phase condition is observed in the reaction tube. The oil - ethanol phase with DES tends to form meniscus compared to without DES, showed that oil and ethanol become more slightly miscible, which favors the reaction. Using DES as co-solvent in ethanolysis showed increasing in yield and easier purification. The esters properties meet the international standards ASTM D6751, with the highest yield achieved 83,67 with 99,77 conversion at DES concentration 2 . Increasing DES concentration above 2 in ethanolysis decrease the conversion and yield, because of the excessive glycerol in the systems makes the reaction equilibrium moves to the reactant side.

  5. Stent thrombosis with bioabsorbable polymer drug-eluting stents: insights from the Food and Drug Administration database.

    PubMed

    Khan, Abdur R; Tripathi, Avnish; Farid, Talha A; Abaid, Bilal; Bhatt, Deepak L; Resar, Jon R; Flaherty, Michael P

    2017-11-01

    SYNERGY, a bioabsorbable polymer-based, everolimus-eluting stent (BP-DES), recently received regulatory approval in the USA for use in percutaneous coronary interventions. Yet, information on the safety of BP-DES in routine clinical practice is limited. Our aim was to compare the safety of the recently approved BP-DES with current durable polymer drug-eluting stents (DP-DES) by analyzing adverse events, namely, stent thrombosis (ST), reported to the Manufacturer and User Facility Device Experience (MAUDE) database. The MAUDE database requires nationwide mandatory notification for adverse events on devices approved for clinical use. This database was searched for adverse events reported between 1 October 2015 and 25 December 2016, encountered after the placement of either BP-DES or DP-DES. Only those adverse events were included where the exposure period to the stents was comparable after the index procedure. Of all the adverse events reported, the event of interest was ST. A total of 951 adverse events were reported. ST occurred in 48/951 of all events, 31/309 and 17/642 when BP-DES or DP-DES were used, respectively (P=0.00001). Of the 31 ST events with BP-DES, 68% (21/31) occurred within less than or equal to 24 h of the index procedure and 52% (16/31) occurred within less than or equal to 2 h. Our results raise the possibility of an increased risk of ST, particularly early ST (within 24 h), with the recently approved BP-DES. However, because of the inherent limitations of reporting within the MAUDE database, these data merely highlight a potential need for additional surveillance and randomized trials to assess further the safety of the bioabsorbable platform.

  6. Advanced Technology for SAM Systems Analysis Synthesis and Simulation

    DTIC Science & Technology

    1984-05-01

    aides de nature op~ratlcnnelle, Einanci~rv et technicue. Ainsi peut-on esp6rer iu’en r~sulte- ront les rhoix les rroilloura. Trois des neuf expras~s...EAST (Royal Military College of Science, UNITED KINGDOM) traite des structures des boucles de quidaqe at compare los lois d’ali- gnement t~l~command~es...avec les lois de navigation des missiles autoquid~s. Dants los structures en alignement, le Dr EAST montre qu’il est possible et indispensable

  7. Real-World Bioresorbable Vascular Scaffold Experience Compared With Second-Generation Metallic Drug-Eluting Stents in Complex Coronary Lesions.

    PubMed

    Okamoto, Naotaka; Ueda, Hiroshi; Yoshimura, Takahiro; Chamaria, Surbhi; Bhatheja, Samit; Vengrenyuk, Yuliya; Rabiei, Samaneh; Barrientos, Yonandy; Kapur, Vishal; Barman, Nitin; Sweeny, Joseph; Baber, Usman; Mehran, Roxana; Sharma, Samin K; Kini, Annapoorna S

    2018-04-15

    The aim of the study was to compare the acute outcomes of Absorb bioresorbable vascular scaffolds (BVS) and second-generation drug-eluting stent (DES) implantation in routine clinical practice. There is a paucity of data regarding BVS use in a real-world patient population. The study population comprised 40 consecutive patients who underwent percutaneous coronary intervention (PCI) with BVS implantation at a tertiary-care center in New York, New York between July and December of 2016. An optimal implantation technique including adequate lesion preparation, mandatory postdilation, and optical coherence tomography (OCT) imaging was used in all cases. De novo lesions treated with BVS were compared to lesions treated with DES matched by OCT calcium arc, scaffold/stent size, use of atherectomy device, and lesion postdilation. Acute lumen gain, minimal device area, malapposition, eccentricity, and symmetry index were assessed using OCT. We analyzed OCT images of 40 BVS cases and 40 matching DES cases from 35 and 40 patients, respectively. Compared to the DES group, the BVS group demonstrated similar acute lumen gain, minimal scaffold/stent area, eccentricity index, and symmetry index after PCI. There were fewer malapposed struts detected after BVS implantation; however, malapposition distance and length were not different between the groups. BVS implantation in a real-world patient population with optimal implantation technique resulted in similar stent expansion and better strut apposition compared to DES implantation.

  8. Deep eutectic solvent (DES) as a pretreatment for oil palm empty fruit bunch (OPEFB) in production of sugar

    NASA Astrophysics Data System (ADS)

    Nor, Nur Atikah Md; Mustapha, Wan Aida Wan; Hassan, Osman

    2015-09-01

    Oil Palm Empty Fruit Bunch (OPEFB) was pretreated using Deep Eutectic Solvent (DES) at different parameters to enable a highest yield of sugar. DES is a combination of two or more cheap and safe components to form a eutectic mixture through hydrogen bond interaction, which has a melting point lower than that of each component. DES can be used to replace ionic liquids (ILs), which are more expensive and toxic. In this study, OPEFB was pretreated with DES mixture of choline chloride: urea in 1:2 molar ratio. The pretreatment was performed at temperature 110°C and 80°C for 4 hours and 1 hour. Pretreatment A (110°C, 4 hours), B (110°C, 1 hour), C (80°C, 4 hours) and D (80°C, 1 hour). Enzymatic hydrolysis was done by using the combination of two enzymes, namely, Cellic Ctec2 and Cellic Htec2. The treated fiber is tested for crystallinity using XRD and functional group analysis using FTIR, to check the effect of the pretreatment on the fiber and compared it with the untreated fiber. From XRD analysis, DES successfully gave an effect towards degree of crystallinity of cellulose. Pretreatment A (110°C, 4 hours) and B (110°C, 1 hour) successfully reduce the percentage of crystallinity while pretreatment C (80°C, 4 hours) and D (80°C, 1 hour) increased the percentage of crystallinity. From FTIR analysis, DES cannot remove the functional group of lignin and hemicellulose but it is believed that DES can expose the structure of cellulose. Upon enzymatic hydrolysis, DES-treated fiber successfully produced sugar but not significantly when compared with raw. Pretreatment A (110°C, 4 hours), B (110°C, 1 hour), C (80°C, 4 hours) and D (80°C, 1 hour) produced glucose at the amount of 60.47 mg/ml, 66.33 mg/ml, 61.96 mg/ml and 59.12 mg/ml respectively. However, pretreatment C gave the highest xylose (70.01 mg/ml) production compared to other DES pretreatments.

  9. Percutaneous treatment with drug-eluting stent vs bypass surgery in patients suffering from chronic stable angina with multivessel disease involving significant proximal stenosis in left anterior descending artery.

    PubMed

    Yan, Qiao; Changsheng, Ma; Shaoping, Nie; Xiaohui, Liu; Junping, Kang; Qiang, Lv; Xin, Du; Rong, Hu; Yin, Zhang; Changqi, Jia; Jiahui, Wu; Xinmin, Liu; Jianzeng, Dong; Fang, Chen; Yujie, Zhou; Shuzheng, Lv; Fangjiong, Huang; Chengxiong, Gu; Xuesi, Wu

    2009-10-01

    The aim of the present study was to compare the effects of drug-eluting stents (DES) and coronary artery bypass grafting (CABG) in patients suffering from chronic stable angina with multivessel disease, involving significant proximal stenosis in the left anterior descending artery (LAD). All consecutive patients suffering from chronic stable angina with multivessel disease involving significant proximal LAD stenosis underwent DES implantation (n=600) or CABG (n=709) at our institution. At 2 years, the unadjusted mortality was significantly lower in the DES group than in the CABG group (2.2% vs 5.2%, P=0.004), but the adjusted risk of death was similar (odds ratio (OR) 0.74, 95%CI 0.28-1.97, P=0.555). Furthermore, both the adjusted rate of nonfatal myocardial infarction and cerebrovascular events was also comparable. However, the unadjusted and adjusted risk of major adverse cardiac cerebrovascular events in the DES was significantly higher than in the CABG (13.3% vs 9.6%, OR 2.71, 95%CI 1.56-4.74, P<0.001), which is probably attributed to the higher subsequent revascularization rate after DES implantation. DES showed comparable long-term mortality for the treatment of multivessel disease involving significant proximal stenosis in LAD in comparison with CABG.

  10. Nonlinear Dynamical Model of a Soft Viscoelastic Dielectric Elastomer

    NASA Astrophysics Data System (ADS)

    Zhang, Junshi; Chen, Hualing; Li, Dichen

    2017-12-01

    Actuated by alternating stimulation, dielectric elastomers (DEs) show a behavior of complicated nonlinear vibration, implying a potential application as dynamic electromechanical actuators. As is well known, for a vibrational system, including the DE system, the dynamic properties are significantly affected by the geometrical sizes. In this article, a nonlinear dynamical model is deduced to investigate the geometrical effects on dynamic properties of viscoelastic DEs. The DEs with square and arbitrary rectangular geometries are considered, respectively. Besides, the effects of tensile forces on dynamic performances of rectangular DEs with comparably small and large geometrical sizes are explored. Phase paths and Poincaré maps are utilized to detect the periodicity of the nonlinear vibrations of DEs. The resonance characteristics of DEs incorporating geometrical effects are also investigated. The results indicate that the dynamic properties of DEs, including deformation response, vibrational periodicity, and resonance, are tuned when the geometrical sizes vary.

  11. 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

  12. What sediment plumes at tide water glaciers can tell us about fjord circulation and subglacial hydrology

    NASA Astrophysics Data System (ADS)

    Schild, K. M.; Hawley, R. L.

    2013-12-01

    Marine-terminating outlet glaciers discharge most of Greenland's mass, but the subglacial transport of meltwater is not well understood. The coincident rise in both ice velocity and surface melt during the last decade points to a possible link between the amount of surface melt, glacier velocities, and discharge rates through processes including basal lubrication and/or an increase in melt at the terminus due to discharge plume enhanced entrainment of warm ocean waters. Characterizing the response of the Greenland Ice Sheet to increasing melt is limited in part by the lack of direct observation of the subglacial system. We use ground-based observations (time lapse cameras, DMI weather stations) and satellite remote sensing (MODIS) to infer the subglacial hydrological evolution of a tidewater glacier by identifying the lag between meltwater availability, inferred from warm temperatures and supraglacial lake drainage, and the appearance of a sediment plume at the terminus. The detection of sediment plumes is constrained by melange presence in the spring and decreasing solar illumination in the fall. At Rink Isbræ, West Greenland, we find the appearance of sediment plumes lagging the onset of positive temperatures from 2007-2011 by approximately 44 days, but the plumes are present as the melange clears suggesting this lag may be much shorter but is undetectable. We also observe an abundance of sediment plumes each season (11-25 individual events), which indicates supraglacial drainage events are not the sole source for all sediment plumes. These findings suggest multiple passageways exist from the surface to the subglacial system and the presence of a well-established drainage network early in the melt season. In this poster, we will discuss potential mechanisms for the episodic nature of the recorded plume events; whether they are the product of variable subglacial water supply (suggesting the presence of pulse drainages from subglacial storage basins), highly variable fjord circulation (only allowing subglacial sediment plumes to appear at the surface under specific fjord and plume conditions), or a combination. A clearer understanding of sediment plumes are important for understanding the subglacial hydrological system of tidewater glaciers, as well as gauging the impact of rapid fresh water delivery to melange/sea ice extent in the fjord, terminus stability, submarine melting and fjord circulation.

  13. Are Everolimus-Eluting Stents Associated With Better Clinical Outcomes Compared to Other Drug-Eluting Stents in Patients With Type 2 Diabetes Mellitus?

    PubMed Central

    Bundhun, Pravesh Kumar; Pursun, Manish; Teeluck, Abhishek Rishikesh; Long, Man-Yun

    2016-01-01

    Abstract Controversies still exist with the use of Everolimus-Eluting Stents (EES) compared to other Drug-Eluting Stents (DES) in patients with Type 2 Diabetes Mellitus (T2DM). Therefore, in order to solve this issue, we aim to compare the 1-year adverse clinical outcomes between EES and non-EE DES with a larger number of patients with T2DM. Medline, EMBASE, PubMed databases, as well as the Cochrane library were searched for randomized controlled trials (RCTs) and observational studies (OS) comparing EES and non-EE DES in patients with T2DM. One-year adverse outcomes were considered as the clinical endpoints in this study. Odd ratios (OR) with 95% confidence interval (CI) were used to express the pooled effect on discontinuous variables and the pooled analyses were performed with RevMan 5.3. Ten studies consisting of a total of 11,981 patients with T2DM (6800 patients in the EES group and 5181 in the non-EE DES group) were included in this meta-analysis. EES were associated with a significantly lower major adverse cardiac events (MACEs) with OR: 0.83, 95% CI: 0.70–0.98, P = 0.03. Revascularization including target vessel revascularization (TVR) and target lesion revascularization (TLR) were also significantly lower in the EES group with OR: 0.62, 95% CI: 0.40–0.94, P = 0.03 and OR: 0.74, 95% CI: 0.57–0.95, P = 0.02, respectively. Also, a significantly lower rate of stent thrombosis with OR: 0.63, 95% CI: 0.46–0.86, P = 0.003 was observed in the EES group. However, a similar mortality rate was reported between the EES and non-EE DES groups. During this 1-year follow-up period, EES were associated with significantly better clinical outcomes compared to non-EE DES in patients suffering from T2DM. However, further research comparing EES with non-EE DES in insulin-treated and noninsulin-treated patients with T2DM are recommended. PMID:27057888

  14. From Fact to Function: Aspects of the Work of the C.R.A.P.E.L. Melanges Pedagogiques, 1974.

    ERIC Educational Resources Information Center

    Riley, P.

    The aim of this paper is to describe certain characteristic aspects of the work of C.R.A.P.E.L. (Centre de Recherches et d'Applications Pedagogiques en Langues), and, in doing so, to outline the overall approach and the conceptual framework on which that work is based. The description of the nature and organization of C.R.A.P.E.L. is followed by a…

  15. Metamorphism in the Potomac composite terrane, Virginia-Maryland

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

    Drake, A.A. Jr.

    1985-01-01

    Metamorphic rocks in the Potomac Valley occur in three allochthon-precursory melange pairs unconformably overlain by the Popes Head Formation which is at greenschist facies of metamorphism. The highest motif, the Piney Branch Complex and Yorkshire Formation are also in the greenschist facies. The middle motif, consists of the Peters Creek Schist and the Sykesville Formation. Quartzose schists and metagraywacke of the Peters Creek contain serpentinite debris and have had a complex metamorphic history: Barrovian prograde to amphibolite facies (with sillimanite), a localized retrograde event producing chlorite phyllonite, and a later greenschist prograde event. The Sykeville is at biotite +/- garnetmore » grade and contains deformed olistoliths of Peters Creek, including phyllonite, at various grades. The lower motif consists of the Annandale Group (pelitic schists and metasandstone) and Indian Run Formation. The Annandale has experienced two greenschist metamorphisms. The Indian Run is at biotite +/- garnet grade and contains previously metamorphosed and deformed olistoliths of Annandale. The allochthons have had different histories, but after stacking they were metamorphosed with their melanges and the Popes Head to biotite grade. The Popes Head has experienced three phases of folding, the earliest synkinematic with Occoquan emplacement. These fold phases are superposed on earlier structures in the older rocks and are probably of Late Cambrian age (Penobscotian). Earlier deformation is probably of Late Proterozoic age (Cadomian). Neither of these deformations is recognized in North American rocks.« less

  16. HHP treatment of liquid egg at 200-350 MPa

    NASA Astrophysics Data System (ADS)

    Tóth, A.; Németh, Cs; Palotás, P.; Surányi, J.; Zeke, I.; Csehi, B.; Castillo, L. A.; Friedrich, L.; Balla, Cs

    2017-10-01

    High hydrostatic pressure (HHP) treatment of egg proteins partially limits their sensitivity to pressure. According to the literature, at the 450 MPa level, denaturation of some proteins sets in to the extent that sensory and functional characteristics are impacted. This study involved treating liquid egg (egg white, yolk, and melange) at less than the above-mentioned value, after which the microbiological effect was examined. For the study, pressure pouches were filled with 100ml of raw liquid egg per pouch. Then the samples were treated at 200, 250, 300 and 350 MPa. In each case, the level was reached by increasing pressure at a rate of 100 MPa/min. Measurements were taken at the Corvinus University of Budapest, Faculty of Food Science, Dept. of Refrigeration and Livestock Products Technology RESATO FPU 100-2000 equipment. Denaturation was determined with calorimetric (DSC) tests. From our results, it appears that even at 250 MPa pressure treatment, the viable cell count decreases. Further, it can be said that microbe count went down in the egg white samples at 300-350 MPa, below the impact level. Significant denaturation was not detected during our examinations. In summary, we state that the most HHP-sensitive liquid egg type, egg white, can be pressure treated to reduce microbe count at a level less than that which causes denaturation. Microbe reduction was smaller in yolk and melange, so higher pressure values are appropriate for these products.

  17. Geology of the Ulugh Muztagh area, northern Tibet

    USGS Publications Warehouse

    Burchfiel, B.C.; Molnar, P.; Zhao, Ziyun; Liang, K'uangyi; Wang, Shuji; Huang, Minmin; Sutter, J.

    1989-01-01

    Within the Ulugh Muztagh area, north central Tibet, an east-west-trending ophiolitic melange marks a suture that apparently was formed during a late Triassic or slightly younger collision between a continental fragment to the south and the rest of Asia. The southern continental fragment carries a thick sequence of upper Triassic sandstone, but the contact between the sandstone and the ophiolitic melange is covered by a younger redbed sequence of unknown age. A suite of 2-mica, tourmaline-bearing leucogranite plutons and dikes intruded the Triassic sandstone at shallow crustal levels 10.5 to 8.4 Ma. These rocks range from granite to tonalite in composition, are geochemically very similar to slightly older High Himalayan leucogranite and are interpreted to have been derived by the partial melting of crustal material. We interpret this to mean that crustal thickening began in this part of the Tibetan plateau at least by 10.5 Ma. Welded rhyolitic tuff rests on a conglomerate that consists of abundant debris from the Ulugh Muztagh intrusive rocks and has yielded Ar Ar ages of about 4 Ma. The tuffs are geochemically identical to the intrusive rocks suggesting that crustal thickening may have continued to 4 Ma. Crustal thickening probably occurred by distributed crustal shortening similar to shortening now occurring north of Ulugh Muztagh along the northern margin of the Tibetan Plateau. ?? 1989.

  18. Properties of Polyvinylpyrrolidone in a Deep Eutectic Solvent

    DOE PAGES

    Sapir, Liel; Stanley, Christopher B.; Harries, Daniel

    2016-03-10

    Deep eutectic solvents (DES) are mixtures of two or more components with high melting temperatures, which form a liquid at room temperature. These DES hold great promise as green solvents for chemical processes, as they are inexpensive and environmentally friendly. Specifically, they present a unique solvating environment to polymers that is different from water. In this paper, we use small angle neutron scattering to study the polymer properties of the common, water-soluble, polyvinylpyrrolidone (PVP) in the prominent DES formed by a 1:2 molar mixture of choline chloride and urea. We find that the polymer adopts a slightly different structure inmore » DES than in water, so that at higher concentrations the polymer favors a more expanded conformation compared to the same concentration in water. Yet, the osmotic pressure of PVP solutions in DES is very similar to that in water, indicating that both solvents are of comparable quality and that the DES components interact favorably with PVP. Finally, the osmotic pressure measurements within this novel class of promising solvents should be of value toward future technological applications as well as for osmotic stress experiments in nonaqueous environments.« less

  19. Properties of Polyvinylpyrrolidone in a Deep Eutectic Solvent

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

    Sapir, Liel; Stanley, Christopher B.; Harries, Daniel

    Deep eutectic solvents (DES) are mixtures of two or more components with high melting temperatures, which form a liquid at room temperature. These DES hold great promise as green solvents for chemical processes, as they are inexpensive and environmentally friendly. Specifically, they present a unique solvating environment to polymers that is different from water. In this paper, we use small angle neutron scattering to study the polymer properties of the common, water-soluble, polyvinylpyrrolidone (PVP) in the prominent DES formed by a 1:2 molar mixture of choline chloride and urea. We find that the polymer adopts a slightly different structure inmore » DES than in water, so that at higher concentrations the polymer favors a more expanded conformation compared to the same concentration in water. Yet, the osmotic pressure of PVP solutions in DES is very similar to that in water, indicating that both solvents are of comparable quality and that the DES components interact favorably with PVP. Finally, the osmotic pressure measurements within this novel class of promising solvents should be of value toward future technological applications as well as for osmotic stress experiments in nonaqueous environments.« less

  20. Use of drug-eluting stents versus bare-metal stents in Korea: a cost-minimization analysis using population data.

    PubMed

    Suh, Hae Sun; Song, Hyun Jin; Jang, Eun Jin; Kim, Jung-Sun; Choi, Donghoon; Lee, Sang Moo

    2013-07-01

    The goal of this study was to perform an economic analysis of a primary stenting with drug-eluting stents (DES) compared with bare-metal stents (BMS) in patients with acute myocardial infarction (AMI) admitted through an emergency room (ER) visit in Korea using population-based data. We employed a cost-minimization method using a decision analytic model with a two-year time period. Model probabilities and costs were obtained from a published systematic review and population-based data from which a retrospective database analysis of the national reimbursement database of Health Insurance Review and Assessment covering 2006 through 2010 was performed. Uncertainty was evaluated using one-way sensitivity analyses and probabilistic sensitivity analyses. Among 513 979 cases with AMI during 2007 and 2008, 24 742 cases underwent stenting procedures and 20 320 patients admitted through an ER visit with primary stenting were identified in the base model. The transition probabilities of DES-to-DES, DES-to-BMS, DES-to-coronary artery bypass graft, and DES-to-balloon were 59.7%, 0.6%, 4.3%, and 35.3%, respectively, among these patients. The average two-year costs of DES and BMS in 2011 Korean won were 11 065 528 won/person and 9 647 647 won/person, respectively. DES resulted in higher costs than BMS by 1 417 882 won/person. The model was highly sensitive to the probability and costs of having no revascularization. Primary stenting with BMS for AMI with an ER visit was shown to be a cost-saving procedure compared with DES in Korea. Caution is needed when applying this finding to patients with a higher level of severity in health status.

  1. Synthesis-Free Phase-Selective Gelator for Oil-Spill Remediation.

    PubMed

    Cui, Yaowen; Li, Mei-Chun; Wu, Qinglin; Pojman, John A; Kuroda, Daniel G

    2017-10-04

    A new deep eutectic solvent (DES) was developed as a phase-selective gelator for oil-spill remediation. The newly designed nonionic DES is based on a combination of an amide (N-methylacetamide) and a long chain carboxylic acid (lauric acid) and does not require any synthetic procedure besides mixing. Our studies show that the DES works as gelator by forming a gel between lauric acid and the hydrocarbon, whereas the amide serves to form the DES and dissolves in water during the gelation process. In addition, the DES material has gelation properties comparable to those considered as state-of-the-art. Overall, the newly developed material shows a promising future in oil recovery methodologies.

  2. Analysis of the impact of a cognitive task on the posture of elderly subjects with depression compared with healthy elderly subjects.

    PubMed

    Casteran, Matthieu; Putot, Alain; Pfitzenmeyer, François; Thomas, Elizabeth; Manckoundia, Patrick

    2016-11-01

    While previous studies have demonstrated that depressive elderly subjects (DES) experience difficulties in the processing of simultaneous cognitive tasks, few have examined the coupling of cognitive tasks with seemingly 'automatic' tasks, such as standing upright. Current patient management focuses on pharmacological treatments and cognitive-behavioral therapies. Healthy elderly (HES) and non-treated DES were included. Postural sway in DES was compared with that in HES while in single-task and dual-task conditions. The single-task consisted of standing upright. For the dual-task, the subjects recalled various items from memory or counted while standing upright. Postural sway was evaluated by computing the center of pressure (CoP) area and path length. DES showed greater postural sway than HES in all conditions. The HES showed a greater CoP area in the dual-task than in the single-task conditions. In DES, the CoP area in the single-task condition was similar to that in the dual-task condition. The greater postural sway observed in DES may be a cause of a greater risk of falls. We showed that even seemingly automatic tasks, such as maintaining an upright posture, are affected by depression. These results are important for the management of DES. Copyright © 2016 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  3. Fine Structure of Diffuse Scattering Rings in Al-Li-Cu Quasicrystal: A Comparative X-ray and Electron Diffraction Study

    NASA Astrophysics Data System (ADS)

    Donnadieu, P.; Dénoyer, F.

    1996-11-01

    A comparative X-ray and electron diffraction study has been performed on Al-Li-Cu icosahedral quasicrystal in order to investigate the diffuse scattering rings revealed by a previous work. Electron diffraction confirms the existence of rings but shows that the rings have a fine structure. The diffuse aspect on the X-ray diffraction patterns is then due to an averaging effect. Recent simulations based on the model of canonical cells related to the icosahedral packing give diffractions patterns in agreement with this fine structure effect. Nous comparons les diagrammes de diffraction des rayon-X et des électrons obtenus sur les mêmes échantillons du quasicristal icosaèdrique Al-Li-Cu. Notre but est d'étudier les anneaux de diffusion diffuse mis en évidence par un travail précédent. Les diagrammes de diffraction électronique confirment la présence des anneaux mais ils montrent aussi que ces anneaux possèdent une structure fine. L'aspect diffus des anneaux révélés par la diffraction des rayons X est dû à un effet de moyenne. Des simulations récentes basées sur la décomposition en cellules canoniques de l'empilement icosaédrique produisent des diagrammes de diffraction en accord avec ces effects de structure fine.

  4. Stent Thrombosis With Drug-Eluting Stents and Bioresorbable Scaffolds: Evidence From a Network Meta-Analysis of 147 Trials.

    PubMed

    Kang, Si-Hyuck; Chae, In-Ho; Park, Jin-Joo; Lee, Hak Seung; Kang, Do-Yoon; Hwang, Seung-Sik; Youn, Tae-Jin; Kim, Hyo-Soo

    2016-06-27

    This study sought to perform a systematic review and network meta-analysis to compare the relative safety and efficacy of contemporary DES and BVS. To improve outcomes of patients undergoing percutaneous coronary revascularization, there have been advances in the design of drug-eluting stents (DES), including the development of drug-eluting bioresorbable vascular scaffolds (BVS). Prospective, randomized, controlled trials comparing bare-metal stents (BMS), paclitaxel-eluting stents (PES), sirolimus-eluting stents (SES), Endeavor zotarolimus-eluting stents (E-ZES), cobalt-chromium (CoCr) everolimus-eluting stents (EES), platinum-chromium (PtCr)-EES, biodegradable polymer (BP)-EES, Resolute zotarolimus-eluting stents (R-ZES), BP biolimus-eluting stents (BP-BES), hybrid sirolimus-eluting stents (H [Orsiro]-SES), polymer-free sirolimus- and probucol-eluting stents, or BVS were searched in online databases. The primary endpoint was definite or probable stent thrombosis at 1 year. A total of 147 trials including 126,526 patients were analyzed in this study. All contemporary DES were superior to BMS and PES in terms of definite or probable stent thrombosis at 1 year. CoCr-EES, PtCr-EES, and H-SES were associated with significantly lower risk than BVS. CoCr-EES and H-SES were superior to SES and BP-BES. The risk of myocardial infarction was significantly lower with H-SES than with BVS. There were no significant differences regarding all-cause or cardiac mortality. Contemporary devices including BVS showed comparably low risks of repeat revascularization. Contemporary DES, including biocompatible DP-DES, BP-DES, and polymer-free DES, showed a low risk of definite or probable stent thrombosis at 1 year. BVS had an increased risk of device thrombosis compared with CoCr-EES, PtCr-EES, and H-SES. Data from extended follow-up are warranted to confirm the long-term safety of contemporary coronary devices. Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  5. Stent Thrombosis in Drug-Eluting or Bare-Metal Stents in Patients Receiving Dual Antiplatelet Therapy.

    PubMed

    Kereiakes, Dean J; Yeh, Robert W; Massaro, Joseph M; Driscoll-Shempp, Priscilla; Cutlip, Donald E; Steg, P Gabriel; Gershlick, Anthony H; Darius, Harald; Meredith, Ian T; Ormiston, John; Tanguay, Jean-François; Windecker, Stephan; Garratt, Kirk N; Kandzari, David E; Lee, David P; Simon, Daniel I; Iancu, Adrian Corneliu; Trebacz, Jaroslaw; Mauri, Laura

    2015-10-01

    This study sought to compare rates of stent thrombosis and major adverse cardiac and cerebrovascular events (MACCE) (composite of death, myocardial infarction, or stroke) after coronary stenting with drug-eluting stents (DES) versus bare-metal stents (BMS) in patients who participated in the DAPT (Dual Antiplatelet Therapy) study, an international multicenter randomized trial comparing 30 versus 12 months of dual antiplatelet therapy in subjects undergoing coronary stenting with either DES or BMS. Despite antirestenotic efficacy of coronary DES compared with BMS, the relative risk of stent thrombosis and adverse cardiovascular events is unclear. Many clinicians perceive BMS to be associated with fewer adverse ischemic events and to require shorter-duration dual antiplatelet therapy than DES. Prospective propensity-matched analysis of subjects enrolled into a randomized trial of dual antiplatelet therapy duration was performed. DES- and BMS-treated subjects were propensity-score matched in a many-to-one fashion. The study design was observational for all subjects 0 to 12 months following stenting. A subset of eligible subjects without major ischemic or bleeding events were randomized at 12 months to continued thienopyridine versus placebo; all subjects were followed through 33 months. Among 10,026 propensity-matched subjects, DES-treated subjects (n = 8,308) had a lower rate of stent thrombosis through 33 months compared with BMS-treated subjects (n = 1,718, 1.7% vs. 2.6%; weighted risk difference -1.1%, p = 0.01) and a noninferior rate of MACCE (11.4% vs. 13.2%, respectively, weighted risk difference -1.8%, p = 0.053, noninferiority p < 0.001). DES-treated subjects have long-term rates of stent thrombosis that are lower than BMS-treated subjects. (The Dual Antiplatelet Therapy Study [DAPT study]; NCT00977938). Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  6. Developmental Exposure to Diethylstilbestrol Alters Uterine Gene Expression That May Be Associated With Uterine Neoplasia Later in Life

    PubMed Central

    Newbold, Retha R.; Jefferson, Wendy N.; Grissom, Sherry F.; Padilla-Banks, Elizabeth; Snyder, Ryan J.; Lobenhofer, Edward K.

    2008-01-01

    Previously, we described a mouse model where the well-known reproductive carcinogen with estrogenic activity, diethylstilbestrol (DES), caused uterine adenocarcinoma following neonatal treatment. Tumor incidence was dose-dependent reaching >90% by 18 mo following neonatal treatment with 1000 μg/kg/d of DES. These tumors followed the initiation/promotion model of hormonal carcinogenesis with developmental exposure as initiator, and exposure to ovarian hormones at puberty as the promoter. To identify molecular pathways involved in DES-initiation events, uterine gene expression profiles were examined in prepubertal mice exposed to DES (1, 10, or 1000 μg/kg/d) on days 1–5 and compared to controls. Of more than 20 000 transcripts, approximately 3% were differentially expressed in at least one DES treatment group compared to controls; some transcripts demonstrated dose–responsiveness. Assessment of gene ontology annotation revealed alterations in genes associated with cell growth, differentiation, and adhesion. When expression profiles were compared to published studies of uteri from 5-d-old DES-treated mice, or adult mice treated with 17β estradiol, similarities were seen suggesting persistent differential expression of estrogen responsive genes following developmental DES exposure. Moreover, several altered genes were identified in human uterine adenocarcinomas. Four altered genes [lactotransferrin (Ltf), transforming growth factor beta inducible (Tgfb1), cyclin D1 (Ccnd1), and secreted frizzled-related protein 4 (Sfrp4)], selected for real-time RT-PCR analysis, correlated well with the directionality of the microarray data. These data suggested altered gene expression profiles observed 2 wk after treatment ceased, were established at the time of developmental exposure and maybe related to the initiation events resulting in carcinogenesis. PMID:17394237

  7. Developmental exposure to diethylstilbestrol alters uterine gene expression that may be associated with uterine neoplasia later in life.

    PubMed

    Newbold, Retha R; Jefferson, Wendy N; Grissom, Sherry F; Padilla-Banks, Elizabeth; Snyder, Ryan J; Lobenhofer, Edward K

    2007-09-01

    Previously, we described a mouse model where the well-known reproductive carcinogen with estrogenic activity, diethylstilbestrol (DES), caused uterine adenocarcinoma following neonatal treatment. Tumor incidence was dose-dependent reaching >90% by 18 mo following neonatal treatment with 1000 microg/kg/d of DES. These tumors followed the initiation/promotion model of hormonal carcinogenesis with developmental exposure as initiator, and exposure to ovarian hormones at puberty as the promoter. To identify molecular pathways involved in DES-initiation events, uterine gene expression profiles were examined in prepubertal mice exposed to DES (1, 10, or 1000 microg/kg/d) on days 1-5 and compared to controls. Of more than 20 000 transcripts, approximately 3% were differentially expressed in at least one DES treatment group compared to controls; some transcripts demonstrated dose-responsiveness. Assessment of gene ontology annotation revealed alterations in genes associated with cell growth, differentiation, and adhesion. When expression profiles were compared to published studies of uteri from 5-d-old DES-treated mice, or adult mice treated with 17beta estradiol, similarities were seen suggesting persistent differential expression of estrogen responsive genes following developmental DES exposure. Moreover, several altered genes were identified in human uterine adenocarcinomas. Four altered genes [lactotransferrin (Ltf), transforming growth factor beta inducible (Tgfb1), cyclin D1 (Ccnd1), and secreted frizzled-related protein 4 (Sfrp4)], selected for real-time RT-PCR analysis, correlated well with the directionality of the microarray data. These data suggested altered gene expression profiles observed 2 wk after treatment ceased, were established at the time of developmental exposure and maybe related to the initiation events resulting in carcinogenesis. (c) 2007 Wiley-Liss, Inc.

  8. Performance comparison between multienzymes loaded single and dual electrodes for the simultaneous electrochemical detection of adenosine and metabolites in cancerous cells.

    PubMed

    Hussain, Khalil K; Akhtar, Mahmood H; Kim, Moo-Hyun; Jung, Dong-Keun; Shim, Yoon-Bo

    2018-06-30

    The analytical performance of the multi enzymes loaded single electrode sensor (SES) and dual electrode sensor (DES) was compared for the detection of adenosine and metabolites. The SES was fabricated by covalent binding of tri-enzymes, adenosine deaminase (ADA), purine nucleoside phosphorylase (PNP), and xanthine oxidase (XO) along with hydrazine (Hyd) onto a functionalized conducting polymer [2,2:5,2-terthiophene-3-(p-benzoic acid)] (pTTBA). The enzyme reaction electrode in DES was fabricated by covalent binding of ADA and PNP onto pTTBA coated on Au nanoparticles. The detection electrode in DES was constructed by covalent binding of XO and Hyd onto pTTBA coated on porous Au. Due to the higher amount (3.5 folds) of the immobilized enzymes and Hyd onto the DES than SES, and the lower Michaelis constant (Km) value for DES (28.7 µM) compared to SES (36.1 µM), the sensitivity was significantly enhanced for the DES (8.2 folds). The dynamic range obtained using DES was from 0.5 nM to 120.0 µM with a detection limit of 1.43 nM ± 0.02, 0.76 nM ± 0.02, and 0.48 nM ± 0.01, for adenosine (AD), inosine (IN), and hypoxanthine (Hypo) respectively. Further, the DES was coupled with an electrochemical potential modulated microchannel for the separation and simultaneous detection of AD, IN, and Hypo in an extracellular matrix of cancerous (A549) and non-cancerous (Vero) cells. The sensor probe confirms a higher basal level of extracellular AD and its metabolites in cancer cells compared to normal cells. In addition, the effect of dipyridamole on released adenosine in A549 cells was investigated. Copyright © 2018 Elsevier B.V. All rights reserved.

  9. Characterization of conducting cellulose acetate based polymer electrolytes doped with "green" ionic mixture.

    PubMed

    Ramesh, S; Shanti, R; Morris, Ezra

    2013-01-02

    Polymer electrolytes were developed by solution casting technique utilizing the materials of cellulose acetate (CA), lithium bis(trifluoromethanesulfonyl)imide (LiTFSI) and deep eutectic solvent (DES). The DES is synthesized from the mixture of choline chloride and urea of 1:2 ratios. The increasing DES content well plasticizes the CA:LiTFSI:DES matrix and gradually improves the ionic conductivity and chemical integrity. The highest conducting sample was identified for the composition of CA:LiTFSI:DES (28 wt.%:12 wt.%:60 wt.%), which has the greatest ability to retain the room temperature ionic conductivity over the entire 30 days of storage time. The changes in FTIR cage peaks upon varying the DES content in CA:LiTFSI:DES prove the complexation. This complexation results in the collapse of CA matrix crystallinity, observed from the reduced intensity of XRD diffraction peaks. The DES-plasticized sample is found to be more heat-stable compared to pure CA. Nevertheless, the addition of DES diminishes the CA:LiTFSI matrix's heat-resistivity but at the minimum addition the thermal stability is enhanced. Copyright © 2012 Elsevier Ltd. All rights reserved.

  10. Hypermethylation of Homeobox A10 by in Utero Diethylstilbestrol Exposure: An Epigenetic Mechanism for Altered Developmental Programming

    PubMed Central

    Bromer, Jason G.; Wu, Jie; Zhou, Yuping; Taylor, Hugh S.

    2009-01-01

    Diethylstilbestrol (DES) is a nonsteroidal estrogen that induces developmental anomalies of the female reproductive tract. The homeobox gene HOXA10 controls uterine organogenesis, and its expression is altered after in utero DES exposure. We hypothesized that an epigenetic mechanism underlies DES-mediated alterations in HOXA10 expression. We analyzed the expression pattern and methylation profile of HOXA10 after DES exposure. Expression of HOXA10 is increased in human endometrial cells after DES exposure, whereas Hoxa10 expression is repressed and shifted caudally from its normal location in mice exposed in utero. Cytosine guanine dinucleotide methylation frequency in the Hoxa10 intron was higher in DES-exposed offspring compared with controls (P = 0.017). The methylation level of Hoxa10 was also higher in the caudal portion of the uterus after DES exposure at the promoter and intron (P < 0.01). These changes were accompanied by increased expression of DNA methyltransferases 1 and 3b. No changes in methylation were observed after in vitro or adult DES exposure. DES has a dual mechanism of action as an endocrine disruptor; DES functions as a classical estrogen and directly stimulates HOXA10 expression with short-term exposure, however, in utero exposure results in hypermethylation of the HOXA10 gene and long-term altered HOXA10 expression. We identify hypermethylation as a novel mechanism of DES-induced altered developmental programming. PMID:19299448

  11. Thermally conductive of nanofluid from surfactant doped polyaniline nanoparticle and deep eutectic ionic liquid

    NASA Astrophysics Data System (ADS)

    Siong, Chew Tze; Daik, Rusli; Hamid, Muhammad Azmi Abdul

    2014-09-01

    Nanofluid is a colloidal suspension of nano-size particles in a fluid. Spherical shape dodecylbenzenesulfonic acid doped polyaniline (DBSA-PANI) nanoparticles were synthesized via reverse micellar polymerization in isooctane with average size of 50 nm- 60 nm. The aim of study is to explore the possibility of using deep eutectic ionic liquid (DES) as a new base fluid in heat transfer application. DES was prepared by heating up choline chloride and urea with stirring. DES based nanofluids containing DBSA-PANI nanoparticles were prepared using two-step method. Thermal conductivity of nanofluids was measured using KD2 Pro Thermal Properties Analyzer. When incorporated with DBSA-PANI nanoparticles, DES with water was found to exhibit a bigger increase in thermal conductivity compared to that of the pure DES. The thermal conductivity of DES with water was increased by 4.67% when incorporated with 0.2 wt% of DBSA-PANI nanoparticles at 50°C. The enhancement in thermal conductivity of DES based nanofluids is possibly related to Brownian motion of nanoparticles as well as micro-convection of base fluids and also interaction between dopants and DES ions.

  12. Electromagnetic Gauge Study of Laser-Induced Shock Waves in Aluminium Alloys

    NASA Astrophysics Data System (ADS)

    Peyre, P.; Fabbro, R.

    1995-12-01

    The laser-shock behaviour of three industrial aluminum alloys has been analyzed with an Electromagnetic Gauge Method (EMV) for measuring the velocity of the back free surface of thin foils submitted to plane laser irradiation. Surface pressure, shock decay in depth and Hugoniot Elastic Limits (HEL) of the materials were investigated with increasing thicknesses of foils to be shocked. First, surface peak pressures values as a function of laser power density gave a good agreement with conventional piezoelectric quartz measurements. Therefore, comparison of experimental results with computer simulations, using a 1D hydrodynamic Lagrangian finite difference code, were also in good accordance. Lastly, HEL values were compared with static and dynamic compressive tests in order to estimate the effects of a very large range of strain rates (10^{-3} s^{-1} to 10^6 s^{-1}) on the mechanical properties of the alloys. Cet article fait la synthèse d'une étude récente sur la caractérisation du comportement sous choc-laser de trois alliages d'aluminium largement utilisés dans l'industrie à travers la méthode dite de la jauge électromagnétique. Cette méthode permet de mesurer les vitesses matérielles induites en face arrière de plaques d'épaisseurs variables par un impact laser. La mise en vitesse de plaques nous a permis, premièrement, de vérifier la validité des pressions d'impact superficielles obtenues en les comparant avec des résultats antérieurs obtenus par des mesures sur capteurs quartz. Sur des plaques d'épaisseurs croissantes, nous avons caractérisé l'atténuation des ondes de choc en profondeur dans les alliages étudiés et mesuré les limites d'élasticité sous choc (pressions d'Hugoniot) des alliages. Les résultats ont été comparés avec succès à des simulations numériques grâce à un code de calcul monodimensionnel Lagrangien. Enfin, les valeurs des pressions d'Hugoniot mesurées ont permis de tracer l'évolution des contraintes d'écoulement plastique en fonction de la vitesse de déformation pour des valeurs comprises entre 10^{-3} s^{-1} et 10^6 s^{-1}.

  13. The efficacy and safety of drug-eluting balloons for the treatment of in-stent restenosis as compared with drug-eluting stents and with conventional balloon angioplasty

    PubMed Central

    Oh, Pyung Chun; Suh, Soon Yong; Kang, Woong Chol; Lee, Kyounghoon; Han, Seung Hwan; Ahn, Taehoon; Shin, Eak Kyun

    2016-01-01

    Background/Aims: Treatment of coronary in-stent restenosis (ISR) is still associated with a high incidence of recurrence. We aimed to compare the efficacy and safety of drug-eluting balloons (DEB) for the treatment of ISR as compared with conventional balloon angioplasty (BA) and drug-eluting stents (DES). Methods: Between January 2006 and May 2012 a total of 177 patients (188 lesions, 64.1 ± 11.7 years old) who underwent percutaneous coronary intervention for ISR were retrospectively enrolled. Clinical outcomes were compared between patients treated with DEB (n = 58, 32.8%), conventional BA (n = 65, 36.7%), or DES (n = 54, 30.5%). The primary end point was a major adverse cardiac event (MACE), defined as a composite of cardiac death, myocardial infarction, and target lesion revascularization(TLR). Results: Baseline characteristics were not different except for a history of previous MI, which was more frequent in patients treated by conventional BA or DES than in patients treated by DEB (40.0% vs. 48.1% vs. 17.2%, respectively, p = 0.002). The total incidences of MACEs were 10.7%, 7.4%, and 15.4% in patients treated by DEB, DES, or conventional BA, respectively (p > 0.05). TLR was more frequent in patients treated by conventional BA than in patients treated by DEB or DES, but this was not statistically significant (10.8% vs. 6.9% vs. 3.7%, p > 0.05 between all group pairs, respectively). Conclusions: This study showed that percutaneous coronary intervention using DEB might be a feasible alternative to conventional BA or DES implantation for treatment of coronary ISR. Further large-scaled, randomized study assessing long-term clinical and angiographic outcomes will be needed. PMID:26951915

  14. Space Shuttle radar investigations of Indonesia

    NASA Technical Reports Server (NTRS)

    Ford, J. P.; Sabins, F. F., Jr.

    1986-01-01

    A preliminary interpretation of structure and lithology from selected Shuttle Imaging Radar-B (SIR-B) images of Borneo, collected in October 1984, is presented. The SIR-B images, obtained at depression angles that ranged from 40 to 50 deg, were interpreted by using the approaches suggested by Sabins (1983). On the basis of radar signatures, six terrain categories; coastal and alluvial plains, and carbonate, clastic, volcanic, and melange, rocks, were defined in east, central, and south Kalimantan, and in the Malaysian state of Sarawak.

  15. Long-term efficacy and safety of biodegradable-polymer biolimus-eluting stents: main results of the Basel Stent Kosten-Effektivitäts Trial-PROspective Validation Examination II (BASKET-PROVE II), a randomized, controlled noninferiority 2-year outcome trial.

    PubMed

    Kaiser, Christoph; Galatius, Soeren; Jeger, Raban; Gilgen, Nicole; Skov Jensen, Jan; Naber, Christoph; Alber, Hannes; Wanitschek, Maria; Eberli, Franz; Kurz, David J; Pedrazzini, Giovanni; Moccetti, Tiziano; Rickli, Hans; Weilenmann, Daniel; Vuillomenet, André; Steiner, Martin; Von Felten, Stefanie; Vogt, Deborah R; Wadt Hansen, Kim; Rickenbacher, Peter; Conen, David; Müller, Christian; Buser, Peter; Hoffmann, Andreas; Pfisterer, Matthias

    2015-01-06

    Biodegradable-polymer drug-eluting stents (BP-DES) were developed to be as effective as second-generation durable-polymer drug-eluting stents (DP-DES) and as safe >1 year as bare-metal stents (BMS). Thus, very late stent thrombosis (VLST) attributable to durable polymers should no longer appear. To address these early and late aspects, 2291 patients presenting with acute or stable coronary disease needing stents ≥3.0 mm in diameter between April 2010 and May 2012 were randomly assigned to biolimus-A9-eluting BP-DES, second-generation everolimus-eluting DP-DES, or thin-strut silicon-carbide-coated BMS in 8 European centers. All patients were treated with aspirin and risk-adjusted doses of prasugrel. The primary end point was combined cardiac death, myocardial infarction, and clinically indicated target-vessel revascularization within 2 years. The combined secondary safety end point was a composite of VLST, myocardial infarction, and cardiac death. The cumulative incidence of the primary end point was 7.6% with BP-DES, 6.8% with DP-DES, and 12.7% with BMS. By intention-to-treat BP-DES were noninferior (predefined margin, 3.80%) compared with DP-DES (absolute risk difference, 0.78%; -1.93% to 3.50%; P for noninferiority 0.042; per protocol P=0.09) and superior to BMS (absolute risk difference, -5.16; -8.32 to -2.01; P=0.0011). The 3 stent groups did not differ in the combined safety end point, with no decrease in events >1 year, particularly VLST with BP-DES. In large vessel stenting, BP-DES appeared barely noninferior compared with DP-DES and more effective than thin-strut BMS, but without evidence for better safety nor lower VLST rates >1 year. Findings challenge the concept that durable polymers are key in VLST formation. http://www.clinicaltrials.gov. Unique identifier: NCT01166685. © 2014 American Heart Association, Inc.

  16. Comparing Dark Energy Survey and HST –CLASH observations of the galaxy cluster RXC J2248.7-4431: implications for stellar mass versus dark matter

    DOE PAGES

    Palmese, A.; Lahav, O.; Banerji, M.; ...

    2016-08-20

    We derive the stellar mass fraction in the galaxy cluster RXC J2248.7-4431 observed with the Dark Energy Survey (DES) during the Science Verification period. We compare the stellar mass results from DES (5 filters) with those from the Hubble Space Telescope CLASH (17 filters). When the cluster spectroscopic redshift is assumed, we show that stellar masses from DES can be estimated within 25% of CLASH values. We compute the stellar mass contribution coming from red and blue galaxies, and study the relation between stellar mass and the underlying dark matter using weak lensing studies with DES and CLASH. An analysismore » of the radial profiles of the DES total and stellar mass yields a stellar-to-total fraction of f*=7.0+-2.2x10^-3 within a radius of r_200c~3 Mpc. Our analysis also includes a comparison of photometric redshifts and star/galaxy separation efficiency for both datasets. We conclude that space-based small field imaging can be used to calibrate the galaxy properties in DES for the much wider field of view. The technique developed to derive the stellar mass fraction in galaxy clusters can be applied to the ~100 000 clusters that will be observed within this survey. The stacking of all the DES clusters would reduce the errors on f* estimates and deduce important information about galaxy evolution.« less

  17. Device-specificity of vascular healing following implantation of bioresorbable vascular scaffolds and bioabsorbable-polymer metallic drugeluting stents in human coronary arteries. The ESTROFA OCT BVS vs. BP-DES study.

    PubMed

    de la Torre Hernandez, Jose Maria; Gonzalo, Nieves; Otaegui, Imanol; Rumoroso, Jose R; Gutiérrez, Hipólito; Alfonso, Fernando; Marti, Gerard; Serrador Frutos, Ana; Brugaletta, Salvatore; Gomez Menchero, Antonio; Garcia Camarero, Tamara; Biagioni, Corina; Escaned, Javier

    2018-06-12

    We sought to compare vascular healing with bioresorbable everolimus-eluting vascular scaffolds (BVS) and drug-eluting stents with bioabsorbable polymers (BP-DES) at 6 and 12 months implanted both in same patients. Multicenter and prospective study including patients with at least two comparable lesions to treat. In every patient both BVS and BP-DES (Synergy™, Orsiro™ or Biomatrix Flex™) were implanted by lesion randomization. Patients included were evaluated with optical coherence tomography at 6 or 12 months (2:1). Finally, 68 patients had examination at 6 months and 27 patients at 12 months. Uncovered struts rates at 6 months were 1.7±3.2% for BVS and 5.3±5.6% for BP-DES (p=0.0001) and at 12 months 0.48±0.72% and 4.8±5% respectively (p=0.001). Rates of strut malapposition were significantly lower with BVS. There was no significant intra-patient correlation BP-DES / BVS for endpoints. Evaginations were more frequent and larger with BVS. Discontinuities in BVS were observed in 19.4% at 6 months and 14.3% at 12 months. Vascular healing with BVS and BP-DES could be more device-specific than patient-specific. At follow-up, BVS presented less uncovered or non-apposed struts than BP-DES but more frequent and larger evaginations. Discontinuities in BVS were relatively frequent at both time points.

  18. Meta-analysis of long-term outcomes of drug-eluting stent implantations for chronic total coronary occlusions.

    PubMed

    Ma, Jian; Yang, Weiwei; Singh, Manpreet; Peng, Tianqing; Fang, Ningyuan; Wei, Meng

    2011-01-01

    In the treatment of chronic total occlusions (CTOs), some uncertainty exists regarding the effect of drug-eluting stents (DESs) compared with the effects of bare mental stents (BMSs). We reviewed outcomes of DES vs. BMS implantation for CTO lesions, to evaluate the risk-benefit ratio of DES implantation. Relevant studies of long-term clinical outcomes or angiographic outcomes of both BMS and DES implantation were examined. The primary endpoint comprised major adverse cardiovascular events (MACEs), including all-cause deaths, myocardial infarctions (MIs), and target lesion revascularizations (TLRs). A fixed-effect model and random-effect model were used to analyze the pooling results. Ten studies were included according to the selection criteria. Eight were nonrandomized controlled trials, and two consisted of a randomized controlled comparison between DES and BMS implantation. No significant difference was evident for in-hospital MACE rates between the two groups (odds ratio [OR], 1.07; 95% confidence interval [CI], .53 to 2.13), but the long-term MACE rates in the DES group were significantly lower than in the BMS group (OR, .22; 95% CI, .13 to .38; P < .00001). The rates of stent restenosis and reocclusions were also significantly lower in the DES group (OR, .14; 95% CI, .09 to .20; and OR, .23; 95% CI, .12 to .41, respectively). Implantation of the DES improves long-term angiographic and clinical outcomes compared with BMS in the treatment of CTO lesions. Copyright © 2011 Elsevier Inc. All rights reserved.

  19. Comparing Dark Energy Survey and HST –CLASH observations of the galaxy cluster RXC J2248.7-4431: implications for stellar mass versus dark matter

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

    Palmese, A.; Lahav, O.; Banerji, M.

    We derive the stellar mass fraction in the galaxy cluster RXC J2248.7-4431 observed with the Dark Energy Survey (DES) during the Science Verification period. We compare the stellar mass results from DES (5 filters) with those from the Hubble Space Telescope CLASH (17 filters). When the cluster spectroscopic redshift is assumed, we show that stellar masses from DES can be estimated within 25% of CLASH values. We compute the stellar mass contribution coming from red and blue galaxies, and study the relation between stellar mass and the underlying dark matter using weak lensing studies with DES and CLASH. An analysismore » of the radial profiles of the DES total and stellar mass yields a stellar-to-total fraction of f*=7.0+-2.2x10^-3 within a radius of r_200c~3 Mpc. Our analysis also includes a comparison of photometric redshifts and star/galaxy separation efficiency for both datasets. We conclude that space-based small field imaging can be used to calibrate the galaxy properties in DES for the much wider field of view. The technique developed to derive the stellar mass fraction in galaxy clusters can be applied to the ~100 000 clusters that will be observed within this survey. The stacking of all the DES clusters would reduce the errors on f* estimates and deduce important information about galaxy evolution.« less

  20. Cortico-cortical and motor evoked potentials to single and paired-pulse stimuli: An exploratory transcranial magnetic and intracranial electric brain stimulation study.

    PubMed

    Boulogne, Sébastien; Andre-Obadia, Nathalie; Kimiskidis, Vasilios K; Ryvlin, Philippe; Rheims, Sylvain

    2016-11-01

    Paired-pulse (PP) paradigms are commonly employed to assess in vivo cortical excitability using transcranial magnetic stimulation (TMS) to stimulate the primary motor cortex and modulate the induced motor evoked potential (MEP). Single-pulse cortical direct electrical stimulation (DES) during intracerebral EEG monitoring allows the investigation of brain connectivity by eliciting cortico-cortical evoked potentials (CCEPs). However, PP paradigm using intracerebral DES has rarely been reported and has never been previously compared with TMS. The work was intended (i) to verify that the well-established modulations of MEPs following PP TMS remain similar using DES in the motor cortex, and (ii) to evaluate if a similar pattern could be observed in distant cortico-cortical connections through modulations of CCEP. Three patients undergoing intracerebral EEG monitoring with electrodes implanted in the central region were studied. Single-pulse DES (1-3 mA, 1 ms, 0.2 Hz) and PP DES using six interstimulus intervals (5, 15, 30, 50, 100, and 200 ms) in the motor cortex with concomitant recording of CCEPs and MEPs in contralateral muscles were performed. Finally, a navigated PP TMS session targeted the intracranial stimulation site to record TMS-induced MEPs in two patients. MEP modulations elicited by PP intracerebral DES proved similar among the three patients and to those obtained by PP TMS. CCEP modulations elicited by PP intracerebral DES usually showed a pattern comparable to that of MEP, although a different pattern could be observed occasionally. PP intracerebral DES seems to involve excitatory and inhibitory mechanisms similar to PP TMS and allows the recording of intracortical inhibition and facilitation modulation on cortico-cortical connections. Hum Brain Mapp 37:3767-3778, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  1. Quantification des besoins en intrants antipaludiques: contribution à l'actualisation des hypothèses pour la quantification des intrants de prise en charge des cas de paludisme grave en République Démocratique du Congo

    PubMed Central

    Likwela, Joris Losimba; Otokoye, John Otshudiema

    2015-01-01

    Les formes graves de paludisme à Plasmodium falciparum sont une cause majeure de décès des enfants de moins de 5 ans en Afrique Sub-saharienne. Un traitement rapide dépend de la disponibilité de médicaments appropriés au niveau des points de prestation de service. La fréquence des ruptures de stock des commodités antipaludiques, en particuliers celles utilisées pour le paludisme grave, avait nécessité une mise à jour des hypothèses de quantification. Les données issues de la collecte de routine du PNLP de 2007 à 2012 ont été comparées à celles rapportés par d'autres pays africains et utilisées pour orienter les discussions au cours d'un atelier organisé par le PNLP et ses partenaires techniques et financiers afin de dégager un consensus national. La proportion des cas de paludisme rapportés comme grave en RDC est resté autour d'une médiane de 7% avec un domaine de variation de 6 à 9%. Hormis la proportion rapportée au Kenya (2%), les pays africains ont rapporté une proportion de cas grave variant entre 5 et 7%. Il apparaît que la proportion de 1% précédemment utilisée pour la quantification en RDC a été sous-estimée dans le contexte de la gestion des cas graves sur terrain. Un consensus s'est dégagé autour de la proportion de 5% étant entendu que des efforts de renforcement des capacités seraient déployés afin d'améliorer le diagnostic au niveau des points de prestation des services. PMID:26213595

  2. Optimisation thermique de moules d'injection construits par des processus génératifs

    NASA Astrophysics Data System (ADS)

    Boillat, E.; Glardon, R.; Paraschivescu, D.

    2002-12-01

    Une des potentialités les plus remarquables des procédés de production génératifs, comme le frittage sélectif par laser, est leur capacité à fabriquer des moules pour l'injection plastique équipés directement de canaux de refroidissement conformes, parfaitement adaptés aux empreintes Pour que l'industrie de l'injection puisse tirer pleinement parti de cette nouvelle opportunité, il est nécessaire de mettre à la disposition des moulistes des logiciels de simulation capables d'évaluer les gains de productivité et de qualité réalisables avec des systèmes de refroidissement mieux adaptés. Ces logiciels devraient aussi être capables, le cas échéant, de concevoir le système de refroidissement optimal dans des situations où l'empreinte d'injection est complexe. Devant le manque d'outils disponibles dans ce domaine, le but de cet article est de proposer un modèle simple de moules d'injection. Ce modèle permet de comparer différentes stratégies de refroidissement et peut être couplé avec un algorithme d'optimisation.

  3. Evaluation of biodegradable paclitaxel-eluting nanofibre-covered metal stents for the treatment of benign cardia stricture in an experimental model.

    PubMed

    Zhu, Y-Q; Cui, W-G; Cheng, Y-S; Chang, J; Chen, N-W; Yan, L

    2013-05-01

    Benign strictures at the cardia are troublesome for patients and often require repeated endoscopic treatments. Paclitaxel can reduce fibrosis. This study evaluated a biodegradable paclitaxel-eluting nanofibre-covered metal stent for the treatment of benign cardia stricture in vitro and in vivo. Drug release was investigated in vitro at pH 7·4 and 4·0. Eighty dogs were divided randomly into four groups (each n = 20): controls (no stent), bare stent (retained for 1 week), and two drug-eluting stent (DES) groups with retention for either 1 week (DES-1w) or 4 weeks (DES-4w). Lower oesophageal sphincter pressure (LOSP) and 5-min barium height (5-mBH) were assessed before, immediately after stent deployment, at 1 week, and 1, 3 and 6 months later. Five dogs in each group were killed for histological examination at each follow-up point. Stent migration rates were similar (0 bare stent versus 2 DES; P = 0·548). The percentage and amount of paclitaxel released in vitro was higher at pH 4·0 than at pH 7·4. After 6 months, LOSP and 5-mBH were both improved in the DES-1w (P = 0·004 and P = 0·049) and DES-4w (both P < 0·001) groups compared with the bare-stent group, with better relief when the stent was retained for 4 weeks (P = 0·004 and P = 0·007). The DES was associated with a reduced peak inflammatory reaction and less scar formation compared with bare stents, especially when inserted for 4 weeks. The DES was more effective for the treatment of benign cardia stricture than bare stents in a canine model. Retention of the DES for 4 weeks led to a better clinical and pathological outcome than 1 week. © 2013 British Journal of Surgery Society Ltd. Published by John Wiley & Sons Ltd.

  4. Drug-eluting stents and acute myocardial infarction: A lethal combination or friends?

    PubMed Central

    Otsuki, Shuji; Sabaté, Manel

    2014-01-01

    Primary percutaneous coronary intervention is the preferred reperfusion strategy for patients presenting with ST-segment elevation myocardial infarction (STEMI). First generation drug-eluting stents (DES), (sirolimus drug-eluting stents and paclitaxel drug-eluting stents), reduce the risk of restenosis and target vessel revascularization compared to bare metal stents. However, stent thrombosis emerged as a major safety concern with first generation DES. In response to these safety issues, second generation DES were developed with different drugs, improved stent platforms and more biocompatible durable or bioabsorbable polymeric coating. This article presents an overview of safety and efficacy of the first and second generation DES in STEMI. PMID:25276295

  5. Cost-effectiveness of percutaneous coronary intervention with drug-eluting stents versus bypass surgery for patients with 3-vessel or left main coronary artery disease: final results from the Synergy Between Percutaneous Coronary Intervention With TAXUS and Cardiac Surgery (SYNTAX) trial.

    PubMed

    Cohen, David J; Osnabrugge, Ruben L; Magnuson, Elizabeth A; Wang, Kaijun; Li, Haiyan; Chinnakondepalli, Khaja; Pinto, Duane; Abdallah, Mouin S; Vilain, Katherine A; Morice, Marie-Claude; Dawkins, Keith D; Kappetein, A Pieter; Mohr, Friedrich W; Serruys, Patrick W

    2014-09-30

    The Synergy Between Percutaneous Coronary Intervention With TAXUS and Cardiac Surgery (SYNTAX) trial demonstrated that in patients with 3-vessel or left main coronary artery disease, coronary artery bypass graft surgery (CABG) was associated with a lower rate of cardiovascular death, myocardial infarction, stroke, or repeat revascularization compared with percutaneous coronary revascularization with drug-eluting stents (DES-PCI)). The long-term cost-effectiveness of these strategies is unknown. Between 2005 and 2007, 1800 patients with left main or 3-vessel coronary artery disease were randomized to CABG (n=897) or DES-PCI (n=903). Costs were assessed from a US perspective, and health state utilities were evaluated with the EuroQOL questionnaire. A patient-level microsimulation model based on the 5-year in-trial data was used to extrapolate costs, life expectancy, and quality-adjusted life expectancy over a lifetime horizon. Although initial procedural costs were $3415 per patient lower with CABG, total hospitalization costs were $10 036 per patient higher. Over the next 5 years, follow-up costs were higher with DES-PCI as a result of more frequent hospitalizations, revascularization procedures, and higher medication costs. Over a lifetime horizon, CABG remained more costly than DES-PCI, but the incremental cost-effectiveness ratio was favorable ($16 537 per quality-adjusted life-year gained) and remained <$20 000 per quality-adjusted life-year in most bootstrap replicates. Results were consistent across a wide range of assumptions about the long-term effect of CABG versus DES-PCI on events and costs. In patients with left main disease or a SYNTAX score ≤22, however, DES-PCI was economically dominant compared with CABG, although these findings were less certain. For most patients with 3-vessel or left main coronary artery disease, CABG is a clinically and economically attractive revascularization strategy compared with DES-PCI. However, among patients with less complex disease, DES-PCI may be preferred on both clinical and economic grounds. www.clinicaltrials.gov. Unique identifier: NCT00114972. © 2014 American Heart Association, Inc.

  6. Effectiveness of Drug-Eluting Stents versus Bare-Metal Stents in Large Coronary Arteries in Patients with Acute Myocardial Infarction

    PubMed Central

    Sim, Doo Sun; Ahn, Youngkeun; Kim, Young Jo; Chae, Shung Chull; Hong, Taek Jong; Seong, In Whan; Chae, Jei Keon; Kim, Chong Jin; Cho, Myeong Chan; Seung, Ki Bae; Park, Seung Jung

    2011-01-01

    This study compared clinical outcomes of drug-eluting stents (DES) versus bare-metal stents (BMS) in large coronary arteries in patients with acute myocardial infarction (MI). A total of 985 patients who underwent single-vessel percutaneous coronary intervention (PCI) in large coronary arteries (≥ 3.5 mm) in lesions < 25 mm were divided into DES group (n = 841) and BMS group (n = 144). Clinical outcomes during 12 months were compared. In-hospital outcome was similar between the groups. At six months, death/MI rate was not different. However, DES group had significantly lower rates of target-lesion revascularization (TLR) (1.7% vs 5.6%, P = 0.021), target-vessel revascularization (TVR) (2.2% vs 5.6%, P = 0.032), and total major adverse cardiac events (MACE) (3.4% vs 11.9%, P = 0.025). At 12 months, the rates of TLR and TVR remained lower in the DES group (2.5% vs 5.9%, P = 0.032 and 5.9% vs 3.1%, P = 0.041), but the rates of death/MI and total MACE were not statistically different. The use of DES in large vessels in the setting of acute MI is associated with lower need for repeat revascularization compared to BMS without compromising the overall safety over the course of one-year follow-up. PMID:21468259

  7. Ultra-hydrophilic stent platforms promote early vascular healing and minimise late tissue response: a potential alternative to second-generation drug-eluting stents.

    PubMed

    Kolandaivelu, Kumaran; Bailey, Lynn; Buzzi, Stefano; Zucker, Arik; Milleret, Vincent; Ziogas, Algirdas; Ehrbar, Martin; Khattab, Ahmed A; Stanley, James R L; Wong, Gee K; Zani, Brett; Markham, Peter M; Tzafriri, Abraham R; Bhatt, Deepak L; Edelman, Elazer R

    2017-04-20

    Simple surface modifications can enhance coronary stent performance. Ultra-hydrophilic surface (UHS) treatment of contemporary bare metal stents (BMS) was assessed in vivo to verify whether such stents can provide long-term efficacy comparable to second-generation drug-eluting stents (DES) while promoting healing comparably to BMS. UHS-treated BMS, untreated BMS and corresponding DES were tested for three commercial platforms. A thirty-day and a 90-day porcine coronary model were used to characterise late tissue response. Three-day porcine coronary and seven-day rabbit iliac models were used for early healing assessment. In porcine coronary arteries, hydrophilic treatment reduced intimal hyperplasia relative to the BMS and corresponding DES platforms (1.5-fold to threefold reduction in 30-day angiographic and histological stenosis; p<0.04). Endothelialisation was similar on UHS-treated BMS and untreated BMS, both in swine and rabbit models, and lower on DES. Elevation in thrombotic indices was infrequent (never observed with UHS, rare with BMS, most often with DES), but, when present, correlated with reduced endothelialisation (p<0.01). Ultra-hydrophilic surface treatment of contemporary stents conferred good healing while moderating neointimal and thrombotic responses. Such surfaces may offer safe alternatives to DES, particularly when rapid healing and short dual antiplatelet therapy (DAPT) are crucial.

  8. Cost-effectiveness of percutaneous coronary intervention with drug-eluting stents in patients with multivessel coronary artery disease compared to coronary artery bypass surgery five-years after intervention

    PubMed Central

    Krenn, Lisa; Kopp, Christoph; Glogar, Dietmar; Lang, Irene M; Delle-Karth, Georg; Neunteufl, Thomas; Kreiner, Gerhard; Kaider, Alexandra; Bergler-Klein, Jutta; Khorsand, Aliasghar; Nikfardjam, Mariam; Laufer, Günther; Maurer, Gerald; Gyöngyösi, Mariann

    2014-01-01

    Objectives Cost-effectiveness of percutaneous coronary intervention (PCI) using drug-eluting stents (DES), and coronary artery bypass surgery (CABG) was analyzed in patients with multivessel coronary artery disease over a 5-year follow-up. Background DES implantation reducing revascularization rate and associated costs might be attractive for health economics as compared to CABG. Methods Consecutive patients with multivessel DES-PCI (n = 114, 3.3 ± 1.2 DES/patient) or CABG (n = 85, 2.7 ± 0.9 grafts/patient) were included prospectively. Primary endpoint was cost-benefit of multivessel DES-PCI over CABG, and the incremental cost-effectiveness ratio (ICER) was calculated. Secondary endpoint was the incidence of major adverse cardiac and cerebrovascular events (MACCE), including acute myocardial infarction (AMI), all-cause death, revascularization, and stroke. Results Despite multiple uses for DES, in-hospital costs were significantly less for PCI than CABG, with 4551 €/patient difference between the groups. At 5-years, the overall costs remained higher for CABG patients (mean difference 5400 € between groups). Cost-effectiveness planes including all patients or subgroups of elderly patients, diabetic patients, or Syntax score >32 indicated that CABG is a more effective, more costly treatment mode for multivessel disease. At the 5-year follow-up, a higher incidence of MACCE (37.7% vs. 25.8%; log rank P = 0.048) and a trend towards more AMI/death/stroke (25.4% vs. 21.2%, log rank P = 0.359) was observed in PCI as compared to CABG. ICER indicated 45615 € or 126683 € to prevent one MACCE or AMI/death/stroke if CABG is performed. Conclusions Cost-effectiveness analysis of DES-PCI vs. CABG demonstrated that CABG is the most effective, but most costly, treatment for preventing MACCE in patients with multivessel disease. © 2014 Wiley Periodicals, Inc. PMID:24403120

  9. The king's animals and the king's books: the illustrations for the Paris Academy's Histoire des animaux.

    PubMed

    Guerrini, Anita

    2010-07-01

    This essay explores the place of natural philosophy among the patronage projects of Louis XIV, focusing on the Mémoires pour servir a l'histoire naturelle des animaux (or Histoire des animaux) of the 1670s, one of a number of works of natural philosophy to issue from Louis XIV's printing house. Questions particular to the Histoire des animaux include the interaction between text and image, the credibility and authority of images of exotic animals, and the relationship between comparative anatomy and natural history, and between human and animal anatomy. At the same time that the Histoire des animaux contributed to Jean-Baptiste Colbert's management of patronage and of Louis's image, it was a work of natural philosophy, representing the collaborative efforts of the new Paris Academy of Sciences. It examined natural history and comparative anatomy in new ways, and its illustrations broke new ground in their depiction of animals in a natural setting. However, the lavishly formatted books were presentation volumes and did not gain wide circulation until their republication in 1733. Sources consulted include Colbert's manuscript memoires on the royal printers and engravers.

  10. Prenatal diethylstilbestrol induces malformation of the external genitalia of male and female mice and persistent second-generation developmental abnormalities of the external genitalia in two mouse strains

    PubMed Central

    Mahawong, Phitsanu; Sinclair, Adriane; Li, Yi; Schlomer, Bruce; Rodriguez, Esequiel; Max, Ferretti M.; Liu, Baomei; Baskin, Laurence S.; Cunha, Gerald R.

    2014-01-01

    Potential trans-generational influence of diethylstilbestrol (DES) exposure emerged with reports of effects in grandchildren of DES-treated pregnant women and of reproductive tract tumors in offspring of mice exposed in utero to DES. Accordingly, we examined the trans-generational influence of DES on development of external genitalia (ExG) and compared effects of in utero DES exposure in CD-1 and C57BL/6 mice injected with oil or DES every other day from gestational days 12 to 18. Mice were examined at birth, and on 5 to 120 days postnatal to evaluate ExG malformations. Of 23 adult (≥60 days) prenatally DES-exposed males, features indicative of urethral meatal hypospadias (see text for definitions) ranged from 18 to 100% in prenatally DES-exposed CD-1 males and 31 to 100% in prenatally DES-exposed C57BL/6 males. Thus, the strains differed in the incidence of male urethral hypospadias. Ninety-one percent of DES-exposed CD-1 females and 100% of DES-exposed C57BL/6 females had urethral-vaginal fistula. All DES-exposed CD-1 and C57BL/6 females lacked an os clitoris. None of the prenatally oil-treated CD-1 and C57BL/6 male and female mice had ExG malformations. For the second-generation study, 10 adult CD-1 males and females, from oil- and DES-exposed groups, respectively, were paired with untreated CD-1 mice for 30 days, and their offspring evaluated for ExG malformations. None of the F1 DES-treated females were fertile. Nine of 10 prenatally DES-exposed CD-1 males sired offspring with untreated females, producing 55 male and 42 female pups. Of the F2 DES-lineage adult males, 20% had exposed urethral flaps, a criterion of urethral meatal hypospadias. Five of 42 (11.9%) F2 DES lineage females had urethral-vaginal fistula. In contrast, all F2 oil-lineage males and all oil-lineage females were normal. Thus, prenatal DES exposure induces malformations of ExG in both sexes and strains of mice, and certain malformations are transmitted to the second-generation. PMID:25449352

  11. Psychometric properties of the Adolescent Dissociative Experiences Scale in a sample of Italian adolescents.

    PubMed

    Schimmenti, Adriano

    2016-01-01

    The purpose of this study was to examine the psychometric properties of the Italian translation of the Adolescent Dissociative Experiences Scale (A-DES). A sample of 1,806 high-school students between the ages of 13 and 18 years, recruited in 6 Italian cities, completed the A-DES. The A-DES showed high internal consistency, excellent item-to-scale homogeneity, good split-half reliability, and a single-factor structure. The scores of the Italian adolescents were comparable to those found in previous research with the measure. No gender differences were found in mean A-DES scores, but boys and girls showed different patterns of responses on A-DES items. Age differences were also found, with 13- and 18-year-old students scoring higher on the measure than the other participants. A cluster analysis showed that participants could be consistently grouped into 2 clusters of low- and high-dissociative adolescents. This study supports the A-DES as a reliable and valid screening measure for dissociative symptoms in adolescents.

  12. 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.

  13. Long-term clinical follow-up of the multicentre, randomized study to test immunosuppressive therapy with oral prednisone for the prevention of restenosis after percutaneous coronary interventions: Cortisone plus BMS or DES veRsus BMS alone to EliminAte Restenosis (CEREA-DES).

    PubMed

    Ribichini, Flavio; Tomai, Fabrizio; Pesarini, Gabriele; Zivelonghi, Carlo; Rognoni, Andrea; De Luca, Giuseppe; Boccuzzi, Giacomo; Presbitero, Patrizia; Ferrero, Valeria; Ghini, Anna S; Marino, Paolo; Vassanelli, Corrado

    2013-06-01

    To analyse the clinical outcome at 4 years in patients with coronary artery disease treated with bare metal stents (BMS) vs. BMS and oral prednisone, or drug-eluting stents (DES), all assuming similar adjunctive medical treatment. Five Italian hospitals enrolled 375 non-diabetic, ischaemic patients without contraindications to dual anti-platelet treatment or corticosteroid therapy in a randomized controlled study. The primary endpoint was the event-free survival of cardiovascular death, myocardial infarction, and recurrence of ischaemia needing repeated target vessel revascularization at 1 year, and this was significantly lower in the BMS group (80.8%) compared with the prednisone (88.0%) and DES group (88.8%, P = 0.04 and 0.006, respectively). The long-term analysis of the primary endpoint was a pre-specified aim of the trial, and was performed at 1447 days (median, IQ range = 1210-1641). Patients receiving BMS alone had significantly lower event-free survival (75.3%) compared with 84.1% in the prednisone group (HR: 0.447; 95% CI: 0.25-0.80, P = 0.007) and 80.6% in DES patients (HR: 0.519; 95% CI: 0.29-0.93, P = 0.03). Prednisone-treated patients did not develop new treatment-related clinical problems. Drug-eluting stents patients suffered more very late stent thrombosis as a cause of spontaneous myocardial infarction. The need for target vessel revascularization remained lower in the prednisone and DES groups (13.6 and 15.2%, respectively), compared with BMS (23.2%). The clinical benefits of prednisone compared with BMS only persisted almost unchanged at 4 years. Drug-eluting stents performed better than BMS at long-term, although the advantages observed at 1 year were in part attenuated because of the occurrence of very late stent thrombosis and late revascularizations. Clinical Trial NCT 00369356.

  14. Variability of antioxidant and antibacterial effects of essential oils and acetonic extracts of two edible halophytes: Crithmum maritimum L. and Inula crithmoїdes L.

    PubMed

    Jallali, Ines; Zaouali, Yosr; Missaoui, Ibtissem; Smeoui, Abderrazek; Abdelly, Chedly; Ksouri, Riadh

    2014-02-15

    This work aimed to assess the richness of the food halophytes Crithmum maritimum and Inula crithmoїdes on phenolics and essential oils (EOs) and to evaluate the antioxidant and antibacterial potential of these metabolites. Results displayed that extract of I. crithmoїdes possesses considerable contents of phenolic compounds (14.1mg GAE.g⁻¹ DW) related to important antioxidant activities (IC₅₀ = 13 μg ml⁻¹ for the DPPH test) as compared to C. maritimum. C. maritimum EOs composition is dominated by oxygenated monoterpenes, while I. crithmoїdes one is mainly consisted by monoterpene hydrocarbons. EOs have low antioxidant activity as compared to acetone extracts; nevertheless, they show best antimicrobial activity. A significant variability is also depicted between the provenances of each species and depended on the chemical nature of antioxidant and antibacterial molecules as well as the used tests. Copyright © 2013 Elsevier Ltd. All rights reserved.

  15. Dissociation in bipolar disorder: Relationships between clinical variables and childhood trauma.

    PubMed

    Hariri, Aytül Gursu; Gulec, Medine Yazici; Orengul, Fatma Fariha Cengiz; Sumbul, Esra Aydin; Elbay, Rumeysa Yeni; Gulec, Huseyin

    2015-09-15

    The dissociative experiences of patients with bipolar disorder (BD) differ from those of patients with other psychiatric disorders with regard to certain features. The primary goal of this study was to evaluate the relationship between the clinical variables of BD and childhood trauma using the factor structure, psychometric features, and potential subdimensions of the Dissociative Experience Scale (DES). This study included 200 BD patients who were in a remission period and 50 healthy volunteers. The BD patients were recruited from two psychiatry clinic departments in Turkey. The sociodemographic data of the two groups and their scores on the DES and Childhood Trauma Questionnaire (CTQ)-28 were compared. The overall DES scores and the scores for each DES item accurately and reliably measured dissociation in the BD patients (item-total correlation r scores: >0.20, Cronbach's alpha: 0.95), and a factor analysis revealed two subdimensions of the DES for BD: identity confusion/alteration (SubDES-1) and amnesia and depersonalization/derealization (SubDES-2). Although age at onset of BD was significantly correlated with both subdimensions, illness duration was significantly correlated only with the SubDES-2. Of all the subjects, 19.5% (39/200 patients) were identified as having dissociative experiences by the DES-Taxon (DES-T), and subjects in this subscale (DES-T-positive) had significantly higher total scores on the CTQ-28 as well as higher scores on each subgroup of this scale. The highest CTQ-28 subgroup score was emotional neglect, which was followed by emotional abuse and physical neglect and then sexual abuse and physical abuse. There was a significant correlation between total scores on the CTQ-28 and SubDES-2 but none of the CTQ-28 subscale scores was significantly correlated with either SubDES-1 or SubDES-2. The DES sufficiently and reliably identified the experience of dissociative symptoms on the part of BD patients, and a factor analysis revealed two subdimensions of BD on this scale. In particular, DES-T-positive subjects experienced a greater amount of childhood trauma and, as a result, had an earlier age at onset of BD. Additionally, SubDES-2, which was associated with amnesia and depersonalization/derealization, was closely related to illness duration. Copyright © 2015 Elsevier B.V. All rights reserved.

  16. Cancer risk in men exposed in utero to diethylstilbestrol.

    PubMed

    Strohsnitter, W C; Noller, K L; Hoover, R N; Robboy, S J; Palmer, J R; Titus-Ernstoff, L; Kaufman, R H; Adam, E; Herbst, A L; Hatch, E E

    2001-04-04

    An association between prenatal diethylstilbestrol (DES) exposure and cancer in men, especially testicular cancer, has been suspected, but findings from case-control studies have been inconsistent. This study was conducted to investigate the association between prenatal DES exposure and cancer risk in men via prospective follow-up. A total of 3613 men whose prenatal DES exposure status was known were followed from 1978 through 1994. The overall and site-specific cancer incidence rates among the DES-exposed men were compared with those of the unexposed men in the study and with population-based rates. The relative rate (RR) was used to assess the strength of the association between prenatal DES exposure and cancer development. All statistical tests were two-sided. Overall cancer rates among DES-exposed men were similar to those among unexposed men (RR = 1.07; 95% confidence interval [CI] = 0.58 to 1.96) and to national rates (RR = 0.99; 95% CI = 0.65 to 1.44). Testicular cancer may be elevated among DES-exposed men, since the RRs for testicular cancer were 3.05 (95% CI = 0.65 to 22.0) times those of unexposed men in the study and 2.04 (95% CI = 0.82 to 4.20) times those of males in the population-based rates. The higher rate of testicular cancer in the DES-exposed men is, however, also compatible with a chance observation. To date, men exposed to DES in utero do not appear to have an increased risk of most cancers. It remains uncertain, however, whether prenatal DES exposure is associated with testicular cancer.

  17. Strategies facilitant les tests en pre-certification pour la robustesse a l'egard des radiations =

    NASA Astrophysics Data System (ADS)

    Souari, Anis

    Les effets des radiations cosmiques sur l'electronique embarquee preoccupent depuis. quelques decennies les chercheurs interesses par la robustesse des circuits integres. Plusieurs. recherches ont ete menees dans cette direction, principalement pour les applications spatiales. ou l’environnement de leur deploiement est hostile. En effet, ces environnements sont denses. en termes de particules qui, lorsqu’elles interagissent avec les circuits integres, peuvent. mener a leur dysfonctionnement, voir meme a leur destruction. De plus, les effets des. radiations s’accentuent pour les nouvelles generations des circuits integres ou la diminution. de la taille des transistors et l’augmentation de la complexite de ces circuits augmentent la. probabilite d’apparition des anomalies et par consequence la croissance des besoins de test. L’expansion de l’electronique grand public (commercial off-the-shelf, COTS) et l’adoption. de ces composants pour des applications critiques comme les applications avioniques et. spatiales incitent egalement les chercheurs a doubler les efforts de verification de la fiabilite. de ces circuits. Les COTS, malgre leurs meilleures caracteristiques en comparaison avec les. circuits durcis tolerants aux radiations qui sont couteux et en retard en termes de technologie. utilisee, sont vulnerables aux radiations. Afin d’ameliorer la fiabilite de ces circuits, une evaluation de leur vulnerabilite dans les. differents niveaux d’abstraction du flot de conception est recommandee. Ceci aide les. concepteurs a prendre les mesures de mitigation necessaires sur le design au niveau. d’abstraction en question. Enfin, afin de satisfaire les exigences de tolerance aux pannes, des. tests tres couteux de certification, obtenus a l’aide de bombardement de particules (protons, neutrons, etc.), sont necessaires. Dans cette these, nous nous interessons principalement a definir une strategie de precertification. permettant d’evaluer d’une facon realiste la sensibilite des circuits integres face. aux effets des radiations afin d’eviter d’envoyer des circuits non robustes a la phase tres. couteuse de la certification. Les circuits cibles par nos travaux sont les circuits integres. programmables par l’usager (FPGA) a base de memoire SRAM et le type de pannes ciblees, causees par les radiations, est les SEU (single event upset) consistant a un basculement de. l’etat logique d’un element de memoire a son complementaire. En effet, les FPGA a base de. memoire SRAM sont de plus en plus demandes par la communaute de l’aerospatial grace a. leurs caracteristiques de prototypage rapide et de reconfiguration sur site mais ils sont. vulnerables face aux radiations ou les SEU sont les pannes les plus frequentes dans les. elements de memoire de type SRAM. Nous proposons une nouvelle approche d’injection de. pannes par emulation permettant de mimer les effets des radiations sur la memoire de. configuration des FPGA et de generer des resultats les plus fideles possibles des resultats des. tests de certification. Cette approche est basee sur la consideration de la difference de. sensibilite des elements de memoire de configuration lorsqu’ils sont a l’etat '1' et a l’etat '0', observee sous des tests acceleres sous faisceaux de protons au renomme laboratoire. TRIUMF, dans la procedure de generation des sequences de test dans le but de mimer la. distribution des pannes dans la memoire de configuration. Les resultats des experimentations. de validation montrent que la strategie proposee est efficace et genere des resultats realistes. Ces resultats revelent que ne pas considerer la difference de sensibilite peut mener a une. sous-estimation de la sensibilite des circuits face aux radiations. Dans la meme optique d’optimisation de la procedure d’injection des pannes par emulation, a. savoir le test de pre-certification, nous proposons une methodologie permettant de maximiser. la detection des bits critiques (bits provoquant une defaillance fonctionnelle s’ils changent. d’etat) pour un nombre bien determine de SEU (qui est le modele de pannes adopte) ou de. maximiser la precision de l’estimation de nombre des bits critiques. Pour ce faire, une. classification des bits de configuration en differents ensembles est tout d’abord mise en. oeuvre, selon leur contenu, les ressources qu’ils configurent et leur criticite. Ensuite, une. evaluation de la sensibilite de chaque ensemble est accomplie. Enfin, la priorisation. d’injection des pannes dans les ensembles les plus sensibles est recommandee. Plusieurs. scenarios d’optimisation d’injection des pannes sont proposes et les resultats sont compares. avec ceux donnes par la methode conventionnelle d’injection aleatoire des pannes. La. methodologie d’optimisation proposee assure une amelioration de plus de deux ordres de. grandeur. Une derniere approche facilitant l’evaluation de la sensibilite des bits configurant les LUT. (look up table) de FPGA, les plus petites entites configurables du FPGA permettant. d’implementer des fonctions combinatoires, utilises par un design est presentee. Elle permet. l’identification facile et sans cout en termes d’utilisation du materiel ou d’outils externes des. bits des LUT. L’approche proposee est simple et efficace, offrant une couverture de pannes. de 100 % et applicable aux nouvelles generations des FPGA de Xilinx. Les approches proposees contribuent a repondre aux exigences du cahier des charges de cette. these et a achever les objectifs definis. Le realisme et la maximisation de l’estimation de la. vulnerabilite des circuits sous test offerts par les nouvelles approches assurent le. developpement d’une strategie de test en pre-certification efficace. En effet, la premiere. approche d’injection de pannes considerant la difference de sensibilite relative des elements. de memoire selon leur contenu genere des resultats donnant une erreur relative atteignant. 3.1 % quand compares aux resultats obtenus a TRIUMF alors que l’erreur relative donnee. par la comparaison des resultats d’une injection conventionnelle aleatoire de pannes avec. ceux de TRIUMF peut atteindre la valeur de 75 %. De plus, l’application de cette approche a. des circuits plus conventionnels montre que 2.3 fois plus d’erreurs sont detectees en. comparaison avec l’injection aleatoire des pannes. Ceci suggere que ne pas considerer la. difference de sensibilite relative dans la procedure d’emulation peut mener a une sousestimation. de la sensibilite du design face aux radiations. Les resultats de la deuxieme. approche proposee ont ete aussi compares aux resultats d’une injection aleatoire de pannes. L’approche proposee, maximisant le nombre des bits critiques inverses, permet d’atteindre. un facteur d’acceleration de 108 de la procedure d’injection des pannes en comparaison a. l’approche aleatoire. Elle permet aussi de minimiser l’erreur d’estimation du nombre des bits. critiques pour atteindre une valeur de ±1.1 % calculee pour un intervalle de confiance de. 95 % tandis que la valeur d’erreur d’estimation des bits critiques generee par l’approche. aleatoire d’injection des pannes pour le meme intervalle de confiance peut atteindre ±8.6 %. Enfin, la derniere approche proposee d’injection de pannes dans les LUT se distingue des. autres approches disponibles dans la litterature par sa simplicite tout en assurant une. couverture maximale de pannes de 100 %. En effet, l’approche proposee est independante. des outils externes permettant d’identifier les bits configurant les LUT qui sont obsoletes ou. ne supportent pas les nouvelles generations des FPGA. Elle agit directement sur les fichiers. generes par l’outil de synthese adopte.

  18. Prospective Randomized Trial Comparing Efficacy of Topical Loteprednol Etabonate 0.5% Versus Cyclosporine-A 0.05% for Treatment of Dry Eye Syndrome Following Hematopoietic Stem Cell Transplantation.

    PubMed

    Boynton, Grace E; Raoof, Duna; Niziol, Leslie M; Hussain, Munira; Mian, Shahzad I

    2015-07-01

    To evaluate the safety and efficacy of topical loteprednol etabonate (LE) 0.5% compared with cyclosporine A (CsA) 0.05% for the prophylaxis and treatment of dry eye syndrome (DES) after hematopoietic stem cell transplantation (HSCT). Seventy-five patients were randomized to LE (n = 76 eyes of 38 patients) or CsA (n = 74 eyes of 37 patients) pre-HSCT. Lissamine green and fluorescein staining, tear break-up time, tear osmolarity (Osm), Schirmer score (Sch), intraocular pressure, visual acuity, and Ocular Surface Disease Index were assessed pre-HSCT, 3, 6, 9, and 12 months post-HSCT. There were no differences in DES incidence (P = 0.22; log-rank test) or progression (P = 0.41; log-rank test) between the 2 treatment arms during the course of the study. Among eyes with no DES at enrollment, the Kaplan-Meier analysis yielded a 90% rate of DES development in cyclosporine-treated eyes and a 79% rate of DES development in LE-treated eyes by 12 months post-HSCT. The Kaplan-Meier analysis of eyes with DES at enrollment demonstrated a 38% rate of disease progression among cyclosporine-treated eyes and a 26% rate of disease progression among loteprednol-treated eyes by 12 months. No patient in either group had an elevation of 10 mm Hg or greater from baseline at any study visit, and no patients had their treatment discontinued for elevation in intraocular pressure. Pre-HSCT initiation of LE 0.5% appears to be safe and may be as effective as CsA 0.5% for the treatment and prophylaxis of DES following HSCT.

  19. Comparing Dark Energy Survey and HST-CLASH observations of the galaxy cluster RXC J2248.7-4431: implications for stellar mass versus dark matter

    NASA Astrophysics Data System (ADS)

    Palmese, A.; Lahav, O.; Banerji, M.; Gruen, D.; Jouvel, S.; Melchior, P.; Aleksić, J.; Annis, J.; Diehl, H. T.; Hartley, W. G.; Jeltema, T.; Romer, A. K.; Rozo, E.; Rykoff, E. S.; Seitz, S.; Suchyta, E.; Zhang, Y.; Abbott, T. M. C.; Abdalla, F. B.; Allam, S.; Benoit-Lévy, A.; Bertin, E.; Brooks, D.; Buckley-Geer, E.; Burke, D. L.; Capozzi, D.; Carnero Rosell, A.; Carrasco Kind, M.; Carretero, J.; Crocce, M.; Cunha, C. E.; D'Andrea, C. B.; da Costa, L. N.; Desai, S.; Dietrich, J. P.; Doel, P.; Estrada, J.; Evrard, A. E.; Flaugher, B.; Frieman, J.; Gerdes, D. W.; Goldstein, D. A.; Gruendl, R. A.; Gutierrez, G.; Honscheid, K.; James, D. J.; Kuehn, K.; Kuropatkin, N.; Li, T. S.; Lima, M.; Maia, M. A. G.; Marshall, J. L.; Miller, C. J.; Miquel, R.; Nord, B.; Ogando, R.; Plazas, A. A.; Roodman, A.; Sanchez, E.; Scarpine, V.; Sevilla-Noarbe, I.; Smith, R. C.; Soares-Santos, M.; Sobreira, F.; Swanson, M. E. C.; Tarle, G.; Thomas, D.; Tucker, D.; Vikram, V.

    2016-12-01

    We derive the stellar mass fraction in the galaxy cluster RXC J2248.7-4431 observed with the Dark Energy Survey (DES) during the Science Verification period. We compare the stellar mass results from DES (five filters) with those from the Hubble Space Telescope Cluster Lensing And Supernova Survey (CLASH; 17 filters). When the cluster spectroscopic redshift is assumed, we show that stellar masses from DES can be estimated within 25 per cent of CLASH values. We compute the stellar mass contribution coming from red and blue galaxies, and study the relation between stellar mass and the underlying dark matter using weak lensing studies with DES and CLASH. An analysis of the radial profiles of the DES total and stellar mass yields a stellar-to-total fraction of f⋆ = (6.8 ± 1.7) × 10-3 within a radius of r200c ≃ 2 Mpc. Our analysis also includes a comparison of photometric redshifts and star/galaxy separation efficiency for both data sets. We conclude that space-based small field imaging can be used to calibrate the galaxy properties in DES for the much wider field of view. The technique developed to derive the stellar mass fraction in galaxy clusters can be applied to the ˜100 000 clusters that will be observed within this survey and yield important information about galaxy evolution.

  20. Comparing Dark Energy Survey and HST –CLASH observations of the galaxy cluster RXC J2248.7-4431: implications for stellar mass versus dark matter

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

    Palmese, A.; Lahav, O.; Banerji, M.

    We derive the stellar mass fraction in the galaxy cluster RXC J2248.7-4431 observed with the Dark Energy Survey (DES) during the Science Verification period. We compare the stellar mass results from DES (five filters) with those from the Hubble Space Telescope Cluster Lensing And Supernova Survey (CLASH; 17 filters). When the cluster spectroscopic redshift is assumed, we show that stellar masses from DES can be estimated within 25 per cent of CLASH values. We compute the stellar mass contribution coming from red and blue galaxies, and study the relation between stellar mass and the underlying dark matter using weak lensingmore » studies with DES and CLASH. An analysis of the radial profiles of the DES total and stellar mass yields a stellar-to-total fraction of f(star) = (6.8 +/- 1.7) x 10(-3) within a radius of r(200c) similar or equal to 2 Mpc. Our analysis also includes a comparison of photometric redshifts and star/galaxy separation efficiency for both data sets. We conclude that space-based small field imaging can be used to calibrate the galaxy properties in DES for the much wider field of view. The technique developed to derive the stellar mass fraction in galaxy clusters can be applied to the similar to 100 000 clusters that will be observed within this survey and yield important information about galaxy evolution.« less

  1. 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.)

  2. Prenatal Estrogens and the Development of Homosexual Orientation.

    ERIC Educational Resources Information Center

    Meyer-Bahlburg, Heino F. L.; And Others

    1995-01-01

    Examines the hypothesis that prenatal estrogens contribute to the development of human sexual orientation. Several groups of women with a history of prenatal exposure to diethylstilbestrol (DES) were compared with several samples of control women. Findings showed that more DES-exposed women than controls were rated as bisexual or homosexual,…

  3. Les conseils des cliniciens canadiens en matière de commotion dans le sport sont-ils cohérents?

    PubMed Central

    Carson, James D.; Rendely, Alexandra; Garel, Alisha; Meaney, Christopher; Stoller, Jacqueline; Kaicker, Jatin; Hayden, Leigh; Moineddin, Rahim; Frémont, Pierre

    2016-01-01

    Résumé Objectif Comparer les connaissances et l’utilisation des recommandations concernant la prise en charge de la commotion dans le sport (CDS) démontrées par les spécialistes de la médecine du sport et de l’exercice (SMSE) et les urgentologues afin d’évaluer la réussite du transfert des connaissances sur la CDS au Canada. Conception Un sondage à choix multiples envoyé par courriel et autoadministré par des SMSE et des urgentologues. La validité du contenu du sondage a fait l’objet d’une évaluation. Contexte Canada. Participants Le sondage a été complété entre mai et juillet 2012 par des SMSE qui ont réussi l’examen menant au diplôme de l’Académie canadienne de la médecine du sport et de l’exercice et des urgentologues qui n’avaient pas ce diplôme. Principaux paramètres à l’étude La connaissance et l’identification des sources d’information sur la prise en charge des commotions, l’utilisation des stratégies de diagnostic de la commotion et l’utilisation d’une terminologie courante et cohérente dans l’explication des stratégies de repos aux patients après une CDS. Résultats Le taux de réponse était de 28 % (305 sur 1085). Les taux de réponse par les SMSE et les urgentologues se situaient respectivement à 41 % (147 sur 360) et 22 % (158 sur 725). Parmi les répondants, 41 % des urgentologues et 3 % des SMSE n’étaient pas au courant de l’existence de déclarations consensuelles sur la commotion dans le sport; 74 % des SMSE utilisaient « habituellement ou toujours » la version 2 de l’Outil d’évaluation de la commotion dans le sport (SCAT2), tandis que 88 % des urgentologues n’utilisaient jamais le SCAT2. Aucune réponse uniforme n’a été documentée à la question visant à connaître les meilleurs modes de repos cognitif. Conclusion Nous avons cerné des différences et un manque d’uniformité chez les SMSE et les urgentologues dans la mise en application des recommandations concernant les patients ayant subi une CDS. Il semble que le SCAT2 soit davantage utilisé dans le milieu des SMSE que dans le contexte de l’urgence. Des efforts plus poussés de transfert des connaissances et en recherche devraient atténuer les obstacles à des conseils plus uniformes donnés par les médecins qui soignent des patients ayant subi une CDS.

  4. TOXICITY OF NATURAL DEEP EUTECTIC SOLVENT (NaDES) BETAINE:GLYCEROL IN RATS.

    PubMed

    Benlebna, Melha; Ruesgas-Ramon, Mariana; Bonafos, Beatrice; Fouret, Gilles; Casas, Françcois; Coudray, Charles; Durand, Erwann; Figueroa, Maria-Cruz; Feillet-Coudray, Christine

    2018-05-28

    The natural deep eutectic solvents (NaDES) are new natural solvents in green chemistry that in some cases have been shown to allow better extraction of plant bioactive molecules compared to conventional solvents and higher phenolic compounds absorption in rodents. However, there is a serious lack of information regarding their in vivo safety. The purpose of this study was to verify the safety of a NaDES (glycerol:betaine (mole ratio 2:1) + 10 % (v/v) of water) extract from green coffee beans, rich in polyphenols. Twelve 6-weeks-old male Wistar rats were randomized into two groups of 6 animals each and twice daily gavaged for 14 days either with 3 ml water or with 3 ml phenolic NaDES extract. Oral administration of phenolic NaDES extract induced mortality in 2 rats. In addition, it induced excessive water consumption, reduced dietary intake and weight loss, hepatomegaly, plasma oxidative stress associated with high blood lipid levels. In conclusion, this work demonstrated the toxicity of oral administration of the selected NaDES, under a short-term condition. This occurs despite the fact that this NaDES extract contains polyphenols, whose beneficial effects have been shown. Therefore, complementary work is needed to find the best dose and formulation of NaDES that are safe for the environment, animals and ultimately for humans.

  5. Homeodomain Transcription Factor Msx-2 Regulates Uterine Progenitor Cell Response to Diethylstilbestrol.

    PubMed

    Yin, Yan; Lin, Congxing; Zhang, Ivy; Fisher, Alexander V; Dhandha, Maulik; Ma, Liang

    The fate of mouse uterine epithelial progenitor cells is determined between postnatal days 5 to 7. Around this critical time window, exposure to an endocrine disruptor, diethylstilbestrol (DES), can profoundly alter uterine cytodifferentiation. We have shown previously that a homeo domain transcription factor MSX-2 plays an important role in DES-responsiveness in the female reproductive tract (FRT). Mutant FRTs exhibited a much more severe phenotype when treated with DES, accompanied by gene expression changes that are dependent on Msx2 . To better understand the role that MSX-2 plays in uterine response to DES, we performed global gene expression profiling experiment in mice lacking Msx2 By comparing this result to our previously published microarray data performed on wild-type mice, we extracted common and differentially regulated genes in the two genotypes. In so doing, we identified potential downstream targets of MSX-2, as well as genes whose regulation by DES is modulated through MSX-2. Discovery of these genes will lead to a better understanding of how DES, and possibly other endocrine disruptors, affects reproductive organ development.

  6. Homeodomain Transcription Factor Msx-2 Regulates Uterine Progenitor Cell Response to Diethylstilbestrol

    PubMed Central

    Yin, Yan; Lin, Congxing; Zhang, Ivy; Fisher, Alexander V; Dhandha, Maulik; Ma, Liang

    2015-01-01

    The fate of mouse uterine epithelial progenitor cells is determined between postnatal days 5 to 7. Around this critical time window, exposure to an endocrine disruptor, diethylstilbestrol (DES), can profoundly alter uterine cytodifferentiation. We have shown previously that a homeo domain transcription factor MSX-2 plays an important role in DES-responsiveness in the female reproductive tract (FRT). Mutant FRTs exhibited a much more severe phenotype when treated with DES, accompanied by gene expression changes that are dependent on Msx2. To better understand the role that MSX-2 plays in uterine response to DES, we performed global gene expression profiling experiment in mice lacking Msx2 By comparing this result to our previously published microarray data performed on wild-type mice, we extracted common and differentially regulated genes in the two genotypes. In so doing, we identified potential downstream targets of MSX-2, as well as genes whose regulation by DES is modulated through MSX-2. Discovery of these genes will lead to a better understanding of how DES, and possibly other endocrine disruptors, affects reproductive organ development. PMID:26457333

  7. Depositional and deformational history of the Franciscan complex, northernmost California

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

    Aalto, K.R.

    1990-05-01

    Pervasive extensional shear fractures and curvilinear arrays of clay and silt-filled veins in Franciscan Complex melanges and turbidites formed when Franciscan sediments were unlithified. Sandstone dikes both crosscut and follow fractures. Several scales of extensional faulting account for the juxtaposition of turbidites of different facies and/or with varying degrees of stratal disruption, the formation of sandstone lozenges and pinch-and-swell structures, and the formation of scaly foliation within the matrix of melange units. Within turbidites, the upper laminated portions of beds commonly contain abundant listric microfaults and the more massive lower portions of beds contain sediment-filled vein arrays. Veining and faultingmore » occurred concurrently and resulted in differential extension of upper verses lower portions of beds. The finer sediment in veins reflects both cataclasis and filtering in of clay and silt from vein walls. Most Franciscan rocks record an early pervasive, layer-parallel flattening strain, which may be related to the gravitational collapse of late Mesozoic Franciscan inner trench slope sediments that accompanied accretionary prism expansion resulting from underplating. However, some turbidites record noncoaxial extension that resulted from downslope creep of sediments. At Crescent City, sediment creep resulted in oversteepening of the Franciscan inner trench slope, which, in turn, may have triggered large-scale failure of slope materials resulting in the emplacement of the Crescent City olistostrome. The olistostrome crops out for 12 km along the coast, is up to 600 m thick, is in depositional contact with turbidites, and contains chiefly sandstone, greenstone, chert olistoliths up to 200 m across, and zones of slump-folded turbidites.« less

  8. Foreign Exchange Value-at-Risk with Multiple Currency Exposure: A Multivariate and Copula Generalized Autoregressive Conditional Heteroskedasticity Approach

    DTIC Science & Technology

    2014-11-01

    du taux de change, et les responsables de la gestion interne se voient donc pressés de trouver des ... mesurer les effets négatifs que peuvent avoir les fluctuations mo- nétaires sur le budget et la planification du MDN, il faut connaître le poids des ...qualités comparables et qu’ils permettent d’effectuer une meilleure évaluation du risque qu’avec la méthode courante. On obtient désormais des estimations de

  9. A new polymer-free drug-eluting stent with nanocarriers eluting sirolimus from stent-plus-balloon compared with bare-metal stent and with biolimus A9 eluting stent in porcine coronary arteries.

    PubMed

    Takimura, Celso K; Galon, Micheli Z; Gutierrez, Paulo S; Sojitra, Prakash; Vyas, Ashwin; Doshi, Manish; Lemos, Pedro A

    2015-04-01

    Permanent polymers in first generation drug-eluting stent (DES) have been imputed to be a possible cause of persistent inflammation, remodeling, malapposition and late stent thrombosis. We aim to describe the in vivo experimental result of a new polymer-free DES eluting sirolimus from stent-plus-balloon (Focus np stent, Envision Scientific) compared with a bare-metal stent (BMS) (Amazonia CroCo, Minvasys) and with a biolimus A9 eluting stent (Biomatrix, Biosensors). In 10 juvenile pigs, 23 coronary stents were implanted in the coronary arteries (8 Amazonia CroCo, 8 Focus np, and 7 Biomatrix). At 28-day follow-up, optical coherence tomography (OCT) and histology were used to evaluate neointimal hyperplasia and healing response. According to OCT analysis, Focus np stents had a greater lumen area and less neointimal hyperplasia response than BMS and Biomatrix had. Histomorphometry results showed less neointimal hyperplasia in Focus np than in BMS. Histology showed a higher fibrin deposition in Biomatrix stent compared to Focus np and BMS. The new polymer-free DES with sirolimus eluted from stent-plus-balloon demonstrated safety and reduced neointimal proliferation compared with the BMS and Biomatrix stents at 28-day follow-up in this porcine coronary model. This new polymer-free DES is promising and warrants further clinical studies.

  10. Modeling rheumatoid arthritis using different techniques - a review of model construction and results.

    PubMed

    Scholz, Stefan; Mittendorf, Thomas

    2014-12-01

    Rheumatoid arthritis (RA) is a chronic, inflammatory disease with severe effects on the functional ability of patients. Due to the prevalence of 0.5 to 1.0 percent in western countries, new treatment options are a major concern for decision makers with regard to their budget impact. In this context, cost-effectiveness analyses are a helpful tool to evaluate new treatment options for reimbursement schemes. To analyze and compare decision analytic modeling techniques and to explore their use in RA with regard to their advantages and shortcomings. A systematic literature review was conducted in PubMED and 58 studies reporting health economics decision models were analyzed with regard to the modeling technique used. From the 58 reviewed publications, we found 13 reporting decision tree-analysis, 25 (cohort) Markov models, 13 publications on individual sampling methods (ISM) and seven discrete event simulations (DES). Thereby 26 studies were identified as presenting independently developed models and 32 models as adoptions. The modeling techniques used were found to differ in their complexity and in the number of treatment options compared. Methodological features are presented in the article and a comprehensive overview of the cost-effectiveness estimates is given in Additional files 1 and 2. When compared to the other modeling techniques, ISM and DES have advantages in the coverage of patient heterogeneity and, additionally, DES is capable to model more complex treatment sequences and competing risks in RA-patients. Nevertheless, the availability of sufficient data is necessary to avoid assumptions in ISM and DES exercises, thereby enabling biased results. Due to the different settings, time frames and interventions in the reviewed publications, no direct comparison of modeling techniques was applicable. The results from other indications suggest that incremental cost-effective ratios (ICERs) do not differ significantly between Markov and DES models, but DES is able to report more outcome parameters. Given a sufficient data supply, DES is the modeling technique of choice when modeling cost-effectiveness in RA. Otherwise transparency on the data inputs is crucial for valid results and to inform decision makers about possible biases. With regard to ICERs, Markov models might provide similar estimates as more advanced modeling techniques.

  11. Long-term outcome after drug-eluting versus bare-metal stent implantation in patients with ST-segment elevation myocardial infarction: 5 years follow-up from the randomized DEDICATION trial (Drug Elution and Distal Protection in Acute Myocardial Infarction).

    PubMed

    Holmvang, Lene; Kelbæk, Henning; Kaltoft, Anne; Thuesen, Leif; Lassen, Jens Flensted; Clemmensen, Peter; Kløvgaard, Lene; Engstrøm, Thomas; Bøtker, Hans E; Saunamäki, Kari; Krusell, Lars R; Jørgensen, Erik; Tilsted, Hans-Henrik; Christiansen, Evald H; Ravkilde, Jan; Køber, Lars; Kofoed, Klaus Fuglsang; Terkelsen, Christian J; Helqvist, Steffen

    2013-06-01

    This study sought to compare the long-term effects of drug-eluting stent (DES) compared with bare-metal stent (BMS) implantation in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention. The randomized DEDICATION (Drug Elution and Distal Protection in Acute Myocardial Infarction) trial evaluated the outcome after DES compared with BMS implantation in patients with STEMI undergoing primary percutaneous coronary intervention. Patients with a high-grade stenosis/occlusion of a native coronary artery presenting with symptoms <12 h and ST-segment elevation were enrolled after giving informed consent. Patients were randomly assigned to receive a DES or a BMS in the infarct-related lesion. Patients were followed for at least 5 years, and clinical endpoints were evaluated from population registries and hospital charts. The main endpoint was the occurrence of the first major adverse cardiac event (MACE), defined as cardiac death, nonfatal recurrent myocardial infarction, and target lesion revascularization. Complete clinical status was available in 623 patients (99.5%) at 5 years follow-up. The combined MACE rate was insignificantly lower in the DES group (16.9% vs. 23%), mainly driven by a lower need of repeat revascularization (p = 0.07). Whereas the number of deaths from all causes tended to be higher in the DES group (16.3% vs. 12.1%, p = 0.17), cardiac mortality was significantly higher (7.7% vs. 3.2%, p = 0.02). The 5-year stent thrombosis rates were generally low and similar between the DES and the BMS groups. No cardiac deaths occurring within 1 month could be clearly ascribed to stent thrombosis, whereas stent thrombosis was involved in 78% of later-occurring deaths. The 5-year MACE rate was insignificantly different, but the cardiac mortality was higher after DES versus BMS implantation in patients with STEMI. Stent thrombosis was the main cause of late cardiac deaths. Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  12. Dry Eye Syndrome After Proton Therapy of Ocular Melanomas

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

    Thariat, Juliette, E-mail: jthariat@gmail.com; Maschi, Celia; Lanteri, Sara

    Purpose: To investigate whether proton therapy (PT) performs safely in superotemporal melanomas, in terms of risk of dry-eye syndrome (DES). Methods and Materials: Tumor location, DES grade, and dose to ocular structures were analyzed in patients undergoing PT (2005-2015) with 52 Gy (prescribed dose, not accounting for biologic effectiveness correction of 1.1). Prognostic factors of DES and severe DES (sDES, grades 2-3) were determined with Cox proportional hazard models. Visual acuity deterioration and enucleation rates were compared by sDES and tumor locations. Results: Median follow-up was 44 months (interquartile range, 18-60 months). Of 853 patients (mean age, 64 years), 30.5% had temporal and 11.4% superotemporalmore » tumors. Five-year incidence of DES and sDES was 23.0% (95% confidence interval [CI] 19.0%-27.7%) and 10.9% (95% CI 8.2%-14.4%), respectively. Multivariable analysis showed a higher risk for sDES in superotemporal (hazard ratio [HR] 5.82, 95% CI 2.72-12.45) and temporal tumors (HR 2.63, 95% CI 1.28-5.42), age ≥70 years (HR 1.90, 95% CI 1.09-3.32), distance to optic disk ≥5 mm (HR 2.71, 95% CI 1.52-4.84), ≥35% of retina receiving 12 Gy (HR 2.98, 95% CI 1.54-5.77), and eyelid rim irradiation (HR 2.68, 95% CI 1.49-4.80). The same risk factors were found for DES. Visual acuity deteriorated more in patients with sDES (0.86 ± 1.10 vs 0.64 ± 0.98 logMAR, P=.034) but not between superotemporal/temporal and other locations (P=.890). Enucleation rates were independent of sDES (P=.707) and tumor locations (P=.729). Conclusions: Severe DES was more frequent in superotemporal/temporal melanomas. Incidence of vision deterioration and enucleation was no higher in patients with superotemporal melanoma than in patients with tumors in other locations. Tumor location should not contraindicate PT.« less

  13. Blast pulmonaire primaire chez le brûlé. a propos d’un cas et revue de la littérature

    PubMed Central

    Siah, S.; Emane, A.; Bertin-Maghit, M.

    2016-01-01

    Summary Le blast est à l’origine de lésions spécifiques pour lesquelles une prise en charge spécialisée est nécessaire. Après une explosion on peut observer des lésions de blast primaire, liées à l’onde de choc, secondaire par polycriblage et tertiaire par projection du patient. Les blasts secondaire et tertiaire sont plus fréquents que le blast primaire et peuvent entraîner un polytraumatisme. Dans 5% des cas, on retrouve des brûlures pouvant faire partie du blast quaternaire, qui regroupe toutes les lésions d’autres mécanismes que ceux précités. La prise en charge des lésions secondaires et tertiaires de blast est comparable à celle des traumatisés graves. Le blast pulmonaire primaire aggrave le pronostic des blessés les plus graves mais impose rarement une prise en charge spécifique. La connaissance des particularités physiopathologiques et lésionnelles permet de mieux traiter les blastés et brûlés graves survivants. Nous rapportons une observation de blast pulmonaire primaire chez un brûlé. PMID:28149247

  14. Bitumen recovery from oil sands using deep eutectic solvent and its aqueous solutions

    NASA Astrophysics Data System (ADS)

    Pulati, Nuerxida

    Oil sands compose a significant proportion of the world's known oil reserves. Oil sands are also known as tar sands and bituminous sands, are complex mixtures of sand, clays, water and bitumen, which is "heavy" and highly viscous oil. The extraction and separation of bitumen from oil sands requires significant amount of energy and large quantities of water and poses several environmental challenges. Bitumen can be successfully separated from oil sands using imidazolium based ionic liquids and nonpolar solvents, however, ionic liquids are expensive and toxic. In this thesis, the ionic liquid alternatives- deep eutectic solvent, were investigated. Oil sands separation can be successfully achieved by using deep eutectic solvents DES (choline chloride and urea) and nonpolar solvent naphtha in different types of oil sands, including Canadian ("water-wet"), Utah ("oil-wet") and low grade Kentucky oil sands. The separation quality depends on oil sands type, including bitumen and fine content, and separation condition, such as solvent ratio, temperature, mixing time and mechanical centrifuge. This separation claims to the DES ability to form ion /charge layering on mineral surface, which results in reduction of adhesion forces between bitumen and minerals and promote their separation. Addition of water to DES can reduce DES viscosity. DES water mixture as a media, oil sands separation can be achieved. However, concentration at about 50 % or higher might be required to obtain a clear separation. And the separation efficiency is oil sands sample dependent. The highest bitumen extraction yield happened at 75% DES-water solution for Utah oil sands samples, and at 50 60% DES-water solutions for Alberta oil sands samples. Force curves were measured using Atomic Force Microscopy new technique, PeakForce Tapping Quantitative Nanomechanical Mapping (PFTQNM). The results demonstrate that, by adding DES, the adhesion force between bitumen and silica and dissipation energy will decrease comparing to DI water. At higher concentration DES solution (>80%DES), the amount of decrease can be up to 80-90%. In lower concentration, at about 50% decrease was observed. The results provide fundamental insights into the mechanism of bitumen separation from oil sands. The reduction of adhesion force between bitumen and minerals (silica) in DES media is the main reason which facilitates the separation between them, which by means existence of DES will favor bitumen and minerals separation. Comparing to other techniques, DES based separation is environmentally compatible and economically viable. The separation can easily happen at room temperature. Choline chloride and urea are biodegradable, environmentally compatible, accessible in large scale and easily prepared by mixing and heating (<80 °C). Further improvement is needed regarding to separation quality and efficiency, either in the direction of developing better separation techniques or by looking for chemical additives which can improve separation and reduce environmental side-effects.

  15. Disappearing and reappearing differences in drug-eluting stent use by race.

    PubMed

    Federspiel, Jerome J; Stearns, Sally C; Reiter, Kristin L; Geissler, Kimberley H; Triplette, Matthew A; D'Arcy, Laura P; Sheridan, Brett C; Rossi, Joseph S

    2013-04-01

    Drug-eluting coronary stents (DES) rapidly dominated the marketplace in the United States after approval in 2003, but utilization rates were initially lower among African American patients. We assess whether racial differences persisted as DES diffused into practice. Medicare claims data were used to identify coronary stenting procedures among elderly patients with acute coronary syndromes (ACS). Regression models of the choice of DES versus bare mental stent controlled for demographics, ACS type, co-morbidities and hospital characteristics. Diffusion was assessed in the short run (2003-2004) and long run (2007), with the effect of race calculated to allow for time-varying effects. The sample included 381,887 Medicare beneficiaries treated with stent insertion; approximately 5% were African American. Initially (May 2003-February 2004), African American race was associated with lower DES use compared to other races (44.3% versus 46.5%, P < 0.01). Once DES usage was high in all patients (March-December 2004), differences were not significant (79.8% versus 80.3%, P = 0.45). Subsequent concerns regarding DES safety caused reductions in DES use, with African Americans having lower use than other racial groups in 2007 (63.1% versus 65.2%, P < 0.01). Racial disparities in DES use initially disappeared during a period of rapid diffusion and high usage rates; the reappearance of disparities in use by 2007 may reflect DES use tailored to unmeasured aspects of case mix and socio-economic status. Further work is needed to understand whether underlying differences in race reflect decisions regarding treatment appropriateness. © 2011 Blackwell Publishing Ltd.

  16. Determining clinical benefits of drug-eluting coronary stents according to the population risk profile: a meta-regression from 31 randomized trials.

    PubMed

    Moreno, Raul; Martin-Reyes, Roberto; Jimenez-Valero, Santiago; Sanchez-Recalde, Angel; Galeote, Guillermo; Calvo, Luis; Plaza, Ignacio; Lopez-Sendon, Jose-Luis

    2011-04-01

    The use of drug-eluting stents (DES) in unfavourable patients has been associated with higher rates of clinical complications and stent thrombosis, and because of that concerns about the use of DES in high-risk settings have been raised. This study sought to demonstrate that the clinical benefit of DES increases as the risk profile of the patients increases. A meta-regression analysis from 31 randomized trials that compared DES and bare-metal stents, including overall 12,035 patients, was performed. The relationship between the clinical benefit of using DES (number of patients to treat [NNT] to prevent one episode of target lesion revascularization [TLR]), and the risk profile of the population (rate of TLR in patients allocated to bare-metal stents) in each trial was evaluated. The clinical benefit of DES increased as the risk profile of each study population increased: NNT for TLR=31.1-1.2 (TLR for bare-metal stents); p<0.001. The use of DES was safe regardless of the risk profile of each study population, since the effect of DES in mortality, myocardial infarction, and stent thrombosis, was not adversely affected by the risk profile of each study population (95% confidence interval for β value 0.09 to 0.11, -0.12 to 0.19, and -0.03 to-0.15 for mortality, myocardial infarction, and stent thrombosis, respectively). The clinical benefit of DES increases as the risk profile of the patients increases, without affecting safety. Copyright © 2009 Elsevier Ireland Ltd. All rights reserved.

  17. Rationale and design of the East-West late lumen loss study: Comparison of late lumen loss between Eastern and Western drug-eluting stent study cohorts.

    PubMed

    Harrison, Robert W; Radhakrishnan, Vaishnavi; Lam, Peter S; Allocco, Dominic J; Brar, Sandeep; Fahy, Martin; Fisher, Rebecca; Ikeno, Fumiaki; Généreux, Philippe; Kimura, Takeshi; Liu, Minglei; Lye, Weng Kit; Mintz, Gary S; Nagai, Hirofumi; Suzuki, Yuka; White, Roseann; Allen, John C; Krucoff, Mitchell W

    2016-12-01

    The contemporary evaluation of novel drug-eluting stents (DES) includes mechanistic observations that characterize postdeployment stent behavior. Quantification of late lumen loss due to neointimal hyperplasia 8-13 months after stent implantation, via quantitative coronary angiography (QCA), constitutes such an observation and is required by most regulatory authorities. Late lumen loss, as determined by QCA, has been validated as a surrogate for clinical endpoints such as target vessel revascularization. The mechanistic response to DES has not been directly compared across predominantly Asian or Western populations, whereas understanding their comparability across geographic populations could enhance global DES evaluation. The East-West late lumen loss study is designed to demonstrate whether the residual differences in late lumen loss, as assessed by QCA, is different between Eastern and Western DES recipients from studies with protocol angiography at 8-13 months of follow-up. Data from independent core laboratories that have characterized angiographic late lumen loss in DES clinical trials with protocol follow-up angiography will be compiled and dichotomized into Eastern and Western populations. A prospectively developed propensity score model incorporating clinical and anatomic variables affecting late lumen loss will be used to adjust comparisons of QCA measurements. Documentation of whether there are clinically meaningful differences in mechanistic response to DES implantation across genetically unique geographies could facilitate both the quality and efficiency of global device evaluation requiring invasive follow-up for novel stent designs. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Planning for operating room efficiency and faster anesthesia wake-up time in open major upper abdominal surgery.

    PubMed

    Lai, Hou-Chuan; Chan, Shun-Ming; Lu, Chueng-He; Wong, Chih-Shung; Cherng, Chen-Hwan; Wu, Zhi-Fu

    2017-02-01

    Reducing anesthesia-controlled time (ACT) may improve operation room (OR) efficiency result from different anesthetic techniques. However, the information about the difference in ACT between desflurane (DES) anesthesia and propofol-based total intravenous anesthesia (TIVA) techniques for open major upper abdominal surgery under general anesthesia (GA) is not available in the literature.This retrospective study uses our hospital database to analyze the ACT of open major upper abdominal surgery without liver resection after either desflurane/fentanyl-based anesthesia or TIVA via target-controlled infusion with fentanyl/propofol from January 2010 to December 2011. The various time intervals including waiting for anesthesia time, anesthesia time, surgical time, extubation time, exit from OR after extubation, total OR time, and postanesthetic care unit (PACU) stay time and percentage of prolonged extubation (≥15 minutes) were compared between these 2 anesthetic techniques.We included data from 343 patients, with 159 patients receiving TIVA and 184 patients receiving DES. The only significant difference is extubation time, TIVA was faster than the DES group (8.5 ± 3.8 vs 9.4 ± 3.7 minutes; P = 0.04). The factors contributed to prolonged extubation were age, gender, body mass index, DES anesthesia, and anesthesia time.In our hospital, propofol-based TIVA by target-controlled infusion provides faster emergence compared with DES anesthesia; however, it did not improve OR efficiency in open major abdominal surgery. Older, male gender, higher body mass index, DES anesthesia, and lengthy anesthesia time were factors that contribute to extubation time.

  19. CABG Surgery Remains the best Option for Patients with Left Main Coronary Disease in Comparison with PCI-DES: Meta-Analysis of Randomized Controlled Trials

    PubMed Central

    Sá, Michel Pompeu Barros Oliveira; Soares, Artur Freire; Miranda, Rodrigo Gusmão Albuquerque; Araújo, Mayara Lopes; Menezes, Alexandre Motta; Silva, Frederico Pires Vasconcelos; Lima, Ricardo Carvalho

    2017-01-01

    Objective To compare the safety and efficacy of coronary artery bypass grafting (CABG) with percutaneous coronary intervention (PCI) using drug-eluting stents (DES) in patients with unprotected left main coronary artery (ULMCA) disease. Methods MEDLINE, EMBASE, CENTRAL/CCTR, SciELO, LILACS, Google Scholar and reference lists of relevant articles were searched for clinical studies that reported outcomes at 1-year follow-up after PCI with DES and CABG for the treatment of ULMCA stenosis. Five studies fulfilled our eligibility criteria and they included a total of 4.595 patients (2.298 for CABG and 2.297 for PCI with DES). Results At 1-year follow-up, there was no significant difference between CABG and DES groups concerning the risk for death (risk ratio [RR] 0.973, P=0.830), myocardial infarction (RR 0.694, P=0.148), stroke (RR 1.224, P=0.598), and major adverse cerebrovascular and cardiovascular events (RR 0.948, P=0.680). The risk for target vessel revascularization (TVR) was significantly lower in the CABG group compared to the DES group (RR 0.583, P<0.001). It was observed no publication bias regarding the outcomes, but only the outcome TVR was free from substantial statistical heterogeneity of the effects. In the meta-regression, there was evidence that the factor "female gender" modulated the effect regarding myocardial infarction rates, favoring the CABG strategy. Conclusion CABG surgery remains the best option of treatment for patients with ULMCA disease, with lower TVR rates. PMID:29211222

  20. Developpement d'une methode calorimetrique de mesure des pertes ac pour des rubans supraconducteurs a haute temperature critique

    NASA Astrophysics Data System (ADS)

    Dolez, Patricia

    Le travail de recherche effectue dans le cadre de ce projet de doctorat a permis la mise au point d'une methode de mesure des pertes ac destinee a l'etude des supraconducteurs a haute temperature critique. Pour le choix des principes de cette methode, nous nous sommes inspires de travaux anterieurs realises sur les supraconducteurs conventionnels, afin de proposer une alternative a la technique electrique, presentant lors du debut de cette these des problemes lies a la variation du resultat des mesures selon la position des contacts de tension sur la surface de l'echantillon, et de pouvoir mesurer les pertes ac dans des conditions simulant la realite des futures applications industrielles des rubans supraconducteurs: en particulier, cette methode utilise la technique calorimetrique, associee a une calibration simultanee et in situ. La validite de la methode a ete verifiee de maniere theorique et experimentale: d'une part, des mesures ont ete realisees sur des echantillons de Bi-2223 recouverts d'argent ou d'alliage d'argent-or et comparees avec les predictions theoriques donnees par Norris, nous indiquant la nature majoritairement hysteretique des pertes ac dans nos echantillons; d'autre part, une mesure electrique a ete realisee in situ dont les resultats correspondent parfaitement a ceux donnes par notre methode calorimetrique. Par ailleurs, nous avons compare la dependance en courant et en frequence des pertes ac d'un echantillon avant et apres qu'il ait ete endommage. Ces mesures semblent indiquer une relation entre la valeur du coefficient de la loi de puissance modelisant la dependance des pertes avec le courant, et les inhomogeneites longitudinales du courant critique induites par l'endommagement. De plus, la variation en frequence montre qu'au niveau des grosses fractures transverses creees par l'endommagement dans le coeur supraconducteur, le courant se partage localement de maniere a peu pres equivalente entre les quelques grains de matiere supraconductrice qui restent fixes a l'interface coeur-enveloppe, et le revetement en alliage d'argent. L'interet d'une methode calorimetrique par rapport a la technique electrique, plus rapide, plus sensible et maintenant fiable, reside dans la possibilite de realiser des mesures de pertes ac dans des environnements complexes, reproduisant la situation presente par exemple dans un cable de transport d'energie ou dans un transformateur. En particulier, la superposition d'un courant dc en plus du courant ac habituel nous a permis d'observer experimentalement, pour la premiere fois a notre connaissance, un comportement particulier des pertes ac en fonction de la valeur du courant dc decrit theoriquement par LeBlanc. Nous avons pu en deduire la presence d'un courant d'ecrantage Meissner de 16 A, ce qui nous permet de determiner les conditions dans lesquelles une reduction du niveau de pertes ac pourrait etre obtenue par application d'un courant dc, phenomene denomme "vallee de Clem".

  1. CABG Versus PCI

    PubMed Central

    Habib, Robert H.; Dimitrova, Kamellia R.; Badour, Sanaa A.; Yammine, Maroun B.; El-Hage-Sleiman, Abdul-Karim M.; Hoffman, Darryl M.; Geller, Charles M.; Schwann, Thomas A.; Tranbaugh, Robert F.

    2017-01-01

    BACKGROUND Treatment of multivessel coronary artery disease with traditional single-arterial coronary artery bypass graft (SA-CABG) has been associated with superior intermediate-term survival and reintervention compared with percutaneous coronary intervention (PCI) using either bare-metal stents (BMS) or drug-eluting stents (DES). OBJECTIVES This study sought to investigate longer-term outcomes including the potential added advantage of multiarterial coronary artery bypass graft (MA-CABG). METHODS We studied 8,402 single-institution, primary revascularization, multivessel coronary artery disease patients: 2,207 BMS-PCI (age 66.6 ± 11.9 years); 2,381 DES-PCI (age 65.9 ± 11.7 years); 2,289 SA-CABG (age 69.3 ± 9.0 years); and 1,525 MA-CABG (age 58.3 ± 8.7 years). Patients with myocardial infarction within 24 h, shock, or left main stents were excluded. Kaplan-Meier analysis and Cox regression were used to separately compare 9-year all-cause mortality and unplanned reintervention for BMS-PCI and DES-PCI to respective propensity-matched SA-CABG and MA-CABG cohorts. RESULTS BMS-PCI was associated with worse survival than SA-CABG, especially from 0 to 7 years (p = 0.015) and to a greater extent than MA-CABG was (9-year follow-up: 76.3% vs. 86.9%; p < 0.001). The surgery-to-BMS-PCI hazard ratios (HR) were as follows: versus SA-CABG, HR: 0.87; and versus MA-CABG, HR: 0.38. DES-PCI showed similar survival to SA-CABG except for a modest 0 to 3 years surgery advantage (HR: 1.06; p = 0.615). Compared with MA-CABG, DES-PCI exhibited worse survival at 5 (86.3% vs. 95.6%) and 9 (82.8% vs. 89.8%) years (HR: 0.45; p <0.001). Reintervention was substantially worse with PCI for all comparisons (all p <0.001). CONCLUSIONS Multiarterial surgical revascularization, compared with either BMS-PCI or DES-PCI, resulted in substantially enhanced death and reintervention-free survival. Accordingly, MA-CABG represents the optimal therapy for multivessel coronary artery disease and should be enthusiastically adopted by multidisciplinary heart teams as the best evidence-based therapy. PMID:26403338

  2. Comparing performances of a CdTe X-ray spectroscopic detector and an X-ray dual-energy sandwich detector

    NASA Astrophysics Data System (ADS)

    Gorecki, A.; Brambilla, A.; Moulin, V.; Gaborieau, E.; Radisson, P.; Verger, L.

    2013-11-01

    Multi-energy (ME) detectors are becoming a serious alternative to classical dual-energy sandwich (DE-S) detectors for X-ray applications such as medical imaging or explosive detection. They can use the full X-ray spectrum of irradiated materials, rather than disposing only of low and high energy measurements, which may be mixed. In this article, we intend to compare both simulated and real industrial detection systems, operating at a high count rate, independently of the dimensions of the measurements and independently of any signal processing methods. Simulations or prototypes of similar detectors have already been compared (see [1] for instance), but never independently of estimation methods and never with real detectors. We have simulated both an ME detector made of CdTe - based on the characteristics of the MultiX ME100 and - a DE-S detector - based on the characteristics of the Detection Technology's X-Card 1.5-64DE model. These detectors were compared to a perfect spectroscopic detector and an optimal DE-S detector. For comparison purposes, two approaches were investigated. The first approach addresses how to distinguise signals, while the second relates to identifying materials. Performance criteria were defined and comparisons were made over a range of material thicknesses and with different photon statistics. Experimental measurements in a specific configuration were acquired to checks simulations. Results showed good agreement between the ME simulation and the ME100 detector. Both criteria seem to be equivalent, and the ME detector performs 3.5 times better than the DE-S detector with same photon statistics based on simulations and experimental measurements. Regardless of the photon statistics ME detectors appeared more efficient than DE-S detectors for all material thicknesses between 1 and 9 cm when measuring plastics with an attenuation signature close that of explosive materials. This translates into an improved false detection rate (FDR): DE-S detectors have an FDR 2.87±0.03-fold higher than ME detectors for 4 cm of POM with 20 000 incident photons, when identifications are screened against a two-material base.

  3. Comparaison des théories des mouvements des satellites de Saturne avec des observations de phénomènes.

    NASA Astrophysics Data System (ADS)

    Thuillot, W.; Arlot, J.-E.; Colas, F.; Berthier, J.; Vu, D. T.; Descamps, P.; Ruatti, C.

    As every fifteen years, phenomena occurred among the Saturnian system of satellites in 1995. Because the Sun and Earth passed through the equatorial plane of the planet which is close to the orbital planes of its main satellites, eclipses and occultations by Saturn occur as well as eclipses and occultations of a satellite by another. These phenomena lead to accurate astrometric observations; therefore the authors organized an international campaign to observe them. At the present time, they have collected one hundred of such mutual events and have analyzed half of them. In this preliminar analysis they got precisions of 0″048 by comparing the observed data either with the Dourneau's theory or with the Vienne and Duriez TASS theory.

  4. Proper balance of omega-3 and omega-6 fatty acid supplements with topical cyclosporine attenuated contact lens-related dry eye syndrome.

    PubMed

    Wang, Ling; Chen, Xi; Hao, Jingfang; Yang, Lu

    2016-12-01

    Essential fatty acids had been applied in the treatment of dry eye syndrome (DES), but the effects of different combinations of fatty acids have not been investigated. 360 long-term contact lens wearers were included in this double-blinded study. Omega-3 and omega-6 fatty acids were combined in different ratios and supplied to the participants that were randomly divided into six groups, and the effects of different essential fatty acids mixture on DES with or without topical cyclosporine were investigated. More than half of long-term contact lens wearers suffered from DES, which were found to be attenuated by oral supplement of properly balanced O3FA and O6FA fatty acid. The topical cyclosporine treatment considerably inhibited the production of cytokines compared to the cyclosporine negative groups, which further relieved DES. Proper balance of omega-3 and omega-6 fatty acid combination significantly alleviated contact lens-related DES.

  5. Test of a mosquito eggshell isolation method and subsampling procedure.

    PubMed

    Turner, P A; Streever, W J

    1997-03-01

    Production of Aedes vigilax, the common salt-marsh mosquito, can be assessed by determining eggshell densities found in soil. In this study, 14 field-collected eggshell samples were used to test a subsampling technique and compare eggshell counts obtained with a flotation method to those obtained by direct examination of sediment (DES). Relative precision of the subsampling technique was assessed by determining the minimum number of subsamples required to estimate the true mean and confidence interval of a sample at a predetermined confidence level. A regression line was fitted to cube-root transformed eggshell counts obtained from flotation and DES and found to be significant (P < 0.001, r2 = 0.97). The flotation method allowed processing of samples in about one-third of the time required by DES, but recovered an average of 44% of the eggshells present. Eggshells obtained with the flotation method can be used to predict those from DES using the following equation: DES count = [1.386 x (flotation count)0.33 - 0.01]3.

  6. Analyse de L'ancrage des Vortex Intergrains pour le Yttrium BARYUM(2) CUIVRE(3) OXYGENE(7) Polycristallin

    NASA Astrophysics Data System (ADS)

    Fournier, Patrick

    Le Modele de l'Etat Critique Generalise (MECG) est utilise pour decrire les proprietes magnetiques et de transport du YBa_2Cu_3O _7 polycristallin. Ce modele empirique permet de relier la densite de courant critique a la densite de lignes de flux penetrant dans la region intergrain. Deux techniques de mesures sont utilisees pour caracteriser nos materiaux. La premiere consiste a mesurer le champ au centre d'un cylindre creux en fonction du champ magnetique applique pour des temperatures comprises entre 20 et 85K. En variant l'epaisseur de la paroi du cylindre creux, il est possible de suivre l'evolution des cycles d'hysteresis et de determiner des champs caracteristiques qui varient en fonction de cette dimension. En utilisant un lissage des resultats experimentaux, nous determinons J _{co}, H_ {o} et n, les parametres du MECG. La forme des cylindres, avec une longueur comparable au diametre externe, entrai ne la presence d'un champ demagnetisant qui peut etre inclus dans le modele theorique. Ceci nous permet d'evaluer la fraction du volume ecrante, f _{g}, ainsi que le facteur demagnetisant N. Nous trouvons que J_{ co}, H_{o} et f_{g} dependent de la temperature, tandis que n et N (pour une epaisseur de paroi fixe) n'en dependent pas. La deuxieme technique consiste a mesurer le courant critique de lames minces en fonction du champ applique pour differentes temperatures. Nous utilisons un montage que nous avons developpe permettant d'effectuer ces mesures en contact direct avec le liquide refrigerant, i.e. dans l'azote liquide. Nous varions la temperature du liquide en variant la pression du gaz au-dessus du bain d'azote. Cette methode nous permet de balayer des temperatures entre 65K et la temperature critique du materiau ({~ }92K). Nous effectuons le lissage des courbes de courant critique en fonction du champ applique encore a l'aide du MECG, pour a nouveau obtenir ses parametres. Pour trois echantillons avec des traitements thermiques differents, les parametres sont differents confirmant que la variation des proprietes macroscopiques de ces supraconducteurs est intimement reliee a la nature des jonctions entre les grains et de la surface des grains. L'oxygenation prolongee retablit les proprietes initiales des echantillons qui se sont degrades durant le recuit des contacts.

  7. Production technology optimization of biscuit baked by electric-contact way

    NASA Astrophysics Data System (ADS)

    Sidorenko, G. A.; Popov, V. P.; Khanina, T. V.; Maneeva, E. Sh; Krasnova, M. S.

    2018-03-01

    Electric-contact way of baking allows one to maintain more nutrients used in biscuit making. As a result of the biscuit production technology optimization, it is established that 30-62,5% is an optimal amount of starch brought instead of flour; 184-200% is optimal amount of egg melange; at this a complex indicator of organoleptic properties will be more than 340 degrees, a complex indicator of physical and chemical properties will be more than 3,3 degrees, and specific costs of energy spent on the biscuit electric-contact baking process will be less than 100 W/kg.

  8. Reconnaissance bedrock geology of the southeastern part of the Kenai quadrangle, Alaska: A section in Geologic studies in Alaska by the U.S. Geological Survey, 1998

    USGS Publications Warehouse

    Bradley, Dwight C.; Wilson, Frederic H.

    2000-01-01

    We present a new reconnaissance geologic map of the southeastern part of the Kenai quadrangle that improves on previously published maps. Melange of the McHugh Complex is now known to form a continuous strike belt that can be traced from the Seldovia to the Valdez quadrangle; a problematic 75-km-long gap in the McHugh Complex in the Kenai and Seldovia quadrangles does not exist. An Eocene near-trench pluton underlies a range of nunataks in Harding Icefield.

  9. Management of Heat and Cold Stress -- Guidance to NATO Medical Personnel (Gestion des contraintes thermiques (chaleur et froid) Conseils aux personnels medicaux de I’OTAN)

    DTIC Science & Technology

    2013-12-01

    de la performance de leurs troupes; b) d’importants écarts scientifiques / de capacités existent en ce qui concerne la susceptibilité, le... La HFM/RTG-187 avait pour but de : a) comparer et évaluer les ressources techniques qui sont actuellement utilisées pour un « système de gestion des ...d’une doctrine et de programmes d’enseignement intégrés pour la gestion des risques thermiques afin de garantir le maintien

  10. Apport de l’IRM dans la prise en charge des compressions médullaires lentes non traumatiques

    PubMed Central

    Badji, Nfally; Deme, Hamidou; Akpo, Geraud; Ndong, Boucar; Toure, Mouhamadou Hamine; Diop, Sokhna Ba; Niang, El Hadji

    2016-01-01

    Les compressions médullaires lentes sont dues au développement dans le canal médullaire d’une lésion expansive. C’est une pathologie très fréquente dont le diagnostic est essentiellement clinique. L’imagerie par résonnance magnétique occupe une place incontournable dans le diagnostic de localisation et la recherche étiologique. En Europe l’étiologie tumorale est prépondérante. Le but de cette étude était de décrire les aspects IRM des compressions médullaires lentes et de déterminer le profil étiologique. Il s’agit d’une étude rétrospective portant sur 97 observations colligées au service de radiologie du CHUN de Fann sur une période de 30 mois (du 08/03/10 au 29/09/12). On été inclus dans l’étude, tous les patients adressés pour un tableau de compression médullaire lente survenu dans un contexte non traumatique. L’âge moyen des patients était de 42,6 ans avec des extrêmes compris entre 04 mois et 85 ans. Nous avons étudié la topographie des lésions (étage rachidien, compartiments canalaires) leur rehaussement et les critères d’orientation étiologique. Le protocole d’examen permettait la réalisation de séquence pondérées T1 sans avec injection de gado, T2, STIR et T2 DRIVE centrées sur les niveaux lésionnels ou les zones suspectes. L’IRM a permis de préciser le siège exact et l’étendue des lésions. L’atteinte du rachis dorsal représentait 42% des cas, suivi du rachis cervical avec 32% des cas. Les atteintes lombo-sacrées et pluri-étagées représentaient respectivement 18% et 08% des cas. Les lésions extradurales représentaient 87% des cas, suivi des lésions intradurales extramédullaires avec 08% des cas et des lésions intramédullaires dans 05% des cas. La particularité du profil étiologique de notre étude est la prédominance des épidurites infectieuses et la fréquence relative des épidurites métastatiques comparée aux séries occidentales. L’IRM vertébro-médullaire occupe une place capitale dans le diagnostic positif, topographique et étiologique des compressions médullaires. PMID:27800076

  11. Everolimus-Eluting Stents in Patients With Bare-Metal and Drug-Eluting In-Stent Restenosis: Results From a Patient-Level Pooled Analysis of the RIBS IV and V Trials.

    PubMed

    Alfonso, Fernando; Pérez-Vizcayno, María José; García Del Blanco, Bruno; García-Touchard, Arturo; López-Mínguez, José-Ramón; Masotti, Mónica; Zueco, Javier; Melgares, Rafael; Mainar, Vicente; Moreno, Raul; Domínguez, Antonio; Sanchís, Juan; Bethencourt, Armando; Moreu, José; Cequier, Angel; Martí, Vicens; Otaegui, Imanol; Bastante, Teresa; Gonzalo, Nieves; Jiménez-Quevedo, Pilar; Cárdenas, Alberto; Fernández, Cristina

    2016-07-01

    Treatment of patients with drug-eluting stent (DES) in-stent restenosis (ISR) is more challenging than that of patients with bare-metal stent ISR. However, the results of everolimus-eluting stents (EES) in these distinct scenarios remain unsettled. A pooled analysis of the RIBS IV (Restenosis Intra-Stent of Drug-Eluting Stents: Paclitaxel-Eluting Balloon vs Everolimus-Eluting Stent) and RIBS V (Restenosis Intra-Stent of Bare Metal Stents: Paclitaxel-Eluting Balloon vs Everolimus-Eluting Stent) randomized trials was performed using patient-level data to compare the efficacy of EES in bare-metal stent ISR and DES-ISR. Inclusion and exclusion criteria were identical in both trials. Results of 94 patients treated with EES for bare-metal stent ISR were compared with those of 155 patients treated with EES for DES-ISR. Baseline characteristics were more adverse in patients with DES-ISR, although they presented later and more frequently with a focal pattern. After intervention, minimal lumen diameter (2.22±0.5 versus 2.38±0.5 mm, P=0.01) was smaller in the DES-ISR group. Late angiographic findings (89.3% of eligible patients), including minimal lumen diameter (2.03±0.7 versus 2.36±0.6 mm, P<0.001) and diameter stenosis (23±22 versus 13±17%, P<0.001) were poorer in patients with DES-ISR. Results were consistent in the in-segment and in-lesion analyses. On multiple linear regression analysis, minimal lumen diameter at follow-up remained significantly smaller in patients with DES-ISR. Finally, at 1-year clinical follow-up (100% of patients), mortality (2.6 versus 0%, P<0.01) and need for target vessel revascularization (8 versus 2%, P=0.03) were higher in the DES-ISR group. This patient-level pooled analysis of the RIBS IV and RIBS V randomized clinical trials suggests that EES provide favorable outcomes in patients with ISR. However, the results of EES are less satisfactory in patients with DES-ISR than in those with bare-metal stent ISR. URL: http://www.clinicaltrials.gov. Unique identifiers: NCT01239953 and NCT01239940. © 2016 American Heart Association, Inc.

  12. L'Infection Nosocomiale en Reanimation des Brules

    PubMed Central

    Siah, S.; Belefqih, R.; Elouennass, M.; Fouadi, F.E.; Ihrai, I.

    2009-01-01

    Summary L'infection nosocomiale bactérienne étant l'une des principales causes de morbidité et de mortalité chez le brûlé, nous avons réalisé une étude rétrospective portant sur 84 patients hospitalisés au sein du service de réanimation des brûlés de l'Hôpital Militaire d'Instruction Mohammed V de Rabat, sur une période de 3 ans, du premier janvier 2001 au 31 décembre 2003. Les critères d'infection nosocomiale étaient ceux du Center for Disease Control d'Atlanta de 1988. Les taux d'incidence ont été calculés. La population infectée a été comparée à celle non infectée. L'écologie bactérienne du service a été décrite comme aussi l'antibiotype. Il ressort de cette étude la survenue de 87 infections nosocomiales chez 27 patients. L'incidence cumulative était de 103 infections pour 1000 jours de traitement. Pour ce qui est des caractéristiques des infections bactériennes, les sites infectés étaient la peau (77%), le sang (13,8%), les voies urinaires (8%) et les poumons (1,1%). Les principaux germes étaient: Staphylococcus sp. (33,3%), Pseudomonas aeruginosa (23%), Enterococcus faecalis et Acinetobacter (8%). Les staphylocoques étaient méticillo-résistants dans 22,2% des cas. Le Pseudomonas et l'Acinetobacter étaient multirésistants (60%). Dans notre étude les facteurs prédictifs de survenue des infections nosocomiales que nous avons retenus après l'étude comparative des populations infectées et non infectées ont été l'âge, le body mass index, l'abbreviated burn severity index et le remplissage initial. En isolant ces paramètres, nous avons pu établir une équation à valeur prédictive de survenue d'infection nosocomiale chez le patient brûlé. PMID:21991158

  13. Decreased Desmin expression in the developing diaphragm of the nitrofen-induced congenital diaphragmatic hernia rat model.

    PubMed

    Takahashi, Toshiaki; Friedmacher, Florian; Zimmer, Julia; Puri, Prem

    2016-12-01

    Congenital diaphragmatic hernia (CDH) is presumed to originate from defects in the primordial diaphragmatic mesenchyme, mainly comprising of muscle connective tissue (MCT). Thus, normal diaphragmatic morphogenesis depends on the structural integrity of the underlying MCT. Developmental mutations that inhibit normal formation of diaphragmatic MCT have been shown to result in CDH. Desmin (DES) is a major filament protein in the MCT, which is essential for the tensile strength of the developing diaphragm muscle. DES -/- knockout mice exhibit significant reductions in stiffness and elasticity of the developing diaphragmatic muscle tissue. Furthermore, sequence changes in the DES gene have recently been identified in human cases of CDH, suggesting that alterations in DES expression may lead to diaphragmatic defects. This study was designed to investigate the hypothesis that diaphragmatic DES expression is decreased in fetal rats with nitrofen-induced CDH. Time-mated Sprague-Dawley rats were exposed to either nitrofen or vehicle on gestational day 9 (D9). Fetuses were harvested on selected time-points D13, D15 and D18, and dissected diaphragms (n = 72) were divided into control and nitrofen-exposed specimens (n = 12 per time-point and experimental group, respectively). Laser-capture microdissection was used to obtain diaphragmatic tissue elements. Diaphragmatic gene expression of DES was analyzed by quantitative real-time polymerase chain reaction. Immunofluorescence double staining for DES was combined with the mesenchymal marker GATA4 to evaluate protein expression and localization in developing fetal diaphragms. Relative mRNA expression levels of DES were significantly decreased in pleuroperitoneal folds on D13 (1.49 ± 1.79 vs. 3.47 ± 2.32; p < 0.05), developing diaphragms on D15 (1.49 ± 1.41 vs. 3.94 ± 3.06; p < 0.05) and fully muscularized diaphragms on D18 (2.45 ± 1.47 vs. 5.12 ± 3.37; p < 0.05) of nitrofen-exposed fetuses compared to controls. Confocal laser scanning microscopy demonstrated markedly diminished immunofluorescence of DES mainly in diaphragmatic MCT, which was associated with a reduction of proliferating mesenchymal cells in nitrofen-exposed fetuses on D13, D15 and D18 compared to controls. Decreased expression of DES in the fetal diaphragm may disturb the basic integrity of myofibrils and the cytoskeletal network during myogenesis, causing malformed MCT and leading to diaphragmatic defects in the nitrofen-induced CDH model.

  14. Alcohol based-deep eutectic solvent (DES) as an alternative green additive to increase rotenone yield

    NASA Astrophysics Data System (ADS)

    Othman, Zetty Shafiqa; Hassan, Nur Hasyareeda; Zubairi, Saiful Irwan

    2015-09-01

    Deep eutectic solvents (DESs) are basically molten salts that interact by forming hydrogen bonds between two added components at a ratio where eutectic point reaches a melting point lower than that of each individual component. Their remarkable physicochemical properties (similar to ionic liquids) with remarkable green properties, low cost and easy handling make them a growing interest in many fields of research. Therefore, the objective of pursuing this study is to analyze the potential of alcohol-based DES as an extraction medium for rotenone extraction from Derris elliptica roots. DES was prepared by a combination of choline chloride, ChCl and 1, 4-butanediol at a ratio of 1/5. The structure of elucidation of DES was analyzed using FTIR, 1H-NMR and 13C-NMR. Normal soaking extraction (NSE) method was carried out for 14 hours using seven different types of solvent systems of (1) acetone; (2) methanol; (3) acetonitrile; (4) DES; (5) DES + methanol; (6) DES + acetonitrile; and (7) [BMIM] OTf + acetone. Next, the yield of rotenone, % (w/w), and its concentration (mg/ml) in dried roots were quantitatively determined by means of RP-HPLC. The results showed that a binary solvent system of [BMIM] OTf + acetone and DES + acetonitrile was the best solvent system combination as compared to other solvent systems. It contributed to the highest rotenone content of 0.84 ± 0.05% (w/w) (1.09 ± 0.06 mg/ml) and 0.84 ± 0.02% (w/w) (1.03 ± 0.01 mg/ml) after 14 hours of exhaustive extraction time. In conclusion, a combination of the DES with a selective organic solvent has been proven to have a similar potential and efficiency as of ILs in extracting bioactive constituents in the phytochemical extraction process.

  15. Prenatal diethylstilbestrol exposure and reproductive hormones in premenopausal women.

    PubMed

    Wise, L A; Troisi, R; Hatch, E E; Titus, L J; Rothman, K J; Harlow, B L

    2015-06-01

    Diethylstilbestrol (DES), a synthetic estrogen widely prescribed to pregnant women in the mid-1900s, is a potent endocrine disruptor. Prenatal DES exposure has been associated with reproductive disorders in women, but little is known about its effects on endogenous hormones. We assessed the association between prenatal DES exposure and reproductive hormones among participants from the Harvard Study of Moods and Cycles (HSMC), a longitudinal study of premenopausal women aged 36-45 years from Massachusetts (1995-1999). Prenatal DES exposure was reported at baseline (43 DES exposed and 782 unexposed). Early follicular-phase concentrations of follicle-stimulating hormone (FSH), luteinizing hormone (LH) and estradiol were measured at baseline and every 6 months during 36 months of follow-up. Inhibin B concentrations were measured through 18 months. We used multivariable logistic and repeated-measures linear regression to estimate odds ratios (OR) and percent differences in mean hormone values (β), respectively, comparing DES exposed with unexposed women, adjusted for potential confounders. DES-exposed women had lower mean concentrations of estradiol (pg/ml) (β=-15.6%, 95% confidence interval (CI): -26.5%, -3.2%) and inhibin B (pg/ml) (β=-20.3%, CI: -35.1%, -2.3%), and higher mean concentrations of FSH (IU/I) (β=12.2%, CI: -1.5%, 27.9%) and LH (IU/I) (β=10.4%, CI: -7.2%, 31.3%), than unexposed women. ORs for the association of DES with maximum FSH>10 IU/I and minimum inhibin B<45 pg/ml--indicators of low ovarian reserve--were 1.90 (CI: 0.86, 4.22) and 4.00 (CI: 0.88-18.1), respectively. Prenatal DES exposure was associated with variation in concentrations of FSH, estradiol and inhibin B among women of late reproductive age.

  16. Evaluation de la qualite osseuse par les ondes guidees ultrasonores =

    NASA Astrophysics Data System (ADS)

    Abid, Alexandre

    La caracterisation des proprietes mecaniques de l'os cortical est un domaine d'interet pour la recherche orthopedique. En effet, cette caracterisation peut apporter des informations primordiales pour determiner le risque de fracture, la presence de microfractures ou encore depister l'osteoporose. Les deux principales techniques actuelles de caracterisation de ces proprietes sont le Dual-energy X-ray Absorptiometry (DXA) et le Quantitative Computed Tomogaphy (QCT). Ces techniques ne sont pas optimales et presentent certaines limites, ainsi l'efficacite du DXA est questionnee dans le milieu orthopedique tandis que le QCT necessite des niveaux de radiations problematiques pour en faire un outil de depistage. Les ondes guidees ultrasonores sont utilisees depuis de nombreuses annees pour detecter les fissures, la geometrie et les proprietes mecaniques de cylindres, tuyaux et autres structures dans des milieux industriels. De plus, leur utilisation est plus abordable que celle du DXA et n'engendrent pas de radiation ce qui les rendent prometteuses pour detecter les proprietes mecaniques des os. Depuis moins de dix ans, de nombreux laboratoires de recherche tentent de transposer ces techniques au monde medical, en propageant les ondes guidees ultrasonores dans les os. Le travail presente ici a pour but de demontrer le potentiel des ondes guidees ultrasonores pour determiner l'evolution des proprietes mecaniques de l'os cortical. Il commence par une introduction generale sur les ondes guidees ultrasonores et une revue de la litterature des differentes techniques relatives a l'utilisation des ondes guidees ultrasonores sur les os. L'article redige lors de ma maitrise est ensuite presente. L'objectif de cet article est d'exciter et de detecter certains modes des ondes guides presentant une sensibilite a la deterioration des proprietes mecaniques de l'os cortical. Ce travail est realise en modelisant par elements finis la propagation de ces ondes dans deux modeles osseux cylindriques. Ces deux modeles sont composes d'une couche peripherique d'os cortical et remplis soit d'os trabeculaire soit de moelle osseuse. Ces deux modeles permettent d'obtenir deux geometries, chacune propice a la propagation circonferentielle ou longitudinale des ondes guidees. Les resultats, ou trois differents modes ont pu etre identifies, sont compares avec des donnees experimentales obtenues avec des fantomes osseux et theoriques. La sensibilite de chaque mode pour les differents parametres des proprietes mecaniques est alors etudiee ce qui permet de conclure sur le potentiel de chaque mode quant a la prediction de risque de fracture ou de presence de microfractures.

  17. Comparison of neointimal hyperplasia with drug-eluting stents versus bare metal stents in patients undergoing intracoronary bone-marrow mononuclear cell transplantation following acute myocardial infarction.

    PubMed

    Villa, Adolfo; Arnold, Roman; Sánchez, Pedro L; Gimeno, Federico; Ramos, Benigno; Cantero, Teresa; Fernández, Maria Eugenia; Sanz, Ricardo; Gutiérrez, Oliver; Mota, Pedro; García-Frade, Javier; San Román, José Alberto; Fernández-Avilés, Francisco

    2009-06-15

    The aims of this study were to assess the safety of drug-eluting stent (DES) use and to compare the incidence of in-stent restenosis (ISR) and neointimal hyperplasia formation according to the type of stent implanted (DES vs bare-metal stents [BMS]) in patients who underwent intracoronary bone marrow mononuclear cell transplantation after acute ST elevation myocardial infarction. Fifty-nine patients with successfully revascularized ST elevation myocardial infarction (37 using BMS and 22 using DES) underwent paired angiographic examinations at baseline and 6 to 9 months after the intracoronary injection of 91 million +/- 56 million autologous bone marrow mononuclear cells. A subgroup of 30 patients also underwent serial intravascular ultrasound examinations. Off-line angiographic assessment showed 4 cases of binary ISR, primarily in BMS (3 cases), and no major adverse cardiac events were associated with stent type (mean follow-up period 41 +/- 10 months). At follow-up, angiographic late luminal loss was significantly lower in patients with DES than in those patients with BMS (0.35 +/- 0.66 vs 0.71 +/- 0.38 mm, p = 0.011). Multivariate analysis identified the use of DES (beta = -0.32, 95% confidence interval [CI] -0.57 to -0.26, p = 0.03) and a smaller baseline reference vessel diameter (beta = 0.29, 95% CI 0.04 to 0.54, p = 0.02) as independent predictors of lower late loss. Moreover, intravascular ultrasound showed a significant reduction of in-stent neointimal hyperplasia formation related to DES use compared with BMS use (Delta neointimal hyperplasia volume 5.4 mm(3) [95% CI 2.7 to 28.1] vs 35.9 mm(3) [95% CI 22.0 to 43.6], p = 0.035). In conclusion, these findings suggest that the use of DES is safe and may prevent ISR and neointimal hyperplasia formation in patients who undergo intracoronary bone marrow mononuclear cell transplantation after a successfully revascularized ST elevation myocardial infarction.

  18. Drug-eluting stents versus bare-metal stents for off-label indications: a propensity score-matched outcome study.

    PubMed

    Austin, David; Oldroyd, Keith G; McConnachie, Alex; Slack, Rachel; Eteiba, Hany; Flapan, Andrew D; Jennings, Kevin P; Northcote, Robin J; Pell, Alastair C H; Starkey, Ian R; Pell, Jill P

    2008-08-01

    The US Food and Drug Administration recently concluded that data on off-label drug-eluting stent (DES) safety are limited. However, in actual clinical practice, DES are often used for off-label indications, and observational studies demonstrate that complications are higher when compared with on-label use. We aimed to determine whether clinical outcomes differ after DES and bare-metal stent implantation in a patient cohort defined by DES off-label indications. We used the national revascularization registry in Scotland to identify patients who underwent coronary stenting for an off-label indication between January 2003 and September 2005. Individual-level linkage to comprehensive national admission and death databases was used to ascertain the end points of death, myocardial infarction, and target-vessel revascularization. We calculated propensity scores on the basis of clinical, demographic, and angiographic variables and matched DES to bare-metal stents on a 1:1 basis. The final study population consisted of 1642 patients, well matched for important covariables at baseline. Event-free survival was calculated over 24 months with the Kaplan-Meier method. All-cause death was more common after bare-metal stent implantation during follow-up (7.7% versus 6.6%; hazard ratio 0.63; 95% confidence interval, 0.40 to 0.99; P=0.04). No difference in the rates of myocardial infarction were noted (7.3% versus 7.5%; hazard ratio 1.02; 95% confidence interval, 0.69 to 1.54; P=0.92). Target-vessel revascularization was reduced in patients treated with DES (13.9% versus 10.7%; hazard ratio 0.67; 95% confidence interval, 0.49 to 0.93; P=0.02). At 24 months, patients treated with DES for off-label indications had lower rates of death and target-vessel revascularization and similar rates of myocardial infarction, as compared with patients treated with bare-metal stents.

  19. Improved outcomes of elderly patients treated with drug-eluting versus bare metal stents in large coronary arteries: results from the BAsel Stent Kosten-Effektivitäts Trial PROspective Validation Examination randomized trial.

    PubMed

    Kurz, David J; Bernheim, Alain M; Tüller, David; Zbinden, Rainer; Jeger, Raban; Kaiser, Christoph; Galatius, Soeren; Hansen, Kim W; Alber, Hannes; Pfisterer, Matthias; Eberli, Franz R

    2015-10-01

    Drug-eluting stents (DES) improve outcomes in elderly patients with small coronary artery disease compared with bare-metal stents (BMS), but randomized data in elderly patients in need of large coronary stents are not available. Planned secondary analysis of patients ≥75 years recruited to the "BASKET-PROVE" trial, in which 2,314 patients undergoing percutaneous coronary intervention for large (≥3.0 mm) native vessel disease were randomized 2:1 to DES (everolimus- vs sirolimus-eluting stents 1:1) versus BMS. All patients received 12 months of dual antiplatelet therapy. The primary end point was a composite of cardiac death or nonfatal myocardial infarction at 2 years. Comparison of DES versus BMS among 405 patients ≥75 years showed significantly lower rates of the primary end point for DES (5.0% vs 11.6%; hazard ration (HR) 0.64 [0.44-0.91]; P = .014). Rates of nonfatal myocardial infarction (1.2% vs 5.5%, hazard ration (HR) 0.44 [0.21-0.83]; P = .009), all-cause death (7.4% vs 14.4%; HR 0.7 [0.51-0.95]; P = .02), and target vessel revascularization (TVR) (2.3% vs 6.2%; HR 0.59 [0.34-0.99]; P = .046) were also lower, whereas stent thrombosis and bleeding rates were similar. In contrast, among patients <75 years (n = 1,909), the only significant benefit of DES was a reduced rate of TVR (4.0% vs 8.7%, HR 0.66 [0.55-0.80]; P < .0001). In patients ≥75 years requiring large (≥3.0 mm) coronary stents, use of DES was beneficial compared with BMS and reduced the rate of ischemic events, mortality, and TVR. These data suggest that DES should be preferred over BMS in elderly patients. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. A new polymer-free drug-eluting stent with nanocarriers eluting sirolimus from stent-plus-balloon compared with bare-metal stent and with biolimus A9 eluting stent in porcine coronary arteries

    PubMed Central

    Galon, Micheli Z.; Gutierrez, Paulo S.; Sojitra, Prakash; Vyas, Ashwin; Doshi, Manish; Lemos, Pedro A.

    2015-01-01

    Background Permanent polymers in first generation drug-eluting stent (DES) have been imputed to be a possible cause of persistent inflammation, remodeling, malapposition and late stent thrombosis. We aim to describe the in vivo experimental result of a new polymer-free DES eluting sirolimus from stent-plus-balloon (Focus np stent, Envision Scientific) compared with a bare-metal stent (BMS) (Amazonia CroCo, Minvasys) and with a biolimus A9 eluting stent (Biomatrix, Biosensors). Methods In 10 juvenile pigs, 23 coronary stents were implanted in the coronary arteries (8 Amazonia CroCo, 8 Focus np, and 7 Biomatrix). At 28-day follow-up, optical coherence tomography (OCT) and histology were used to evaluate neointimal hyperplasia and healing response. Results According to OCT analysis, Focus np stents had a greater lumen area and less neointimal hyperplasia response than BMS and Biomatrix had. Histomorphometry results showed less neointimal hyperplasia in Focus np than in BMS. Histology showed a higher fibrin deposition in Biomatrix stent compared to Focus np and BMS. Conclusions The new polymer-free DES with sirolimus eluted from stent-plus-balloon demonstrated safety and reduced neointimal proliferation compared with the BMS and Biomatrix stents at 28-day follow-up in this porcine coronary model. This new polymer-free DES is promising and warrants further clinical studies. PMID:25984451

  1. Dysfunctional elimination symptoms in childhood and adulthood.

    PubMed

    Bower, W F; Yip, S K; Yeung, C K

    2005-10-01

    The dysfunctional elimination syndrome (DES) is rare in adulthood. We evaluate the natural history of DES to identify aspects of the disorder that may be carried into adulthood. A 2-part questionnaire was devised and self-administered to 191 consecutive women attending a urogynecological clinic (UG) and to 251 normal women. The first section asked for recall of childhood symptoms known to be associated with DES, while the lat-ter section explored current bladder and bowel problems. Data sets from the normal cohort (55) reporting current bladder problems were excluded. Descriptive statistics, chi-square and Mann-Whitney-U tests were used to compare variables. UG patients had significantly higher childhood DES scores than normal women. Overall 41.7% of UG patients could be labeled as having dysfunctional elimination as an adult. Symptoms reported significantly more often in childhood by UG patients than by control women were frequent urinary tract infection, vesicoureteral reflux, frequency, urge incontinence, slow and intermittent urine flow, small volume high urge voids, hospitalization for constipation, frequent fecal soiling and nocturnal enuresis. Higher DES scores correlated significantly with current adult urgency, urge leak, stress incontinence, incomplete emptying, post-void leak, hesitancy, nocturia and nocturnal enuresis. Constipation and fecal incontinence in adulthood also showed a significant association with high DES scores. Logistic regression revealed childhood urgency to be associated with adult DES. Childhood lower urinary tract dysfunction may have a negative impact on bladder and bowel function later life.

  2. Etude de l'amelioration de la qualite des anodes par la modification des proprietes du brai

    NASA Astrophysics Data System (ADS)

    Bureau, Julie

    La qualite des anodes produites se doit d'etre bonne afin d'obtenir de l'aluminium primaire tout en reduisant le cout de production du metal, la consommation d'energie et les emissions environnementales. Or, l'obtention des proprietes finales de l'anode necessite une liaison satisfaisante entre le coke et le brai. Toutefois, la matiere premiere actuelle n'assure pas forcement la compatibilite entre le coke et le brai. Une des solutions les plus prometteuses, pour ameliorer la cohesion entre ces deux materiaux, est la modification des proprietes du brai. L'objectif de ce travail consiste a modifier les proprietes du brai par l'ajout d'additifs chimiques afin d'ameliorer la mouillabilite du coke par le brai modifie pour produire des anodes de meilleure qualite. La composition chimique du brai est modifiee en utilisant des tensioactifs ou agents de modification de surface choisis dans le but d'enrichir les groupements fonctionnels susceptibles d'ameliorer la mouillabilite. L'aspect economique, l'empreinte environnementale et l'impact sur la production sont consideres dans la selection des additifs chimiques. Afin de realiser ce travail, la methodologie consiste a d'abord caracteriser les brais non modifies, les additifs chimiques et les cokes par la spectroscopie infrarouge a transformee de Fourier (FTIR) afin d'identifier les groupements chimiques presents. Puis, les brais sont modifies en ajoutant un additif chimique afin de possiblement modifier ses proprietes. Differentes quantites d'additif sont ajoutees afin d'examiner l'effet de la variation de la concentration sur les proprietes du brai modifie. La methode FTIR permet d'evaluer la composition chimique des brais modifies afin de constater si l'augmentation de la concentration d'additif enrichit les groupements fonctionnels favorisant l'adhesion coke/brai. Ensuite, la mouillabilite du coke par le brai est observee par la methode goutte- sessile. Une amelioration de la mouillabilite par la modification a l'aide d'un additif chimique signifie une possible amelioration de l'interaction entre le coke et le brai modifie. Afin de completer l'evaluation des donnees recueillies, les resultats de la FTIR et de la mouillabilite sont analyses par le reseau neuronal artificiel afin de mieux comprendre les mecanismes sous-jacents. A la lumiere des resultats obtenus, les additifs chimiques les plus prometteurs sont selectionnes afin de verifier l'effet de leur utilisation sur la qualite des anodes. Pour ce faire, des anodes de laboratoire sont produites en utilisant des brais non modifies et des brais modifies avec les additifs chimiques selectionnes. Par la suite, les anodes sont carottees afin de les caracteriser en determinant certaines de leurs proprietes physiques et chimiques. Enfin, les resultats des echantillons d'anodes faites d'un meme brai non modifie et modifie sont compares afin d'evaluer l'amelioration de la qualite des anodes. Finalement, un examen de l'impact possible de l'utilisation d'un additif chimique pour modifier le brai sur la consommation energetique et en carbone ainsi que la quantite d'aluminium produit est realise. Afin de modifier le brai, trois differents additifs chimiques sont selectionnes, soit un tensioactif et deux agents de modification de surface. L'analyse FTIR des experimentations menees sur les brais modifies demontre que deux additifs ont modifie la composition chimique des brais experimentes. L'analyse des resultats des tests goutte-sessile laisse supposer qu'un brai modifie par ces deux additifs ameliore possiblement l'interaction avec les cokes employes dans cette etude. L'analyse par reseau neuronal artificiel des donnees recueillies permet de mieux comprendre le lien entre la composition chimique d'un brai et sa capacite de mouillabilite avec un coke. La caracterisation des echantillons d'anodes produites permet d'affirmer que ces deux additifs peuvent ameliorer certaines des proprietes anodiques comparativement aux echantillons standards. L'analyse des resultats demontre que l'un des deux additifs semble donner des resultats plus prometteurs. Au final, les travaux realises au cours de ce projet demontrent qu'il est possible d'ameliorer la qualite anodique en modifiant les proprietes du brai. De plus, l'analyse des resultats obtenus fournit une meilleure comprehension des mecanismes entre un brai et un additif chimique.

  3. Rational use of drug-eluting stents: a comparison of different policies.

    PubMed

    Remmel, Marko; Hartmann, Franz; Harland, Lars C; Schunkert, Heribert; Radke, Peter W

    2007-06-01

    Long-term results of recent landmark trials document both benefits and risks of drug-eluting stents (DES) for coronary revascularization. Interestingly, the conclusions drawn from these data vary widely since significant differences in DES penetration rates become obvious when the utilization of this technology is compared between hospitals or even countries. Based on the recommendations of the European Society of Cardiology, the FDA as well as data derived from the BASKET-LATE study, we propose that a maximum penetration rate of 50% for DES seems appropriate at present. Analysis of the length/diameter distribution combined with the use of validated restenosis reference charts allows identification of high-risk patients regarding restenosis risk and modeling the use of DES depending on financial resources and clinical indication. Such algorithm provides the rational for preprocedural risk stratification and efficient use of resources.

  4. Long term outcomes of new generation drug eluting stents versus coronary artery bypass grafting for multivessel and/or left main coronary artery disease. A Bayesian network meta-analysis of randomized controlled trials.

    PubMed

    Mina, George S; Watti, Hussam; Soliman, Demiana; Shewale, Anand; Atkins, Jessica; Reddy, Pratap; Dominic, Paari

    2018-01-05

    Most data guiding revascularization of multivessel disease (MVD) and/or left main disease (LMD) favor coronary artery bypass grafting (CABG) over percutaneous coronary intervention (PCI). However, those data are based on trials comparing CABG to bare metal stents (BMS) or old generation drug eluting stents (OG-DES). Hence, it is essential to outcomes of CABG to those of new generation drug eluting stents (NG-DES). We searched PUBMED and Cochrane database for trials evaluating revascularization of MVD and/or LMD with CABG and/or PCI. A Bayesian network meta-analysis was performed to calculate odds ratios (OR) and 95% credible intervals (CrI). Primary outcome was major adverse cardiovascular events (MACE) at 3-5 years. Secondary outcomes were mortality, cerebrovascular accidents (CVA), myocardial infarction (MI) and repeat revascularization. We included 10 trials with a total of 9287 patients. CABG was associated with lower MACE when compared to BMS or OG-DES. However, MACE was not significantly different between CABG and NG-DES (OR 0.79, CrI 0.45-1.40). Moreover, there were no significant differences between CABG and NG-DES in mortality (OR 0.78, CrI 0.45-1.37), CVA (OR 0.93 CrI 0.35-2.2) or MI (OR 0.6, CrI 0.17-2.0). On the other hand, CABG was associated with lower repeat revascularization (OR 0.55, CrI 0.36-0.84). Our study suggests that NG-DES is an acceptable alternative to CABG in patients with MVD and/or LMD. However, repeat revascularization remains to be lower with CABG than with PCI. Copyright © 2018. Published by Elsevier Inc.

  5. Significantly lower incidence of early definite stent thrombosis of drug-eluting stents after unrestricted use in Japan using ticlopidine compared to western countries using clopidogrel: a retrospective comparison with western mega-studies.

    PubMed

    Ishikawa, Tetsuya; Nakano, Yosuke; Endoh, Akira; Kubota, Takeyuki; Suzuki, Teruhiko; Nakata, Koutarou; Miyamoto, Takashi; Murakami, Michiaki; Sakamoto, Hiroshi; Imai, Kamon; Mochizuki, Seibu; Yoshimura, Michihiro; Mutoh, Makoto

    2009-10-01

    The incidence of definite stent thrombosis (ST) after use of drug-eluting stents (DES), as defined by the Academic Research Consortium, is known to be lower in Japan than in western countries. However, a statistical difference in the incidence of early definite ST (EDST) associated with the unrestricted use of DES has not yet been documented. Therefore, the incidence of EDST in our Japanese institute after unrestricted use of DES was retrospectively compared with those reported in western mega-studies. During the 40 months from August 2004 to November 2007 (before approval of clopidogrel in Japan), DES were implanted in 3605 lesions in 1885 patients in our institute; lesion- and patient-associated percentages of DES use were 95.2% and 94.7%, respectively. Mean stent length per lesion was 33.2 mm, emergent procedures and ST-elevation myocardial infarctions made up 33.7% and 16.4% of the procedures, respectively, intravascular ultrasonography was used 96.0% of the time, a distal protection device for acute coronary syndrome was used 68.7% of the time, and the mean maximum inflation pressure was 19.5 atm. EDST was observed in five lesions (0.139%) in four patients (0.212%). The incidence of patient-associated EDST at our center was significantly lower than in four western mega-studies (0.736%, 66 of 8970 patients; 0.634%, 149 of 23,500; 0.595%, 52 of 8402; 0.997%, 20 of 2006) (p<0.05, <0.01, <0.05, <0.01, respectively, using a chi(2)-test). Due to differences in procedural approaches in Japan, the incidence of EDST after unrestricted use of DES was significantly lower than in western countries.

  6. Tracheal Self-Expandable Metallic Stents: A Comparative Study of Three Different Stents in a Rabbit Model.

    PubMed

    Serrano, Carolina; Lostalé, Fernando; Rodríguez-Panadero, Francisco; Blas, Ignacio de; Laborda, Alicia; de Gregorio, Miguel Angel

    2016-03-01

    The objective of this study was to assess tracheal reactivity after the deployment of different self-expandable metal stents (SEMS). Forty female New Zealand rabbits were divided into four groups. Three groups received three different SEMS: steel (ST), nitinol (NiTi), or nitinol drug-eluting stent (DES); the fourth group was the control group (no stent). Stents were deployed percutaneously under fluoroscopic guidance. Animals were assessed by multi-slice, computed tomography (CT) scans, and tracheas were collected for anatomical pathology (AP) study. Data from CT and AP were statistically analyzed and correlated. The DES group had the longest stenosis (20.51±14.08mm vs. 5.84±12.43 and 6.57±6.54mm in NiTi and ST, respectively, day 30; P<.05), and higher granuloma formation on CT (50% of cases). The NiTi group showed the lowest grade of stenosis (2.86±6.91% vs. 11.28±13.98 and 15.54±25.95% in DES and ST, respectively; P<.05). The AP study revealed that the ST group developed intense proliferative reactivity compared to the other groups. In the DES group, a destructive response was observed in 70% of the animals, while the NiTi was the least reactive stent. CT was more effective in detecting wall thickening (positive correlation of 68.9%; P<.001) than granuloma (not significant). The ST group developed granulomas and significant stenosis. NiTi was the least reactive stent, while DES caused significant lesions that may be related to drug dosage. This type of DES stent is therefore not recommended for the treatment of tracheobronchial stenosis. Copyright © 2015 SEPAR. Published by Elsevier Espana. All rights reserved.

  7. 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.

  8. Medical therapy v. PCI in stable coronary artery disease: a cost-effectiveness analysis.

    PubMed

    Wijeysundera, Harindra C; Tomlinson, George; Ko, Dennis T; Dzavik, Vladimir; Krahn, Murray D

    2013-10-01

    Percutaneous coronary intervention (PCI) with either drug-eluting stents (DES) or bare metal stents (BMS) reduces angina and repeat procedures compared with optimal medical therapy alone. It remains unclear if these benefits are sufficient to offset their increased costs and small increase in adverse events. Cost utility analysis of initial medical therapy v. PCI with either BMS or DES. . Markov cohort decision model. Data Sources. Propensity-matched observational data from Ontario, Canada, for baseline event rates. Effectiveness and utility data obtained from the published literature, with costs from the Ontario Case Costing Initiative. Patients with stable coronary artery disease, confirmed after angiography, stratified by risk of restenosis based on diabetic status, lesion size, and lesion length. Time Horizon. Lifetime. Perspective. Ontario Ministry of Health and Long Term Care. Interventions. Optimal medical therapy, PCI with BMS or DES. Lifetime costs, quality-adjusted life years (QALYs), and the incremental cost-effectiveness ratio (ICER). of Base Case Analysis. In the overall population, medical therapy had the lowest lifetime costs at $22,952 v. $25,081 and $25,536 for BMS and DES, respectively. Medical therapy had a quality-adjusted life expectancy of 10.1 v. 10.26 QALYs for BMS, producing an ICER of $13,271/QALY. The DES strategy had a quality-adjusted life expectancy of only 10.20 QALYs and was dominated by the BMS strategy. This ranking was consistent in all groups stratified by restenosis risk, except diabetic patients with long lesions in small arteries, in whom DES was cost-effective compared with medical therapy (ICER of $18,826/QALY). Limitations. There is the possibility of residual unobserved confounding. In patients with stable coronary artery disease, an initial BMS strategy is cost-effective.

  9. In-Stent Restenosis of Drug-Eluting Stents Compared With a Matched Group of Patients With De Novo Coronary Artery Stenosis.

    PubMed

    Buchanan, Kyle D; Torguson, Rebecca; Rogers, Toby; Xu, Linzhi; Gai, Jiaxiang; Ben-Dor, Itsik; Suddath, William O; Satler, Lowell F; Waksman, Ron

    2018-03-13

    Drug-eluting stents (DES) significantly reduced the incidence of in-stent restenosis (ISR). However, ISR still exists in the contemporary DES era. Previously deemed to be a benign process, ISR leads to complex presentation and intervention. This study aimed to compare the presentation and outcome of DES-ISR versus de novo lesions. We performed a retrospective analysis of 11,666 patients receiving percutaneous coronary intervention from 2003 to 2017 and divided them into 2 groups by de novo stenosis and ISR. They were matched based on common cardiovascular risk factors at a 4:1 ratio, respectively. After matching, a total of 1,888 patients with 3,126 de novo lesions and 472 patients with 508 ISR lesions were analyzed. Patients with ISR presented more often with unstable angina (61% vs 45%, p <0.001) and less often with myocardial infarction (6% vs 14%, p <0.001). One-year composite major adverse cardiovascular event, defined as death, Q-wave myocardial infarction, and target vessel revascularization, was 10% in the de novo group and 17% in the ISR group (hazard ratio 1.98, 95% confidential interval 1.58 to 2.46, p <0.001). After adjusting for myocardial infarction presentation, hazard ratio of major adverse cardiovascular events was still higher for the ISR group at 1 year (2.03, 95% confidential interval 1.62 to 2.55, p <0.001). ISR of DES remains a therapeutic challenge and leads to complex presentation and worse outcomes compared with matched de novo patients. These data show that DES-ISR demands better appreciation and prevention with more precise stent technique and should motivate the continued development of fully bioresorbable scaffolds. Copyright © 2018 Elsevier Inc. All rights reserved.

  10. Long-term cost-effectiveness of initiating treatment for painful diabetic neuropathy with pregabalin, duloxetine, gabapentin, or desipramine.

    PubMed

    Bellows, Brandon K; Nelson, Richard E; Oderda, Gary M; LaFleur, Joanne

    2016-01-01

    Painful diabetic neuropathy (PDN) affects nearly half of patients with diabetes. The objective of this study was to compare the cost-effectiveness of starting patients with PDN on pregabalin (PRE), duloxetine (DUL), gabapentin (GABA), or desipramine (DES) over a 10-year time horizon from the perspective of third-party payers in the United States. A Markov model was used to compare the costs (2013 $US) and effectiveness (quality-adjusted life-years [QALYs]) of first-line PDN treatments in 10,000 patients using microsimulation. Costs and QALYs were discounted at 3% annually. Probabilities and utilities were derived from the published literature. Costs were average wholesale price for drugs and national estimates for office visits and hospitalizations. One-way and probabilistic (PSA) sensitivity analyses were used to examine parameter uncertainty. Starting with PRE was dominated by DUL as DUL cost less and was more effective. Starting with GABA was extendedly dominated by a combination of DES and DUL. DES and DUL cost $23,468 and $25,979, while yielding 3.05 and 3.16 QALYs, respectively. The incremental cost-effectiveness ratio for DUL compared with DES was $22,867/QALY gained. One-way sensitivity analysis showed that the model was most sensitive to the adherence threshold and utility for mild pain. PSA showed that, at a willingness-to-pay (WTP) of $50,000/QALY, DUL was the most cost-effective option in 56.3% of the simulations, DES in 29.2%, GABA in 14.4%, and PRE in 0.1%. Starting with DUL is the most cost-effective option for PDN when WTP is greater than $22,867/QALY. Decision makers may consider starting with DUL for PDN patients.

  11. Deep SOAR follow-up photometry of two Milky Way outer-halo companions discovered with Dark Energy Survey

    NASA Astrophysics Data System (ADS)

    Luque, E.; Santiago, B.; Pieres, A.; Marshall, J. L.; Pace, A. B.; Kron, R.; Drlica-Wagner, A.; Queiroz, A.; Balbinot, E.; Ponte, M. dal; Neto, A. Fausti; da Costa, L. N.; Maia, M. A. G.; Walker, A. R.; Abdalla, F. B.; Allam, S.; Annis, J.; Bechtol, K.; Benoit-Lévy, A.; Bertin, E.; Brooks, D.; Rosell, A. Carnero; Kind, M. Carrasco; Carretero, J.; Crocce, M.; Davis, C.; Doel, P.; Eifler, T. F.; Flaugher, B.; García-Bellido, J.; Gerdes, D. W.; Gruen, D.; Gruendl, R. A.; Gutierrez, G.; Honscheid, K.; James, D. J.; Kuehn, K.; Kuropatkin, N.; Miquel, R.; Nichol, R. C.; Plazas, A. A.; Sanchez, E.; Scarpine, V.; Schindler, R.; Sevilla-Noarbe, I.; Smith, M.; Soares-Santos, M.; Sobreira, F.; Suchyta, E.; Tarle, G.; Thomas, D.

    2018-04-01

    We report the discovery of a new star cluster, DES 3, in the constellation of Indus, and deeper observations of the previously identified satellite DES J0222.7-5217 (Eridanus III). DES 3 was detected as a stellar overdensity in first-year Dark Energy Survey data, and confirmed with deeper photometry from the 4.1 metre Southern Astrophysical Research (SOAR) telescope. The new system was detected with a relatively high significance and appears in the DES images as a compact concentration of faint blue point sources. We determine that DES 3 is located at a heliocentric distance of ≃ 76.2 kpc and it is dominated by an old (≃ 9.8 Gyr) and metal-poor ([Fe/H] ≃ -1.84) population. While the age and metallicity values of DES 3 are comparable to typical globular clusters (objects with a high stellar density, stellar mass of ˜105M⊙ and luminosity MV ˜ -7.3), its half-light radius (rh ˜ 6.87 pc) and luminosity (MV ˜ -1.7) are more indicative of faint star cluster. Based on the angular size, DES 3, with a value of rh ˜ 0{^'.}31, is among the smallest faint star clusters known to date. Furthermore, using deeper imaging of DES J0222.7-5217 taken with the SOAR telescope, we update structural parameters and perform the first isochrone modeling. Our analysis yields the first age (≃ 12.6 Gyr) and metallicity ([Fe/H] ≃ -2.01) estimates for this object. The half-light radius (rh ≃ 11.24 pc) and luminosity (MV ≃ -2.4) of DES J0222.7-5217 suggest that it is likely a faint star cluster. The discovery of DES 3 indicates that the census of stellar systems in the Milky Way is still far from complete, and demonstrates the power of modern wide-field imaging surveys to improve our knowledge of the Galaxy's satellite population.

  12. The sirolimus-eluting Cypher Select coronary stent for the treatment of bare-metal and drug-eluting stent restenosis: insights from the e-SELECT (Multicenter Post-Market Surveillance) registry.

    PubMed

    Abizaid, Alexandre; Costa, J Ribamar; Banning, Adrian; Bartorelli, Antonio L; Dzavik, Vladimir; Ellis, Stephen; Gao, Runlin; Holmes, David R; Jeong, Muyng Ho; Legrand, Victor; Neumann, Franz-Josef; Nyakern, Maria; Orlick, Amy; Spaulding, Christian; Worthley, Stephen; Urban, Philip M

    2012-01-01

    This study sought to compare the 1-year safety and efficacy of Cypher Select or Cypher Select Plus (Cordis Corporation, Bridgewater, New Jersey) sirolimus-eluting stents (SES) with the treatment of bare-metal stents (BMS) and drug-eluting stent (DES) in-stent restenosis (ISR) in nonselected, real-world patients. There is paucity of consistent data on DES for the treatment of ISR, especially, DES ISR. The e-SELECT (Multicenter Post-Market Surveillance) registry is a Web-based, multicenter and international registry encompassing virtually all subsets of patients and lesions treated with at least 1 SES during the period from 2006 to 2008. We enrolled in this pre-specified subanalysis all patients with at least 1 clinically relevant BMS or DES ISR treated with SES. Primary endpoint was major adverse cardiac events and stent thrombosis rate at 1 year. Of 15,147 patients enrolled, 1,590 (10.5%) presented at least 1 ISR (BMS group, n = 1,235, DES group, n = 355). Patients with DES ISR had higher incidence of diabetes (39.4% vs. 26.9%, p < 0.001), renal insufficiency (5.8% vs. 2.3%, p = 0.003), and prior coronary artery bypass graft (20.5% vs. 11.8%, p < 0.001). At 1 year, death (1.4% for BMS vs. 2.1% for DES, p = 0.3) and myocardial infarction (2.4% for BMS and 3.3% for DES, p = 0.3) rates were similar, whereas ischemia-driven target lesion revascularization and definite/probable late stent thrombosis were higher in patients with DES ISR (6.9% vs. 3.1%, p = 0.003, and 1.8% vs. 0.5%, p = 0.04, respectively). Use of SES for either BMS or DES ISR treatment is safe and associated with low target lesion revascularization recurrence and no apparent safety concern. Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  13. Urogenital teratogenicity of synthetic and natural estrogens in the rat: diethylstilbestrol and estradiol

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

    Henry, E.C.

    1984-01-01

    Diethylstilbestrol (DES), a synthetic estrogen and a carcinogen, is a potent urogenital teratogen in humans and rodents. The natural estrogen, estradiol (E/sub 2/), induces malformations in rats only at a maternal toxic dose. This difference in potency could result from differences in fetal sensitivity, or in the distribution and/or metabolism of the two compounds. The current studies tested the hypothesis that the teratogenicity of DES is mediated by its estrogenic activity (rather than its metabolic activation). The two estrogens were directly compared by injecting them into day 19 fetuses, bypassing any maternal modifying factors. Both DES (0.1, 1 or 10more » ..mu..g/fetus) and E/sub 2/ (10 or 100 ..mu..g/fetus) caused dose-related incidences of urogenital malformations (diagnosed at 6-7 weeks), but DES was 10- to 100-fold more potent. Between 24 h and 9 days after DES or E/sub 2/ exposure, histologic evidence of estrogenic stimulation was observed, including premature myometrial growth and differentiation, and vaginal epithelial thickening. Thus, DES and E/sub 2/ act directly in the fetus, to produce similar teratogenic effects, without maternal mediation. Following both maternal and fetal administration of /sup 14/C-DES or /sup 3/H-E/sub 2/, the /sup 14/C (from DES) was concentrated in fetal tissues, whereas /sup 3/H (from E/sub 2/) was retained in fetal plasma (protein-bound). Fetal genital tract contained the largest proportion of unchanged E/sub 2/ (74%) or DES (86%). It was concluded that (1) the teratogenicity of DES reflects its estrogenic activity in the fetus; (2) the fetus is sensitive to a brief exposure to estrogens, including LY and (3) the synthetic estrogen is more potent that estradiol because of its greater availability to fetal genital tissues: protein binding and rapid metabolism reduce the teratogenicity of the natural estrogen.« less

  14. Effets de l'humidite sur la propagation du delaminage dans un composite carbone/epoxy sollicite en mode mixte I/II

    NASA Astrophysics Data System (ADS)

    LeBlanc, Luc R.

    Les materiaux composites sont de plus en plus utilises dans des domaines tels que l'aerospatiale, les voitures a hautes performances et les equipements sportifs, pour en nommer quelques-uns. Des etudes ont demontre qu'une exposition a l'humidite nuit a la resistance des composites en favorisant l'initiation et la propagation du delaminage. De ces etudes, tres peu traitent de l'effet de l'humidite sur l'initiation du delaminage en mode mixte I/II et aucune ne traite des effets de l'humidite sur le taux de propagation du delaminage en mode mixte I/II dans un composite. La premiere partie de cette these consiste a determiner les effets de l'humidite sur la propagation du delaminage lors d'une sollicitation en mode mixte I/II. Des eprouvettes d'un composite unidirectionnel de carbone/epoxy (G40-800/5276-1) ont ete immergees dans un bain d'eau distillee a 70°C jusqu'a leur saturation. Des essais experimentaux quasi-statiques avec des chargements d'une gamme de mixites des modes I/II (0%, 25%, 50%, 75% et 100%) ont ete executes pour determiner les effets de l'humidite sur la resistance au delaminage du composite. Des essais de fatigue ont ete realises, avec la meme gamme de mixite des modes I/II, pour determiner 1'effet de 1'humidite sur l'initiation et sur le taux de propagation du delaminage. Les resultats des essais en chargement quasi-statique ont demontre que l'humidite reduit la resistance au delaminage d'un composite carbone/epoxy pour toute la gamme des mixites des modes I/II, sauf pour le mode I ou la resistance au delaminage augmente apres une exposition a l'humidite. Pour les chargements en fatigue, l'humidite a pour effet d'accelerer l'initiation du delaminage et d'augmenter le taux de propagation pour toutes les mixites des modes I/II. Les donnees experimentales recueillies ont ete utilisees pour determiner lesquels des criteres de delaminage en statique et des modeles de taux de propagation du delaminage en fatigue en mode mixte I/II proposes dans la litterature representent le mieux le delaminage du composite etudie. Une courbe de regression a ete utilisee pour determiner le meilleur ajustement entre les donnees experimentales et les criteres de delaminage en statique etudies. Une surface de regression a ete utilisee pour determiner le meilleur ajustement entre les donnees experimentales et les modeles de taux de propagation en fatigue etudies. D'apres les ajustements, le meilleur critere de delaminage en statique est le critere B-K et le meilleur modele de propagation en fatigue est le modele de Kenane-Benzeggagh. Afin de predire le delaminage lors de la conception de pieces complexes, des modeles numeriques peuvent etre utilises. La prediction de la longueur de delaminage lors des chargements en fatigue d'une piece est tres importante pour assurer qu'une fissure interlaminaire ne va pas croitre excessivement et causer la rupture de cette piece avant la fin de sa duree de vie de conception. Selon la tendance recente, ces modeles sont souvent bases sur l'approche de zone cohesive avec une formulation par elements finis. Au cours des travaux presentes dans cette these, le modele de progression du delaminage en fatigue de Landry & LaPlante (2012) a ete ameliore en y ajoutant le traitement des chargements en mode mixte I/II et en y modifiant l'algorithme du calcul de la force d'entrainement maximale du delaminage. Une calibration des parametres de zone cohesive a ete faite a partir des essais quasi-statiques experimentaux en mode I et II. Des resultats de simulations numeriques des essais quasi-statiques en mode mixte I/II, avec des eprouvettes seches et humides, ont ete compares avec les essais experimentaux. Des simulations numeriques en fatigue ont aussi ete faites et comparees avec les resultats experimentaux du taux de propagation du delaminage. Les resultats numeriques des essais quasi-statiques et de fatigue ont montre une bonne correlation avec les resultats experimentaux pour toute la gamme des mixites des modes I/II etudiee.

  15. Algorithmes de couplage RANS et ecoulement potentiel

    NASA Astrophysics Data System (ADS)

    Gallay, Sylvain

    Dans le processus de developpement d'avion, la solution retenue doit satisfaire de nombreux criteres dans de nombreux domaines, comme par exemple le domaine de la structure, de l'aerodynamique, de la stabilite et controle, de la performance ou encore de la securite, tout en respectant des echeanciers precis et minimisant les couts. Les geometries candidates sont nombreuses dans les premieres etapes de definition du produit et de design preliminaire, et des environnements d'optimisations multidisciplinaires sont developpes par les differentes industries aeronautiques. Differentes methodes impliquant differents niveaux de modelisations sont necessaires pour les differentes phases de developpement du projet. Lors des phases de definition et de design preliminaires, des methodes rapides sont necessaires afin d'etudier les candidats efficacement. Le developpement de methodes ameliorant la precision des methodes existantes tout en gardant un cout de calcul faible permet d'obtenir un niveau de fidelite plus eleve dans les premieres phases de developpement du projet et ainsi grandement diminuer les risques associes. Dans le domaine de l'aerodynamisme, les developpements des algorithmes de couplage visqueux/non visqueux permettent d'ameliorer les methodes de calcul lineaires non visqueuses en methodes non lineaires prenant en compte les effets visqueux. Ces methodes permettent ainsi de caracteriser l'ecoulement visqueux sur les configurations et predire entre autre les mecanismes de decrochage ou encore la position des ondes de chocs sur les surfaces portantes. Cette these se focalise sur le couplage entre une methode d'ecoulement potentiel tridimensionnelle et des donnees de section bidimensionnelles visqueuses. Les methodes existantes sont implementees et leurs limites identifiees. Une methode originale est ensuite developpee et validee. Les resultats sur une aile elliptique demontrent la capacite de l'algorithme a de grands angles d'attaques et dans la region post-decrochage. L'algorithme de couplage a ete compare a des donnees de plus haute fidelite sur des configurations issues de la litterature. Un modele de fuselage base sur des relations empiriques et des simulations RANS a ete teste et valide. Les coefficients de portance, de trainee et de moment de tangage ainsi que les coefficients de pression extraits le long de l'envergure ont montre un bon accord avec les donnees de soufflerie et les modeles RANS pour des configurations transsoniques. Une configuration a geometrie hypersustentatoire a permis d'etudier la modelisation des surfaces hypersustentees de la methode d'ecoulement potentiel, demontrant que la cambrure peut etre prise en compte uniquement dans les donnees visqueuses.

  16. Integration des sciences et de la langue: Creation et experimentation d'un modele pedagogique pour ameliorer l'apprentissage des sciences en milieu francophone minoritaire

    NASA Astrophysics Data System (ADS)

    Cormier, Marianne

    Les faibles resultats en sciences des eleves du milieu francophone minoritaire, lors d'epreuves au plan national et international, ont interpelle la recherche de solutions. Cette these avait pour but de creer et d'experimenter un modele pedagogique pour l'enseignement des sciences en milieu linguistique minoritaire. En raison de la presence de divers degres de francite chez la clientele scolaire de ce milieu, plusieurs elements langagiers (l'ecriture, la discussion et la lecture) ont ete integres a l'apprentissage scientifique. Nous avions recommande de commencer le processus d'apprentissage avec des elements langagiers plutot informels (redaction dans un journal, discussions en dyades...) pour progresser vers des activites langagieres plus formelles (redaction de rapports ou d'explications scientifiques). En ce qui a trait a l'apprentissage scientifique, le modele preconisait une demarche d'evolution conceptuelle d'inspiration socio-constructiviste tout en s'appuyant fortement sur l'apprentissage experientiel. Lors de l'experimentation du modele, nous voulions savoir si celui-ci provoquait une evolution conceptuelle chez les eleves, et si, simultanement, le vocabulaire scientifique de ces derniers s'enrichissait. Par ailleurs, nous cherchions a comprendre comment les eleves vivaient leurs apprentissages dans le cadre de ce modele pedagogique. Une classe de cinquieme annee de l'ecole de Grande-Digue, dans le Sud-est du Nouveau-Brunswick, a participe a la mise a l'essai du modele en etudiant les marais sales locaux. Lors d'entrevues initiales, nous avons remarque que les connaissances des eleves au sujet des marais sales etaient limitees. En effet, s'ils etaient conscients que les marais etaient des lieux naturels, ils ne pouvaient pas necessairement les decrire avec precision. Nous avons egalement constate que les eleves utilisaient surtout des mots communs (plantes, oiseaux, insectes) pour decrire le marais. Les resultats obtenus indiquent que les eleves ont progresse dans leurs conceptions au sujet des marais. A la suite de l'intervention pedagogique, ils peuvent decrire le marais de facon comparable a des scientifiques en mettant a profit des mots scientifiques (spartine alterniflore, detritus, chevalier a pattes jaunes). Selon nous, les apprentissages des eleves s'expliquent surtout par la juxtaposition, dans le modele pedagogique, des elements langagiers avec une demarche de changement conceptuel a caractere experientiel. En effet, lors de cette demarche, les eleves se sont beaucoup questionnes, ont ecrit leurs reflexions, discute de leurs preoccupations et consulte des documents. Ces activites langagieres se sont deroulees directement dans le marais ainsi qu'a la suite de visites dans celui-ci. Ainsi, la possibilite de decouverte a ete reelle pour eux. Ces differents elements se sont combines pour creer une forte motivation. Le tout s'est arrime pour permettre une evolution conceptuelle et langagiere. Le modele pedagogique experimente pourrait ainsi s'averer tres fecond aupres des eleves du milieu linguistique minoritaire.

  17. 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

  18. Comparaison des effets des irradiations γ, X et UV dans les fibres optiques

    NASA Astrophysics Data System (ADS)

    Girard, S.; Ouerdane, Y.; Baggio, J.; Boukenter, A.; Meunier, J.-P.; Leray, J.-L.

    2005-06-01

    Les fibres optiques présentent de nombreux avantages incitant à les intégrer dans des applications devant résister aux environnements radiatifs associés aux domaines civil, spatial ou militaire. Cependant, leur exposition à un rayonnement entraîne la création de défauts ponctuels dans la silice amorphe pure ou dopée qui constitue les différentes parties de la fibre optique. Ces défauts causent, en particulier, une augmentation transitoire de l'atténuation linéique des fibres optiques responsable de la dégradation voire de la perte du signal propagé dans celles-ci. Dans cet article, nous comparons les effets de deux types d'irradiation: une impulsion X et une dose γ cumulée. Les effets de ces irradiations sont ensuite comparés avec ceux induits par une insolation ultraviolette (244 nm) sur les propriétés d'absorption des fibres optiques. Nous montrons qu'il existe des similitudes entre ces différentes excitations et qu'il est possible, sous certaines conditions, d'utiliser celles-ci afin d'évaluer la capacité de certaines fibres optiques à fonctionner dans un environnement nucléaire donné.

  19. Improvement in the technological feasibility of a web-based dietary survey system in local settings.

    PubMed

    Jung, Hyun Ju; Lee, Sang Eun; Kim, Dongwoo; Noh, Hwayoung; Song, Sujin; Kang, Minji; Song, Yoon Ju; Paik, Hee-Young

    2015-01-01

    The feasibility of a dietary survey tool is crucial for successful nutritional assessment via a community survey and for nutritional epidemiology. In 2012, we identified a newly developed computerized dietary survey system, the Diet Evaluation System (DES), which could be successfully applied to a community survey delivered during home visits using notebook computers when the internet environment was adequate, using either a WiBro modem or a smartphone as a tethered modem. In 2013, we retested DES feasibility using various mobile devices and in a larger number of subjects. We conducted a total of 430 interviews, representing two for each of 215 subjects of various ages, using tablet personal computers (PCs) and laptops. In addition, a group discussion with the interviewers was conducted. The interview success rate was improved to 84% (compared to 67% in 2012). Completing each interview took 14 min 1 s, and data processing was conducted automatically. The subjects' age, gender, and the type of mobile device used influenced the DES interview time. This study implies that the DES is an effective one-stop dietary survey system for use in a local setting. The interviewers' group discussion revealed that a one-stop system using the DES is convenient and that DES optimization for tablet PCs and continued database updating is needed.

  20. Utilisation d'images aeroportees a tres haute resolution spatiale pour l'estimation de la vigueur des peuplements forestiers du nord-ouest du Nouveau-Brunswick

    NASA Astrophysics Data System (ADS)

    Louis, Ognel Pierre

    Le but de cette etude est de developper un outil permettant d'estimer le niveau de risque de perte de vigueur des peuplements forestiers de la region de Gounamitz au nord-ouest du Nouveau-Brunswick via des donnees d'inventaires forestiers et des donnees de teledetection. Pour ce faire, un marteloscope de 100m x 100m et 20 parcelles d'echantillonnages ont ete delimites. A l'interieur de ces derniers, le niveau de risque de perte de vigueur des arbres ayant un DHP superieur ou egal a 9 cm a ete determine. Afin de caracteriser le risque de perte de vigueur des arbres, leurs positions spatiales ont ete repertoriees a partir d'un GPS en tenant compte des defauts au niveau des tiges. Pour mener a bien ce travail, les indices de vegetation et de textures et les bandes spectrales de l'image aeroportee ont ete extraits et consideres comme variables independantes. Le niveau de risque de perte de vigueur obtenu par espece d'arbre a travers les inventaires forestiers a ete considere comme variable dependante. En vue d'obtenir la superficie des peuplements forestiers de la region d'etude, une classification dirigee des images a partir de l'algorithme maximum de vraisemblance a ete effectuee. Le niveau de risque de perte de vigueur par type d'arbre a ensuite ete estime a l'aide des reseaux de neurones en utilisant un reseau dit perceptron multicouches. Il s'agit d'un modele de reseau de neurones compose de : 11 neurones sur la couche d'entree, correspondant aux variables independantes, 35 neurones sur la couche cachee et 4 neurones sur la couche de sortie. La prediction a partir des reseaux de neurones produit une matrice de confusion qui permet d'obtenir des mesures quantitatives d'estimation, notamment un pourcentage de classification globale de 91,7% pour la prediction du risque de perte de vigueur du peuplement de resineux et de 89,7% pour celui du peuplement de feuillus. L'evaluation de la performance des reseaux de neurones fournit une valeur de MSE globale de 0,04, et une RMSE (Mean Square Error) globale de 0,20 pour le peuplement de feuillus. Quant au peuplement de resineux, une valeur de MSE (Mean Square Error) globale de 0,05 et une valeur de RMSE globale de 0,22 ont ete obtenues. Pour la validation des resultats, le niveau de risque de perte de vigueur predit a ete compare avec le risque de perte de vigueur de reference. Les resultats obtenus donnent un coefficient de determination de 0,98 pour le peuplement de feuillus et 0,93 pour le peuplement de resineux.

  1. Low-energy biomass pretreatment with deep eutectic solvents for bio-butanol production.

    PubMed

    Procentese, Alessandra; Raganati, Francesca; Olivieri, Giuseppe; Russo, Maria Elena; Rehmann, Lars; Marzocchella, Antonio

    2017-11-01

    Waste lettuce leaves - from the "fresh cut vegetable" industry - were pretreated with the deep eutectic solvent (DES) made of choline chloride - glycerol. Reaction time (3-16h) and the operation temperature (80-150°C) were investigated. Enzymatic glucose and xylose yields of 94.9% and 75.0%, respectively were obtained when the biomass was pretreated at 150°C for 16h. Sugars contained in the biomass hydrolysate were fermented in batch cultures of Clostridium acetobutylicum DSMZ 792. The energy consumption and the energy efficiency related to the DES pretreatment were calculated and compared to the most common lignocellulosic pretreatment processes reported in the literature. The DES pretreatment process was characterized by lower energy required (about 28% decrease and 72% decrease) than the NAOH pretreatment and steam explosion process respectively. The Net Energy Ratio (NER) value related to butanol production via DES biomass pretreatment was assessed. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Risk of Lower Extremity Injury in a Military Cadet Population After a Supervised Injury-Prevention Program

    PubMed Central

    Carow, Scott D.; Haniuk, Eric M.; Cameron, Kenneth L.; Padua, Darin A.; Marshall, Stephen W.; DiStefano, Lindsay J.; de la Motte, Sarah J.; Beutler, Anthony I.; Gerber, John P.

    2016-01-01

    Context: Specific movement patterns have been identified as possible risk factors for noncontact lower extremity injuries. The Dynamic Integrated Movement Enhancement (DIME) was developed to modify these movement patterns to decrease injury risk. Objective: To determine if the DIME is effective for preventing lower extremity injuries in US Military Academy (USMA) cadets. Design: Cluster-randomized controlled trial. Setting: Cadet Basic Training at USMA. Patients or Other Participants: Participants were 1313 cadets (1070 men, 243 women). Intervention(s): Participants were cluster randomized to 3 groups. The active warm-up (AWU) group performed standard Army warm-up exercises. The DIME groups were assigned to a DIME cadre-supervised (DCS) group or a DIME expert-supervised (DES) group; the former consisted of cadet supervision and the latter combined cadet and health professional supervision. Groups performed exercises 3 times weekly for 6 weeks. Main Outcome Measure(s): Cumulative risk of lower extremity injury was the primary outcome. We gathered data during Cadet Basic Training and for 9 months during the subsequent academic year. Risk ratios and 95% confidence intervals (CIs) were calculated to compare groups. Results: No differences were seen between the AWU and the combined DIME (DCS and DES) groups during Cadet Basic Training or the academic year. During the academic year, lower extremity injury risk in the DES group decreased 41% (relative risk [RR] = 0.59; 95% CI = 0.38, 0.93; P = .02) compared with the DCS group; a nonsignificant 25% (RR = 0.75; 95% CI = 0.49, 1.14; P = .18) decrease occurred in the DES group compared with the AWU group. Finally, there was a nonsignificant 27% (RR = 1.27; 95% CI = 0.90, 1.78; P = .17) increase in injury risk during the academic year in the DCS group compared with the AWU group. Conclusions: We observed no differences in lower extremity injury risk between the AWU and combined DIME groups. However, the magnitude and direction of the risk ratios in the DES group compared with the AWU group, although not statistically significant, indicate that professional supervision may be a factor in the success of injury-prevention programs. PMID:25117875

  3. Risk of Lower Extremity Injury in a Military Cadet Population After a Supervised Injury-Prevention Program.

    PubMed

    Carow, Scott D; Haniuk, Eric M; Cameron, Kenneth L; Padua, Darin A; Marshall, Stephen W; DiStefano, Lindsay J; de la Motte, Sarah J; Beutler, Anthony I; Gerber, John P

    2016-11-01

     Specific movement patterns have been identified as possible risk factors for noncontact lower extremity injuries. The Dynamic Integrated Movement Enhancement (DIME) was developed to modify these movement patterns to decrease injury risk.  To determine if the DIME is effective for preventing lower extremity injuries in US Military Academy (USMA) cadets.  Cluster-randomized controlled trial.  Cadet Basic Training at USMA.  Participants were 1313 cadets (1070 men, 243 women).  Participants were cluster randomized to 3 groups. The active warm-up (AWU) group performed standard Army warm-up exercises. The DIME groups were assigned to a DIME cadre-supervised (DCS) group or a DIME expert-supervised (DES) group; the former consisted of cadet supervision and the latter combined cadet and health professional supervision. Groups performed exercises 3 times weekly for 6 weeks.  Cumulative risk of lower extremity injury was the primary outcome. We gathered data during Cadet Basic Training and for 9 months during the subsequent academic year. Risk ratios and 95% confidence intervals (CIs) were calculated to compare groups.  No differences were seen between the AWU and the combined DIME (DCS and DES) groups during Cadet Basic Training or the academic year. During the academic year, lower extremity injury risk in the DES group decreased 41% (relative risk [RR] = 0.59; 95% CI = 0.38, 0.93; P = .02) compared with the DCS group; a nonsignificant 25% (RR = 0.75; 95% CI = 0.49, 1.14; P = .18) decrease occurred in the DES group compared with the AWU group. Finally, there was a nonsignificant 27% (RR = 1.27; 95% CI = 0.90, 1.78; P = .17) increase in injury risk during the academic year in the DCS group compared with the AWU group.  We observed no differences in lower extremity injury risk between the AWU and combined DIME groups. However, the magnitude and direction of the risk ratios in the DES group compared with the AWU group, although not statistically significant, indicate that professional supervision may be a factor in the success of injury-prevention programs.

  4. CABG Versus PCI: Greater Benefit in Long-Term Outcomes With Multiple Arterial Bypass Grafting.

    PubMed

    Habib, Robert H; Dimitrova, Kamellia R; Badour, Sanaa A; Yammine, Maroun B; El-Hage-Sleiman, Abdul-Karim M; Hoffman, Darryl M; Geller, Charles M; Schwann, Thomas A; Tranbaugh, Robert F

    2015-09-29

    Treatment of multivessel coronary artery disease with traditional single-arterial coronary artery bypass graft (SA-CABG) has been associated with superior intermediate-term survival and reintervention compared with percutaneous coronary intervention (PCI) using either bare-metal stents (BMS) or drug-eluting stents (DES). This study sought to investigate longer-term outcomes including the potential added advantage of multiarterial coronary artery bypass graft (MA-CABG). We studied 8,402 single-institution, primary revascularization, multivessel coronary artery disease patients: 2,207 BMS-PCI (age 66.6 ± 11.9 years); 2,381 DES-PCI (age 65.9 ± 11.7 years); 2,289 SA-CABG (age 69.3 ± 9.0 years); and 1,525 MA-CABG (age 58.3 ± 8.7 years). Patients with myocardial infarction within 24 h, shock, or left main stents were excluded. Kaplan-Meier analysis and Cox regression were used to separately compare 9-year all-cause mortality and unplanned reintervention for BMS-PCI and DES-PCI to respective propensity-matched SA-CABG and MA-CABG cohorts. BMS-PCI was associated with worse survival than SA-CABG, especially from 0 to 7 years (p = 0.015) and to a greater extent than MA-CABG was (9-year follow-up: 76.3% vs. 86.9%; p < 0.001). The surgery-to-BMS-PCI hazard ratios (HR) were as follows: versus SA-CABG, HR: 0.87; and versus MA-CABG, HR: 0.38. DES-PCI showed similar survival to SA-CABG except for a modest 0 to 3 years surgery advantage (HR: 1.06; p = 0.615). Compared with MA-CABG, DES-PCI exhibited worse survival at 5 (86.3% vs. 95.6%) and 9 (82.8% vs. 89.8%) years (HR: 0.45; p <0.001). Reintervention was substantially worse with PCI for all comparisons (all p <0.001). Multiarterial surgical revascularization, compared with either BMS-PCI or DES-PCI, resulted in substantially enhanced death and reintervention-free survival. Accordingly, MA-CABG represents the optimal therapy for multivessel coronary artery disease and should be enthusiastically adopted by multidisciplinary heart teams as the best evidence-based therapy. Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  5. Cost-effectiveness of drug-eluting stents versus bare-metal stents in patients undergoing percutaneous coronary intervention.

    PubMed

    Baschet, Louise; Bourguignon, Sandrine; Marque, Sébastien; Durand-Zaleski, Isabelle; Teiger, Emmanuel; Wilquin, Fanny; Levesque, Karine

    2016-01-01

    To determine the cost-effectiveness of drug-eluting stents (DES) compared with bare-metal stents (BMS) in patients requiring a percutaneous coronary intervention in France, using a recent meta-analysis including second-generation DES. A cost-effectiveness analysis was performed in the French National Health Insurance setting. Effectiveness settings were taken from a meta-analysis of 117 762 patient-years with 76 randomised trials. The main effectiveness criterion was major cardiac event-free survival. Effectiveness and costs were modelled over a 5-year horizon using a three-state Markov model. Incremental cost-effectiveness ratios and a cost-effectiveness acceptability curve were calculated for a range of thresholds for willingness to pay per year without major cardiac event gain. Deterministic and probabilistic sensitivity analyses were performed. Base case results demonstrated that DES are dominant over BMS, with an increase in event-free survival and a cost-reduction of €184, primarily due to a diminution of second revascularisations, and an absence of myocardial infarction and stent thrombosis. These results are robust for uncertainty on one-way deterministic and probabilistic sensitivity analyses. Using a cost-effectiveness threshold of €7000 per major cardiac event-free year gained, DES has a >95% probability of being cost-effective versus BMS. Following DES price decrease, new-generation DES development and taking into account recent meta-analyses results, the DES can now be considered cost-effective regardless of selective indication in France, according to European recommendations.

  6. Comparative effects of neonatal diethylstilbestrol on external genitalia development in adult males of two mouse strains with differential estrogen sensitivity

    PubMed Central

    Mahawong, Phitsanu; Sinclair, Adriane; Li, Yi; Schlomer, Bruce; Rodriguez, Esequiel; Ferretti, Max M.; Liu, Baomai; Baskin, Laurence S.; Cunha, Gerald R.

    2014-01-01

    The effect of neonatal exposure to diethylstilbestrol (DES), a potent synthetic estrogen, was examined to evaluate whether the CD-1 (estrogen insensitive, outbred) and C57 (estrogen sensitive, inbred) mouse strains differ in their response to estrogen disruption of male ExG differentiation. CD-1 and C57BL/6 litters were injected with sesame oil or DES (200 ng/g/5μl in sesame oil vehicle) every other day from birth to day 10. Animals were sacrificed at the following time points: birth, 5, 10 and 60 days postnatal. Neonatally DES-treated mice from both strains had many ExG abnormalities that included the following: (a) severe truncation of the prepuce and glans penis, (b) an abnormal urethral meatus, (c) ventral tethering of the penis, (d) reduced os penis length and glans width, (e) impaired differentiation of cartilage, (f) absence of urethral flaps, and (g) impaired differentiation of erectile bodies. Adverse effects of DES correlated with the expression of estrogen receptors within the affected tissues. While the effects of DES were similar in the more estrogen-sensitive C57BL/6 mice versus the less estrogen-sensitive CD-1 mice, the severity of DES effects was consistently greater in C57BL/6 mice. We suggest that many of the effects of DES, including the induction of hypospadias, are due to impaired growth and tissue fusion events during development. PMID:25449353

  7. 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.

  8. Economic evaluation of drug-eluting stents in coronary angioplasty.

    PubMed

    Santos, Ricardo; Pereira, Hélder

    2005-11-01

    Coronary angioplasty has revolutionized the treatment of coronary artery disease, from the first balloon angioplasty to the current era of drug-eluting stents (DES), which were developed to eliminate the bare metal stent's (BMS) Achilles' heel, restenosis. DES have an extremely low restenosis rate but are significantly more expensive and need more prolonged dual antiplatelet therapy. Restenosis has a generally benign prognosis and is not associated with higher mortality or major adverse cardiovascular events, which has limited the penetration of DES, whose only advantage is the reduction of restenosis. Economic evaluation of DES is therefore of paramount importance for assessing their appropriate use. In randomized trials in which they are compared with BMS, economic evaluation is advantageous for DES, with good cost-effectiveness ratios for both cost per quality-adjusted life year (QALY) and cost per revascularization avoided. However, these trials have two major limitations--the angiographic follow-up protocol and selection of patients with lower risk--and so their results do not accurately reflect reality. Other studies with unselected populations and cost-effectiveness models show that there is an economic advantage in the use of DES in groups with higher risk of restenosis, but not for the whole population undergoing angioplasty. Use of DES will be more appropriate if we can identify populations with a higher likelihood of restenosis, because these are the patients that will benefit most from their use and in whom they will be economically advantageous.

  9. Biodiesel production from ethanolysis of DPO using deep eutectic solvent (DES) based choline chloride - ethylene glycol as co-solvent

    NASA Astrophysics Data System (ADS)

    Taslim, Indra, Leonardo; Manurung, Renita; Winarta, Agus; Ramadhani, Debbie Aditia

    2017-03-01

    Biodiesel is usually produced from transesterification using methanol or ethanol as alcohol. However, biodiesel produced using methanol has several disadvantages because methanol is toxic and not entirely bio-based as it is generally produced from petroleum, natural gas and coal. On the other hand, ethanol also has several disadvantages such as lower reactivity in transesterification process and formation of stable emulsion between ester and glycerol. To improve ethanolysis process, deep eutectic solvent (DES) was prepared from choline chloride and ethylene glycol to be used as co-solvent in ethanolysis. Deep eutectic solvent was prepared by mixing choline chloride and ethylene glycol at molar ratio of 1:2, temperature of 80 °C, and stirring speed of 300 rpm for 1 hour. The DES was characterized by its density and viscosity. The ethanolysis of DPO / Degummed Palm Oil was performed at 70 °C, ethanol to oil molar ratio of 9:1, catalyst (potassium hydroxide) concentration of 0.75 wt.% concentration, co-solvent (DES) concentration of 1, 2, 3, 4, 5 and 6 wt.%, stirring speed of 600 rpm, and reaction time of 1 hour. The obtained biodiesel was then characterized by its density, viscosity and ester content. The oil - ethanol phase condition was observed in reaction tube. The oil - ethanol phase with DES tends to form meniscus compared to that without DES. Which implied that oil and ethanol become more slightly miscible, which favours the reaction. Using DES as co-solvent in ethanolysis resulted in an increase in yield and easier purification. The esters properties met the international standards ASTM D6751, with highest yield achieved at 81.72 % with 99.35 % ethyl ester contents at 4% DES concentration.

  10. De l'importance des orbites periodiques: Detection et applications

    NASA Astrophysics Data System (ADS)

    Doyon, Bernard

    L'ensemble des Orbites Periodiques Instables (OPIs) d'un systeme chaotique est intimement relie a ses proprietes dynamiques. A partir de l'ensemble (en principe infini) d'OPIs cachees dans l'espace des phases, on peut obtenir des quantites dynamiques importantes telles les exposants de Lyapunov, la mesure invariante, l'entropie topologique et la dimension fractale. En chaos quantique (i.e. l'etude de systemes quantiques qui ont un equivalent chaotique dans la limite classique), ces memes OPIs permettent de faire le pont entre le comportement classique et quantique de systemes non-integrables. La localisation de ces cycles fondamentaux est un probleme complexe. Cette these aborde dans un premier temps le probleme de la detection des OPIs dans les systemes chaotiques. Une etude comparative de deux algorithmes recents est presentee. Nous approfondissons ces deux methodes afin de les utiliser sur differents systemes dont des flots continus dissipatifs et conservatifs. Une analyse du taux de convergence des algorithmes est aussi realisee afin de degager les forces et les limites de ces schemes numeriques. Les methodes de detection que nous utilisons reposent sur une transformation particuliere de la dynamique initiale. Cette astuce nous a inspire une methode alternative pour cibler et stabiliser une orbite periodique quelconque dans un systeme chaotique. Le ciblage est en general combine aux methodes de controle pour stabiliser rapidement un cycle donne. En general, il faut connaitre la position et la stabilite du cycle en question. La nouvelle methode de ciblage que nous presentons ne demande pas de connaitre a priori la position et la stabilite des orbites periodiques. Elle pourrait etre un outil complementaire aux methodes de ciblage et de controle actuelles.

  11. Temporal trends in the use of drug-eluting stents for approved and off-label indications: a longitudinal analysis of a large multicenter percutaneous coronary intervention registry.

    PubMed

    Gualano, Sarah K; Gurm, Hitinder S; Share, David; Smith, Dean; Aronow, Herbert D; LaLonde, Thomas; Bates, Eric R; Changezi, Hameem; McNamara, Richard; Moscucci, Mauro

    2010-02-01

    We sought to examine the temporal variations in the rate of both bare-metal stent (BMS) and drug-eluting stent (DES) use for off-label indications after the reports of an increased risk of very late stent thrombosis in patients with DES at the 2006 meeting of the European Society of Cardiology (ESC). To determine whether the decrease in use of DES has affected both on and off-label indications. The study cohort included patients undergoing coronary intervention in a large regional registry, the Blue Cross Blue Shield of Michigan Cardiovascular Consortium (BMC2). Patient demographic and clinical characteristics for patients with DES in the third quarter of 2006 (pre-ESC) were compared to those from the fourth quarter of 2008 (post-guideline changes). Use of DES for off-label indications, such as ST-segment elevation myocardial infarction (STEMI), in-stent restenosis (ISR), and saphenous vein graft (SVG) interventions, were evaluated. The overall deployment of DES fell sharply from 83% pre-ESC to a plateau of 58% in the first quarter of 2008. This corresponded to a rise in BMS use, while angioplasty procedures stayed the same. The STEMI subgroup showed the most dramatic change, from 78% to only 36%. Off-label use in SVGs showed a similar trend, from 74% to 43%. Drug-eluting stent deployment for ISR was less affected, though it also fell 25% (from 79%-56%). The use of DES has fallen dramatically from June 2006 to December 2008, particularly for nonapproved indications. Our study provides a real-world assessment of contemporary change in DES use in response to the presentation of negative observational studies. Copyright 2010 Wiley Periodicals, Inc.

  12. Modélisation par éléments finis 3D du champ magnétostatique dans les enroulements des réactances cuirassées de grande puissance. Comparaison avec le calcul en 2D

    NASA Astrophysics Data System (ADS)

    Ngnegueu, Triomphant; Terme, Claude; Mailhot, Michel

    1993-03-01

    In this paper, the finite element method is applied for the computation of the magnetostatic field in the windings of a shell-form reactor. The modeling is carried out in 3D, using FLUX3D, a software developed at the Laboratoire d'Electrotechnique de Grenoble. The results are compared to those obtained in 2D. These calculation results are also compared to some test results. Dans cet article, nous décrivons une application de la méthode des éléments finis pour la modélisation du champ magnétostatique dans les enroulements d'une réactance cuirassée de grande puissance. La modélisation est conduite en 3D, en utilisant le logiciel FLUX3D. Les résultats du calcul sont comparés avec ceux obtenus en 2D. Quelques comparaisons sont aussi effectuées avec des résultats de mesure.

  13. Broca’s Area as a Pre-articulatory Phonetic Encoder: Gating the Motor Program

    PubMed Central

    Ferpozzi, Valentina; Fornia, Luca; Montagna, Marcella; Siodambro, Chiara; Castellano, Antonella; Borroni, Paola; Riva, Marco; Rossi, Marco; Pessina, Federico; Bello, Lorenzo; Cerri, Gabriella

    2018-01-01

    The exact nature of the role of Broca’s area in control of speech and whether it is exerted at the cognitive or at the motor level is still debated. Intraoperative evidence of a lack of motor responses to direct electrical stimulation (DES) of Broca’s area and the observation that its stimulation induces a “speech arrest” without an apparent effect on the ongoing activity of phono-articulatory muscles, raises the argument. Essentially, attribution of direct involvement of Broca’s area in motor control of speech, requires evidence of a functional connection of this area with the phono-articulatory muscles’ motoneurons. With a quantitative approach we investigated, in 20 patients undergoing surgery for brain tumors, whether DES delivered on Broca’s area affects the recruitment of the phono-articulatory muscles’ motor units. The electromyography (EMG) of the muscles active during two speech tasks (object picture naming and counting) was recorded during and in absence of DES on Broca’s area. Offline, the EMG of each muscle was analyzed in frequency (power spectrum, PS) and time domain (root mean square, RMS) and the two conditions compared. Results show that DES on Broca’s area induces an intensity-dependent “speech arrest.” The intensity of DES needed to induce “speech arrest” when applied on Broca’s area was higher when compared to the intensity effective on the neighboring pre-motor/motor cortices. Notably, PS and RMS measured on the EMG recorded during “speech arrest” were superimposable to those recorded at baseline. Partial interruptions of speech were not observed. Speech arrest was an “all-or-none” effect: muscle activation started only by removing DES, as if DES prevented speech onset. The same effect was observed when stimulating directly the subcortical fibers running below Broca’s area. Intraoperative data point to Broca’s area as a functional gate authorizing the phonetic translation to be executed by the motor areas. Given the absence of a direct effect on motor units recruitment, a direct control of Broca’s area on the phono-articulatory apparatus seems unlikely. Moreover, the strict correlation between DES-intensity and speech prevention, might attribute this effect to the inactivation of the subcortical fibers rather than to Broca’s cortical neurons. PMID:29520225

  14. Direct comparison of coronary bare metal vs. drug-eluting stents: same platform, different mechanics?

    PubMed

    Schmidt, Wolfram; Lanzer, Peter; Behrens, Peter; Brandt-Wunderlich, Christoph; Öner, Alper; Ince, Hüseyin; Schmitz, Klaus-Peter; Grabow, Niels

    2018-01-08

    Drug-eluting stents (DES) compared to bare metal stents (BMS) have shown superior clinical performance, but are considered less suitable in complex cases. Most studies do not distinguish between DES and BMS with respect to their mechanical performance. The objective was to obtain mechanical parameters for direct comparison of BMS and DES. In vitro bench tests evaluated crimped stent profiles, crossability in stenosis models, elastic recoil, bending stiffness (crimped and expanded), and scaffolding properties. The study included five pairs of BMS and DES each with the same stent platforms (all n = 5; PRO-Kinetic Energy, Orsiro: BIOTRONIK AG, Bülach, Switzerland; MULTI-LINK 8, XIENCE Xpedition: Abbott Vascular, Temecula, CA; REBEL Monorail, Promus PREMIER, Boston Scientific, Marlborough, MA; Integrity, Resolute Integrity, Medtronic, Minneapolis, MN; Kaname, Ultimaster: Terumo Corporation, Tokyo, Japan). Statistical analysis used pooled variance t tests for pairwise comparison of BMS with DES. Crimped profiles in BMS groups ranged from 0.97 ± 0.01 mm (PRO-Kinetic Energy) to 1.13 ± 0.01 mm (Kaname) and in DES groups from 1.02 ± 0.01 mm (Orsiro) to 1.13 ± 0.01 mm (Ultimaster). Crossability was best for low profile stent systems. Elastic recoil ranged from 4.07 ± 0.22% (Orsiro) to 5.87 ± 0.54% (REBEL Monorail) including both BMS and DES. The bending stiffness of crimped and expanded stents showed no systematic differences between BMS and DES neither did the scaffolding. Based on in vitro measurements BMS appear superior to DES in some aspects of mechanical performance, yet the differences are small and not class uniform. The data provide assistance in selecting the optimal system for treatment and assessment of new generations of bioresorbable scaffolds. not applicable.

  15. Alcohol based-deep eutectic solvent (DES) as an alternative green additive to increase rotenone yield

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

    Othman, Zetty Shafiqa; Hassan, Nur Hasyareeda; Zubairi, Saiful Irwan

    Deep eutectic solvents (DESs) are basically molten salts that interact by forming hydrogen bonds between two added components at a ratio where eutectic point reaches a melting point lower than that of each individual component. Their remarkable physicochemical properties (similar to ionic liquids) with remarkable green properties, low cost and easy handling make them a growing interest in many fields of research. Therefore, the objective of pursuing this study is to analyze the potential of alcohol-based DES as an extraction medium for rotenone extraction from Derris elliptica roots. DES was prepared by a combination of choline chloride, ChCl and 1,more » 4-butanediol at a ratio of 1/5. The structure of elucidation of DES was analyzed using FTIR, {sup 1}H-NMR and {sup 13}C-NMR. Normal soaking extraction (NSE) method was carried out for 14 hours using seven different types of solvent systems of (1) acetone; (2) methanol; (3) acetonitrile; (4) DES; (5) DES + methanol; (6) DES + acetonitrile; and (7) [BMIM] OTf + acetone. Next, the yield of rotenone, % (w/w), and its concentration (mg/ml) in dried roots were quantitatively determined by means of RP-HPLC. The results showed that a binary solvent system of [BMIM] OTf + acetone and DES + acetonitrile was the best solvent system combination as compared to other solvent systems. It contributed to the highest rotenone content of 0.84 ± 0.05% (w/w) (1.09 ± 0.06 mg/ml) and 0.84 ± 0.02% (w/w) (1.03 ± 0.01 mg/ml) after 14 hours of exhaustive extraction time. In conclusion, a combination of the DES with a selective organic solvent has been proven to have a similar potential and efficiency as of ILs in extracting bioactive constituents in the phytochemical extraction process.« less

  16. [Not Available].

    PubMed

    Siah, S; Belefqih, R; Elouennass, M; Fouadi, F E; Ihrai, I

    2009-06-30

    L'infection nosocomiale bactérienne étant l'une des principales causes de morbidité et de mortalité chez le brûlé, nous avons réalisé une étude rétrospective portant sur 84 patients hospitalisés au sein du service de réanimation des brûlés de l'Hôpital Militaire d'Instruction Mohammed V de Rabat, sur une période de 3 ans, du premier janvier 2001 au 31 décembre 2003. Les critères d'infection nosocomiale étaient ceux du Center for Disease Control d'Atlanta de 1988. Les taux d'incidence ont été calculés. La population infectée a été comparée à celle non infectée. L'écologie bactérienne du service a été décrite comme aussi l'antibiotype. Il ressort de cette étude la survenue de 87 infections nosocomiales chez 27 patients. L'incidence cumulative était de 103 infections pour 1000 jours de traitement. Pour ce qui est des caractéristiques des infections bactériennes, les sites infectés étaient la peau (77%), le sang (13,8%), les voies urinaires (8%) et les poumons (1,1%). Les principaux germes étaient: Staphylococcus sp. (33,3%), Pseudomonas aeruginosa (23%), Enterococcus faecalis et Acinetobacter (8%). Les staphylocoques étaient méticillo-résistants dans 22,2% des cas. Le Pseudomonas et l'Acinetobacter étaient multirésistants (60%). Dans notre étude les facteurs prédictifs de survenue des infections nosocomiales que nous avons retenus après l'étude comparative des populations infectées et non infectées ont été l'âge, le body mass index, l'abbreviated burn severity index et le remplissage initial. En isolant ces paramètres, nous avons pu établir une équation à valeur prédictive de survenue d'infection nosocomiale chez le patient brûlé.

  17. Properties of Dwarf Ellipticals in Low-Density Environments

    NASA Astrophysics Data System (ADS)

    Sur, Debnil; Guhathakurta, P.; Toloba, E.

    2013-01-01

    Dwarf elliptical galaxies have been studied only in dense cluster environments, where they are the most common type of object. While this suggests that their location affects their formation and evolution, the role of distance is not fully understood. Thus, to investigate the physical processes that shape these galaxies, we have conducted a study of dwarf elliptical galaxies (dEs) in low-density environments to compare their properties with those in clusters. Catalogs of such objects have not been created; thus, we have developed a novel objective method to find new dEs through comparing photometric properties with those of galaxies in the Virgo Cluster Catalog. This method utilizes optical colors, surface brightness and ellipticity, and it confirms smoothness through visual classification. In this last step, we found a very low contamination rate, which suggests the procedure’s utility in finding dEs. Through the NSA Sloan Atlas, we have analyzed the spectrophotometric properties of the dE candidates as a function of distance to the nearest massive galaxy, which we refer to as their host. We have found that these dEs are younger and more actively forming stars than dEs in denser regions. This is consistent with a transformation scenario in which low luminosity spiral galaxies are affected by the environment and transformed into quiescent galaxies. This low density regime contains objects in an intermediate state between the spiral galaxy and the classical dE in Virgo, where no star formation is ongoing. The correlation of the studied properties with the distance to the host galaxy provides new evidence that the dEs are created by a process called ram-pressure stripping: the interstellar medium of a host galaxy removes the gas of a smaller star-forming galaxy and provokes its quenching. We are currently analysing Keck/DEIMOS spectroscopy of some of the dE candidates from our catalog to explore in more detail their connection to cluster dEs. Possible similarities include their kinematic behaviour, stellar populations and chemical abundances. This research was supported by the Science Internship Program (SIP) at UCSC and the National Science Foundation.

  18. Utilisation des méthodes contraceptives modernes en République Démocratique du Congo: prévalence et barrières dans la zone de santé de Dibindi à Mbuji-Mayi

    PubMed Central

    Ntambue, Abel Mukengeshayi; Tshiala, Rachel Ngalula; Malonga, Françoise Kaj; Ilunga, Tabitha Mpoyi; Kamonayi, Josaphat Mulumba; Kazadi, Simon Tshimankinda; Matungulu, Charles Matungu; Musau, Angel Nkola; Mulamba, Diese; Dramaix-Wilmet, Michèle; Donnen, Philippe

    2017-01-01

    Introduction l’objectif de cette étude était de déterminer la prévalence contraceptive moderne et les barrières à l’utilisation des méthodes contraceptives modernes chez les couples de la Zone de Santé Dibindi, à Mbuji-Mayi en République Démocratique du Congo. Méthodes de Mai à Juin 2015, nous avons réalisé une étude descriptive transversale. Nous avons inclus les femmes âgées de 15 à 49 ans, en union maritale, non enceinte au moment de l’enquête, qui habitaient la Zone de santé Dibindi depuis deux ans et ayant consenti librement de participer à l’étude. La collecte des données a été réalisée par interview libre des femmes. La prévalence contraceptive moderne se référait aux femmes en cours d’utilisation, au moment de l’enquête, des contraceptifs modernes. La comparaison des proportions a été réalisée au seuil de signification de 5%. Le test de Bonferroni a été utilisé pour comparer, deux à deux, les proportions des barrières à l’utilisation des contraceptifs modernes. Résultats la prévalence contraceptive moderne à Dibindi, en 2015, était de 18,4%. Elle était faible eu égard aux services de planification familiale disponibles dans cette Zone de santé. Plusieurs femmes refusaient d’utiliser les méthodes contraceptives modernes malgré l’information dont elles disposaient à cause de leur désir de maternité, l’interdiction religieuse, l’opposition du conjoint et la crainte des effets secondaires. Conclusion l’information suffisante et centrée sur chaque cliente ou son couple, sur la planification familiale, devrait être renforcée de façon à éliminer les fausses croyances, ce qui accroitrait l’utilisation des méthodes contraceptives modernes. PMID:28674592

  19. Selecting Representative Points in Normal Populations.

    DTIC Science & Technology

    1983-01-14

    where values can be compared. A rather early paper on quantization is by Steinhaus [1956]. In that paper, he demonstrates the two necessary (but not...already noted that Steinhaus lists these two l<i<l conditions. These two necessary conditions for an optimal quantization suggest an iterative...Stanford, California. Steinhaus , H. (1956). Sur la division des corps materiels en parties. Bulletin De L’Academie Polonaise Des Sciences, Cl. III- Vol

  20. Investigations of Flow Over a Hemisphere Using Numerical Simulations (Postprint)

    DTIC Science & Technology

    2015-06-22

    ranging from missile defense, remote sensing , and imaging . An important aspect of these applications is determining the effective beam-on-target...Stokes (URANS), detached eddy simulation (DES), and hybrid RANS/LES. The numerical results were compared with the experiment conducted at Auburn...turret. Using the DES and hybrid RANS/LES turbulence models, Loci-Chem was able to capture the unsteady flow structures, such as the shear layer

  1. Fluctuations Magnetiques des Gaz D'electrons Bidimensionnels: Application AU Compose Supraconducteur LANTHANE(2-X) Strontium(x) Cuivre OXYGENE(4)

    NASA Astrophysics Data System (ADS)

    Benard, Pierre

    Nous presentons une etude des fluctuations magnetiques de la phase normale de l'oxyde de cuivre supraconducteur La_{2-x}Sr _{x}CuO_4 . Le compose est modelise par le Hamiltonien de Hubbard bidimensionnel avec un terme de saut vers les deuxiemes voisins (modele tt'U). Le modele est etudie en utilisant l'approximation de la GRPA (Generalized Random Phase Approximation) et en incluant les effets de la renormalisation de l'interaction de Hubbard par les diagrammes de Brueckner-Kanamori. Dans l'approche presentee dans ce travail, les maximums du facteur de structure magnetique observes par les experiences de diffusion de neutrons sont associes aux anomalies 2k _{F} de reseau du facteur de structure des gaz d'electrons bidimensionnels sans interaction. Ces anomalies proviennent de la diffusion entre particules situees a des points de la surface de Fermi ou les vitesses de Fermi sont tangentes, et conduisent a des divergences dont la nature depend de la geometrie de la surface de Fermi au voisinage de ces points. Ces resultats sont ensuite appliques au modele tt'U, dont le modele de Hubbard usuel tU est un cas particulier. Dans la majorite des cas, les interactions ne determinent pas la position des maximums du facteur de structure. Le role de l'interaction est d'augmenter l'intensite des structures du facteur de structure magnetique associees a l'instabilite magnetique du systeme. Ces structures sont souvent deja presentes dans la partie imaginaire de la susceptibilite sans interaction. Le rapport d'intensite entre les maximums absolus et les autres structures du facteur de structure magnetique permet de determiner le rapport U_ {rn}/U_{c} qui mesure la proximite d'une instabilite magnetique. Le diagramme de phase est ensuite etudie afin de delimiter la plage de validite de l'approximation. Apres avoir discute des modes collectifs et de l'effet d'une partie imaginaire non-nulle de la self-energie, l'origine de l'echelle d'energie des fluctuations magnetiques est examinee. Il est ensuite demontre que le modele a trois bandes predit les memes resultats pour la position des structures du facteur de structure magnetique que le modele a une bande, dans la limite ou l'hybridation des orbitales des atomes d'oxygene des plans Cu-O_2 et l'amplitude de sauts vers les seconds voisins sont nulles. Il est de plus constate que l'effet de l'hybridation des orbitales des atomes d'oxygene est bien modelise par le terme de saut vers les seconds voisins. Meme si ils decrivent correctement le comportement qualitatif des maximums du facteur de structure magnetique, les modeles a trois bandes et a une bande ne permettent pas d'obtenir une position de ces structures conforme avec les mesures experimentales, si on suppose que la bande est rigide, c'est-a-dire que les parametres du Hamiltonien sont independants de la concentration de strontium. Ceci peut etre cause par la dependance des parametres du Hamiltonien sur la concentration de strontium. Finalement, les resultats sont compares avec les experiences de diffusion de neutrons et les autres theories, en particulier celles de Littlewood et al. (1993) et de Q. Si et al. (1993). La comparaison avec les resultats experimentaux pour le compose de lanthane suggere que le liquide de Fermi possede une surface de Fermi disjointe, et qu'il est situe pres d'une instabilite magnetique incommensurable.

  2. 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.

  3. Experimental and theoretical vibrational spectroscopy studies of acetohydroxamic acid and desferrioxamine B in aqueous solution: Effects of pH and iron complexation

    NASA Astrophysics Data System (ADS)

    Edwards, David C.; Nielsen, Steen B.; Jarzęcki, Andrzej A.; Spiro, Thomas G.; Myneni, Satish C. B.

    2005-07-01

    The deprotonation and iron complexation of the hydroxamate siderophore, desferrioxamine B (desB), and a model hydroxamate ligand, acetohydroxamic acid (aHa), were studied using infrared, resonance Raman and UV-vis spectroscopy. The experimental spectra were interpreted by a comparison with DFT calculated spectra of aHa (partly hydrated) and desB (reactive groups of unhydrated molecule) at the B3LYP/6-31G* level of theory. The ab initio models include three water molecules surrounding the deprotonation site of aHa to account for partial hydration. Experiments and calculations were also conducted in D 2O to verify spectral assignments. These studies of aHa suggest that the cis-keto-aHa is the dominant form, and its deprotonation occurs at the oxime oxygen atom in aqueous solutions. The stable form of iron-complexed aHa is identified as Fe(aHa) 3 for a wide range of pH conditions. The spectral information of aHa and an ab initio model of desB were used to interpret the chemical state of different functional groups in desB. Vibrational spectra of desB indicate that the oxime and amide carbonyl groups can be identified unambiguously. Vibrational spectral analysis of the oxime carbonyl after deprotonation and iron complexation of desB indicates that the conformational changes between anion and the iron-complexed anion are small. Enhanced electron delocalization in the oxime group of Fe-desB when compared to that of Fe(aHa) 3 may be responsible for higher stability constant of the former.

  4. Traitement chirurgical initial des brûlures de la main de l’enfant. Revue

    PubMed Central

    Goffinet, L.; Breton, A.; Gavillot, C.; Barbary, S.; Journeau, P.; Lascombes, P.; Dautel, G.

    2015-01-01

    Summary Trente cinq revues concernant la prise en charge chirurgicale de la main brûlée de l’enfant sont indexées dans Pub- Med. Elles portent sur l’indication de la cicatrisation dirigée versus chirurgie, les techniques et délais d’instauration des traitements par excision-greffe, le calendrier et la nature du traitement de réadaptation et la surveillance. L’enfant présente un risque accru de brides cicatricielles, nécessitant un suivi médico-chirurgical attentif et prolongé. L’objet de cet article est de rapporter les spécificités chirurgicales de la prise en charge de ces brûlures. Cette revue de la littérature, réalisée au moyen de la base PubMed (publication entre 2005 et 2011) à partir des mots-clés « hand AND/OR child AND/OR burn » retrouve 67 publications utiles au sein de 171 références. Les données rapportées ont été comparées aux ouvrages de références français et américains. Des données contradictoires sont rapportées concernant la délai de l’excision et de la greffe, avec seulement deux études comparatives comportant de nombreux biais. L’état de la science n’apporte pas d’éléments de preuve suffisant en raison d’un manque de puissance statistique des études, mais de nombreux avis d’expert explorant chaque type d’indication permet d’établir une stratégie claire, guidant les indications thérapeutiques. Il apparaît donc indispensable de réaliser des études prospectives incluant ces patients depuis le suivi initial jusqu’au suivi à long terme, pour augmenter le niveau de preuve de cette stratégie. PMID:27279807

  5. Rationale and design of the Patient Related OuTcomes with Endeavor versus Cypher stenting Trial (PROTECT): randomized controlled trial comparing the incidence of stent thrombosis and clinical events after sirolimus or zotarolimus drug-eluting stent implantation.

    PubMed

    Camenzind, Edoardo; Wijns, William; Mauri, Laura; Boersma, Eric; Parikh, Keyur; Kurowski, Volkhard; Gao, Runlin; Bode, Christoph; Greenwood, John P; Gershlick, Anthony; O'Neill, William; Serruys, Patrick W; Jorissen, Brenda; Steg, P Gabriel

    2009-12-01

    Drug-eluting stents (DES) reduce restenosis rates compared to bare-metal stents. Most trials using DES enrolled selected patient and lesion subtypes, and primary endpoint focused on angiographic metrics or relatively short-term outcomes. When DES are used in broader types of lesions and patients, important differences may emerge in long-term outcomes between stent types, particularly the incidence of late stent thrombosis. PROTECT is a randomized, open-label trial comparing the long-term safety of the zotarolimus-eluting stent and the sirolimus-eluting stent. The trial has enrolled 8,800 patients representative of those seen in routine clinical practice, undergoing elective, unplanned, or emergency procedures in native coronary arteries in 196 centers in 36 countries. Indications for the procedure and selection of target vessel and lesion characteristics were at the operator's discretion. Procedures could be staged, but no more than 4 target lesions could be treated per patient. Duration of dual antiplatelet therapy was prespecified to achieve similar lengths of treatment in both study arms. The shortest predefined duration was 3 months, as per the manufacturer's instructions. The primary outcome measure is the composite rate of definite and probable stent thrombosis at 3 years, centrally adjudicated using Academic Research Consortium definitions. The main secondary end points are 3-year all-cause mortality, cardiac death, large nonfatal myocardial infarction, and all myocardial infarctions. This large, international, randomized, controlled trial will provide important information on comparative rates of stent thrombosis between 2 different DES systems and safety as assessed by patient-relevant long-term clinical outcomes.

  6. [Experience with the use of the bio-active stent coated with titanium nitric oxide compared with zotarolimus-eluting stent: experience of a unit medical high specialty].

    PubMed

    Garcia-Gutierrez, Juan C; Palacios-Rodríguez, Juan M; Cordova-Correa, Horacio G; Becerra-Laguna, Carlos A; López-López, Hugo A; Salinas Aragón, Miguel A; García-Bonilla, Jorge

    2016-01-01

    The use of coronary stents in coronary angioplasty has evolved dramatically in its design, type materials, polymers, and a variety of drugs, the use of coronary stents covered nitric oxide have shown satisfactory results in practice, however compared to the results reported drug-eluting stents, there is little information. The aim of this study was to compare clinical outcomes of a stainless steel stent Bioactive nitric oxide coated titanium (BAS) and a drug-eluting stent zotarolimus (DES) in daily clinical practice. A retrospective, analytical, descriptive and comparative study aimed at evaluating the safety and efficacy of two devices with different characteristics in our population. The primary endpoints were: death, acute infarction (AMI), and re intervention injury Treated (RLT). A total of 759 patients were included in the study which was performed angioplasty to a single vessel. Were divided into two arms 382 with DES and 377 patients with BAS, the one year follow up was carried in 95%. After this follow-up period, primary points (cardiovascular death, myocardial infarction, TLR and stent thrombosis) for arm DES vs BAS; 9.5% vs 8.5% P=NS but with shorter periods of dual antiplatelet therapy for arm BAS 6.9±4.1 vs 11.1±2.5 months DES P=.0001. The results were independent of the clinical syndrome of presentation. After one year of follow no statistically significant difference in major clinical events, there was a trend in favour of BAS vs SM with respect to revascularization of the target lesion without reaching statistical significance. Copyright © 2015 Instituto Nacional de Cardiología Ignacio Chávez. Published by Masson Doyma México S.A. All rights reserved.

  7. Mal-Development of the Penis and Loss of Fertility in Male Rats Treated Neonatally with Female Contraceptive 17α-Ethinyl Estradiol: A Dose-Response Study and a Comparative Study with a Known Estrogenic Teratogen Diethylstilbestrol

    PubMed Central

    Mathews, Ensa; Braden, Tim D.; Williams, Carol S.; Williams, John W.; Bolden-Tiller, Olga; Goyal, Hari O.

    2009-01-01

    The objectives of this study were to find a minimal dose of 17α-ethinyl estradiol (EE) that is detrimental to the developing penis and fertility and to compare estrogenic effects between EE and diethylstilbestrol (DES). Neonatal rats received EE at 10 ng (1 μg/kg), 100 ng, 1 μg, or 10 μg per pup on alternate days from postnatal days 1 to 11 (dose-response study) or received EE or DES at 100 ng per pup daily from postnatal days 1 to 6 (comparative study). Effects of EE were dose dependent, with ≥ 100-ng dose inducing significant (p < 0.05) reductions in penile length, weight, and diameter. Additionally, the penis was malformed, characterized by underdeveloped os penis and accumulation of fat cells. Fertility was 0% in the ≥ 1-μg groups, in contrast to 60% in the 100-ng group and 100% in the 10-ng and control groups. Animals treated with ≥ 10 ng had significant reductions in the weight of bulbospongious muscle, testis, seminal vesicle, epididymal fat pad, and in epididymal sperm numbers. A comparison of EE and DES effects showed similar reductions in penile weight and length and the weight of bulbospongiosus muscle, testis, seminal vesicle, epididymis, and epididymal fat pad in both adolescent and adult rats. While 5/6 control males sired, only 1/6 in the EE group and 0/6 in the DES group sired. Hence, neonatal exposure to EE at 10 ng (environmentally relevant dose) adversely affects male reproductive organs. A dose ten times higher than this leads to permanently mal-developed penis and infertility. Furthermore, EE and DES exposures show similar level of toxicity to male reproductive organs. PMID:19729556

  8. Le changement comme tradition dans la recherche et la formation a la recherche en biotechnologie et en peripherie Etude de cas en sciences de la sante, sciences naturelles et genie

    NASA Astrophysics Data System (ADS)

    Bourque, Claude Julie

    Le champ de la recherche scientifique et de la formation a la recherche est traverse depuis quelques dizaines d'annees par plusieurs courants et discours associes au changement, mais peu de travaux empiriques permettent de comprendre ce qui change concretement. C'est la contribution originale de cette these au champ de l'education, plus specifiquement a l'etude sociologique de l'enseignement superieur ou sont concentrees les activites liees a la triade thematique du programme doctoral dans lequel elle a ete produite : recherche, formation et pratique. L'enquete-terrain a ete realisee en 2009 et 2010 aupres de 808 repondants affilies a 60 etablissements au Quebec et a produit un vaste materiau de nature mixte (donnees quantitatives et qualitatives). Un portrait de la nebuleuse biotechnologique qui touche les secteurs des sciences de la sante, des sciences naturelles et du genie a ete realise. Ce domaine concerne des dizaines de disciplines et se revele de nature transdisciplinaire, mais les pratiques n'y sont pas davantage marquees par le changement que celles d'autres domaines connexes. Les dynamiques sociales ont fait l'objet d'analyses comparatives dans quatre contextes: le choix des programmes, des objets et des methodes, le financement, la diffusion et la planification de la carriere. Les resultats indiquent que les echanges entre les agents traditionnellement situes au coeur des activites de recherche dominent ces dynamiques dans tous les contextes etudies. L'etude des representations au fondement des pratiques a revele l'existence de trois ecoles de pensee qui coexistent dans le champ scientifique: academique, pragmatique et economiste. Ces ecoles permettent de categoriser les agents en fonction des zones de fractures qui marquent leurs oppositions tout en identifiant ce qu'ils ont en commun. Les representations et les pratiques liees a la formation temoignent d'un habitus plutot homogene, alors que les contradictions semblent plus souvent ancrees dans des luttes universitaires que scientifiques, concentrees sur la negociation du capital scientifique, symbolique et economique en jeu dans la formation doctorale, dans les carrieres auxquelles elle mene, et dans les qualites du titre de Ph.D. Au final, la confusion entre des logiques opposees peut etre reduite en reinterpretant le changement comme tradition du champ scientifique. Mots-cles Sociologie, education, enseignement superieur, science et technologie, biotechnologie, formation doctorale, champ scientifique, reseaux sociaux

  9. Green extraction of grape skin phenolics by using deep eutectic solvents.

    PubMed

    Cvjetko Bubalo, Marina; Ćurko, Natka; Tomašević, Marina; Kovačević Ganić, Karin; Radojčić Redovniković, Ivana

    2016-06-01

    Conventional extraction techniques for plant phenolics are usually associated with high organic solvent consumption and long extraction times. In order to establish an environmentally friendly extraction method for grape skin phenolics, deep eutectic solvents (DES) as a green alternative to conventional solvents coupled with highly efficient microwave-assisted and ultrasound-assisted extraction methods (MAE and UAE, respectively) have been considered. Initially, screening of five different DES for proposed extraction was performed and choline chloride-based DES containing oxalic acid as a hydrogen bond donor with 25% of water was selected as the most promising one, resulting in more effective extraction of grape skin phenolic compounds compared to conventional solvents. Additionally, in our study, UAE proved to be the best extraction method with extraction efficiency superior to both MAE and conventional extraction method. The knowledge acquired in this study will contribute to further DES implementation in extraction of biologically active compounds from various plant sources. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Delivery of large biopharmaceuticals from cardiovascular stents: a review

    PubMed Central

    Takahashi, Hironobu; Letourneur, Didier; Grainger, David W.

    2008-01-01

    This review focuses on the new and emerging large-molecule bioactive agents delivered from stent surfaces in drug-eluting stents (DES) to inhibit vascular restenosis in the context of interventional cardiology. New therapeutic agents representing proteins, nucleic acids (small interfering RNAs and large DNA plasmids), viral delivery vectors and even engineered cell therapies require specific delivery designs distinct from traditional smaller molecule approaches on DES. While small molecules are currently the clinical standard for coronary stenting, extension of the DES to other lesion types, peripheral vasculature and non-vasculature therapies will seek to deliver an increasingly sophisticated armada of drug types. This review describes many of the larger molecule and biopharmaceutical approaches reported recently for stent-based delivery with the challenges associated with formulating and delivering these drug classes compared to the current small molecule drugs. It also includes perspectives on possible future applications that may improve safety and efficacy and facilitate diversification of the DES to other clinical applications. PMID:17929968

  11. Teledetection passive et processus decisionnel a reference spatiale: Application a l'aquaculture en milieu marin

    NASA Astrophysics Data System (ADS)

    Habbane, Mohamed

    L'objectif de cette etude est d'elaborer un processus decisionnel a reference spatiale (PDRS) pour la mariculture. Le PDRS est applique aux eaux cotieres de la baie des Chaleurs, dans le golfe du Saint-Laurent (Canada). Une carte preliminaire regionale d'indices du potentiel maricole, d'une limite de resolution spatiale de 1 kmsp2, est produite avec des parametres du niveau 1. Ces parametres englobent la temperature de l'eau de surface, extraite des images AVHRR, la salinite, les courants ainsi que les pigments chlorophylliens, quantifies a l'aide de mesures in situ. Les images AVHRR, prises en 1994, ont ete utiliees comme reference primaire pour selectionner des aires pouvant supporter une activite maricole sur la cote nord de la baie des Chaleurs. La temperature de surface extraite de ces images permet une analyse mesoechelle a la fois qualitative et quantitative des processus cotiers observes pendant la periode d'acquisition des donnees. Les autres donnees, soit la salinite, les courants et les concentrations en pigments chlorophylliens, sont analysees de facon a identifier la variabilite spatio-temporelle des caracteristiques des eaux de surface. L'ensemble des informations permet de produire une carte preliminaire regionale d'indices du potentiel maricole de la partie centrale de la baie des Chaleurs. Selon cet indice (defini entre 0 et 1), le secteur de potentiel aquicole de 0,5 a 0,75 s'etend sur une superficie d'environ 300 kmsp2. La localisation de cette aire potentielle est en accord avec les fortes concentrations en pigments chlrophylliens, presentant des conditions environnementales ideales a une haute productivite biologique. Par la suite la carte preliminaire est modifiee en tenant compte des parametres du niveau 2. Ces parametres sont la geomorphologie littorale, la bathymetrie, les sediments en suspension, les vents, les vagues, le debit d'eau douce, la glace marine, le carbone organique dissous, les aires de peche et les sources de pollution. Ces parametres sont compares deux a deux par rapport a la carte preliminaire regionale d'indices du potentiel maricole pour determiner leur poids relatif. La carte finale produite avec ces parametres du niveau 2 presente un secteur ou les indices du potentiel maricole sont de 0,5 a 0,75. Ce secteur longe la cote et epouse les isobathes de 10 a 30 m de profondeur. L'effet de la profondeur d'eau semble avoir jouer un role important. Le secteur de potentiel maricole de 0,25 a 0,5 est toujours present et couvre une superficie d'environ 426 kmsp2. L'etude necessitera toujours un suivi des conditions environnementales prevalant dans la region. Ce suivi peut etre effectue a l'aide d'un outil de vision aerospatiale (capteurs de teledetection) et d'analyse spatio-temporelle (SIG-PDRS). (Abstract shortened by UMI.)

  12. Cervical screening and general physical examination behaviors of women exposed in utero to diethylstilbestrol.

    PubMed

    Camp, Elizabeth A; Coker, Ann L; Troisi, Rebecca; Robboy, Stanley J; Noller, Kenneth L; Goodman, Karen J; Titus-Ernstoff, Linda T; Hatch, Elizabeth E; Herbst, Arthur L; Kaufman, Raymond H; Adam, Ervin

    2008-04-01

    To estimate whether women exposed in utero to diethylstilbestrol (DES) report receiving more cervical and general physical examinations compared to unexposed women. 1994 Diethylstilbestrol Adenosis cohort data are used to assess the degree of recommended compliance of cervical screenings found in 3,140 DES-exposed and 826 unexposed women. Participants were enrolled at 4 sites: Houston, Boston, Rochester, and Los Angeles. Logistic regression modeling was used to analyze mailed questionnaire data, which included reported frequency over the preceding 5 years (1990-1994) of Papanicolaou smears and general physical examinations. Diethylstilbestrol-exposed women exceeded the recommended frequency of Papanicolaou smear screenings [adjusted odds ratio (aOR) = 2.15, 95% CI (confidence interval) = 1.60-2.88] compared to the unexposed. This association held among those without a history of cervical intraepithelial neoplasia (aOR = 1.88, 95% CI = 1.35-2.62). Diethylstilbestrol-exposed women exceeded annual recommendations for physical examinations (aOR = 2.27, 95% CI = 1.16-4.43) among women without a history of chronic disease when compared to unexposed women. Most DES-exposed women are receiving cervical cancer screening at least at recommended intervals, but one third of the women are not receiving annual Papanicolaou smear examinations.

  13. Influence of platform design of six different drug-eluting stents in provisional coronary bifurcation stenting by rePOT sequence: a comparative bench analysis.

    PubMed

    Derimay, François; Souteyrand, Geraud; Motreff, Pascal; Rioufol, Gilles; Finet, Gerard

    2017-10-13

    The rePOT (proximal optimisation technique) sequence proved significantly more effective than final kissing balloon (FKB) with two drug-eluting stents (DES) in a bench test. We sought to validate efficacy experimentally in a large range of latest-generation DES. On left main fractal coronary bifurcation bench models, five samples of each of the six main latest-generation DES (Coroflex ISAR, Orsiro, Promus PREMIER, Resolute Integrity, Ultimaster, XIENCE Xpedition) were implanted on rePOT (initial POT, side branch inflation, final POT). Proximal elliptical ratio, side branch obstruction (SBO), stent overstretch and strut malapposition were quantified on 2D and 3D OCT. Results were compared to FKB with Promus PREMIER. Whatever the design, rePOT maintained vessel circularity compared to FKB: elliptical ratio, 1.02±0.01 to 1.04±0.01 vs. 1.26±0.02 (p<0.05). Global strut malapposition was much lower: 2.6±1.4% to 0.1±0.2% vs. 40.4±8.4% for FKB (p<0.05). However, only Promus PREMIER and XIENCE Xpedition achieved significantly less SBO: respectively, 5.6±3.5% and 10.0±5.3% vs. 23.5±5.7% for FKB (p<0.05). Platform design differences had little influence on the excellent results of rePOT versus FKB. RePOT optimised strut apposition without proximal elliptical deformation in the six main latest-generation DES. Thickness and design characteristics seemed relevant for optimising SBO.

  14. Ticagrelor with aspirin or alone in high-risk patients after coronary intervention: Rationale and design of the TWILIGHT study.

    PubMed

    Baber, Usman; Dangas, George; Cohen, David J; Gibson, C Michael; Mehta, Shamir R; Angiolillo, Dominick J; Pocock, Stuart J; Krucoff, Mitchell W; Kastrati, Adnan; Ohman, E Magnus; Steg, Philippe Gabriel; Badimon, Juan; Zafar, M Urooj; Chandrasekhar, Jaya; Sartori, Samantha; Aquino, Melissa; Mehran, Roxana

    2016-12-01

    Dual antiplatelet therapy (DAPT) is necessary to prevent thrombosis yet increases bleeding after percutaneous coronary intervention (PCI) with drug-eluting stents (DES). Antiplatelet monotherapy with a potent P2Y 12 receptor antagonist may reduce bleeding while maintaining anti thrombotic efficacy compared with conventional DAPT. TWILIGHT is a randomized, double-blind placebo-controlled trial evaluating the comparative efficacy and safety of antiplatelet monotherapy versus DAPT in up to 9000 high-risk patients undergoing PCI with DES. Upon enrollment after successful PCI, all patients will be treated with open label low-dose aspirin (81-100 mg daily) plus ticagrelor (90 mg twice daily) for 3 months. Event-free patients will then be randomized in a double-blind fashion to low-dose aspirin versus matching placebo with continuation of open-label ticagrelor for an additional 12 months. The primary hypothesis is that a strategy of ticagrelor monotherapy will be superior with respect to the primary endpoint of bleeding academic research consortium type 2, 3 or 5, while maintaining non-inferiority for ischemic events compared with ticagrelor plus ASA. TWILIGHT is the largest study to date that is specifically designed and powered to demonstrate reductions in bleeding with ticagrelor monotherapy versus ticagrelor plus ASA beyond 3 months post-procedure in a high-risk PCI population treated with DES. The trial will provide novel insights with respect to the potential role of ticagrelor monotherapy as an alternative for long-term platelet inhibition in a broad population of patients undergoing PCI with DES. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. 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

  16. Computer-aided classification of breast masses using contrast-enhanced digital mammograms

    NASA Astrophysics Data System (ADS)

    Danala, Gopichandh; Aghaei, Faranak; Heidari, Morteza; Wu, Teresa; Patel, Bhavika; Zheng, Bin

    2018-02-01

    By taking advantages of both mammography and breast MRI, contrast-enhanced digital mammography (CEDM) has emerged as a new promising imaging modality to improve efficacy of breast cancer screening and diagnosis. The primary objective of study is to develop and evaluate a new computer-aided detection and diagnosis (CAD) scheme of CEDM images to classify between malignant and benign breast masses. A CEDM dataset consisting of 111 patients (33 benign and 78 malignant) was retrospectively assembled. Each case includes two types of images namely, low-energy (LE) and dual-energy subtracted (DES) images. First, CAD scheme applied a hybrid segmentation method to automatically segment masses depicting on LE and DES images separately. Optimal segmentation results from DES images were also mapped to LE images and vice versa. Next, a set of 109 quantitative image features related to mass shape and density heterogeneity was initially computed. Last, four multilayer perceptron-based machine learning classifiers integrated with correlationbased feature subset evaluator and leave-one-case-out cross-validation method was built to classify mass regions depicting on LE and DES images, respectively. Initially, when CAD scheme was applied to original segmentation of DES and LE images, the areas under ROC curves were 0.7585+/-0.0526 and 0.7534+/-0.0470, respectively. After optimal segmentation mapping from DES to LE images, AUC value of CAD scheme significantly increased to 0.8477+/-0.0376 (p<0.01). Since DES images eliminate overlapping effect of dense breast tissue on lesions, segmentation accuracy was significantly improved as compared to regular mammograms, the study demonstrated that computer-aided classification of breast masses using CEDM images yielded higher performance.

  17. The Origin of Dwarf Early-Type Galaxies

    NASA Astrophysics Data System (ADS)

    Toloba, Elisa

    2012-10-01

    Abridge. We have conducted a spectrophotometric study of dwarf early-type galaxies (dEs) in the Virgo cluster and in regions of lower density. We have found that these galaxies show many properties in common with late-type galaxies but not with more massive early-types (E/S0). The properties of the dEs in Virgo show gradients within the cluster. dEs in the outer parts of the Virgo cluster are kinematically supported by rotation, while those in the center are supported by the random motions of their stars (i.e. pressure supported). The rotationally supported dEs have disky isophotes and faint underlying spiral/irregular substructures, they also show younger ages than those pressure supported, which have boxy isophotes and are smooth and regular, without any substructure. We compare the position of these dEs with massive early-type galaxies in the Faber-Jackson and Fundamental Plane relations, and we find that, although there is no difference between the position of rotationally and pressure supported dEs, both deviate from the relations of massive early-type galaxies in the direction of dwarf spheroidal systems (dSphs). We have used their offset with respect to the Fundamental Plane of E/S0 galaxies to estimate their dark matter fraction. All the properties studied in this work agree with a ram pressure stripping scenario, where late-type galaxies infall into the cluster, their interaction with the intergalactic medium blows away their gas and, as a result, they are quenched in a small amount of time. However, those dEs in the center of the cluster seem to have been fully transformed leaving no trace of their possible spiral origin, thus, if that is the case, they must have experienced a more violent mechanism in combination with ram pressure stripping.

  18. Etude de la dynamique des porteurs dans des nanofils de silicium par spectroscopie terahertz

    NASA Astrophysics Data System (ADS)

    Beaudoin, Alexandre

    Ce memoire presente une etude des proprietes de conduction electrique et de la dynamique temporelle des porteurs de charges dans des nanofils de silicium sondes par rayonnement terahertz. Les cas de nanofils de silicium non intentionnellement dopes et dopes type n sont compares pour differentes configurations du montage experimental. Les mesures de spectroscopie terahertz en transmission montre qu'il est possible de detecter la presence de dopants dans les nanofils via leur absorption du rayonnement terahertz (˜ 1--12 meV). Les difficultes de modelisation de la transmission d'une impulsion electromagnetique dans un systeme de nanofils sont egalement discutees. La detection differentielle, une modification au systeme de spectroscopie terahertz, est testee et ses performances sont comparees au montage de caracterisation standard. Les instructions et des recommendations pour la mise en place de ce type de mesure sont incluses. Les resultats d'une experience de pompe optique-sonde terahertz sont egalement presentes. Dans cette experience, les porteurs de charge temporairement crees suite a l'absorption de la pompe optique (lambda ˜ 800 nm) dans les nanofils (les photoporteurs) s'ajoutent aux porteurs initialement presents et augmentent done l'absorption du rayonnement terahertz. Premierement, l'anisotropie de l'absorption terahertz et de la pompe optique par les nanofils est demontree. Deuxiemement, le temps de recombinaison des photoporteurs est etudie en fonction du nombre de photoporteurs injectes. Une hypothese expliquant les comportements observes pour les nanofils non-dopes et dopes-n est presentee. Troisiemement, la photoconductivite est extraite pour les nanofils non-dopes et dopes-n sur une plage de 0.5 a 2 THz. Un lissage sur la photoconductivite permet d'estimer le nombre de dopants dans les nanofils dopes-n. Mots-cles: nanofil, silicium, terahertz, conductivite, spectroscopie, photoconductivite.

  19. Reduction of In-Stent Restenosis by Cholesteryl Ester Transfer Protein Inhibition.

    PubMed

    Wu, Ben J; Li, Yue; Ong, Kwok L; Sun, Yidan; Shrestha, Sudichhya; Hou, Liming; Johns, Douglas; Barter, Philip J; Rye, Kerry-Anne

    2017-12-01

    Angioplasty and stent implantation, the most common treatment for atherosclerotic lesions, have a significant failure rate because of restenosis. This study asks whether increasing plasma high-density lipoprotein (HDL) levels by inhibiting cholesteryl ester transfer protein activity with the anacetrapib analog, des-fluoro-anacetrapib, prevents stent-induced neointimal hyperplasia. New Zealand White rabbits received normal chow or chow supplemented with 0.14% (wt/wt) des-fluoro-anacetrapib for 6 weeks. Iliac artery endothelial denudation and bare metal steel stent deployment were performed after 2 weeks of des-fluoro-anacetrapib treatment. The animals were euthanized 4 weeks poststent deployment. Relative to control, dietary supplementation with des-fluoro-anacetrapib reduced plasma cholesteryl ester transfer protein activity and increased plasma apolipoprotein A-I and HDL cholesterol levels by 53±6.3% and 120±19%, respectively. Non-HDL cholesterol levels were unaffected. Des-fluoro-anacetrapib treatment reduced the intimal area of the stented arteries by 43±5.6% ( P <0.001), the media area was unchanged, and the arterial lumen area increased by 12±2.4% ( P <0.05). Des-fluoro-anacetrapib treatment inhibited vascular smooth muscle cell proliferation by 41±4.5% ( P <0.001). Incubation of isolated HDLs from des-fluoro-anacetrapib-treated animals with human aortic smooth muscle cells at apolipoprotein A-I concentrations comparable to their plasma levels inhibited cell proliferation and migration. These effects were dependent on scavenger receptor-B1, the adaptor protein PDZ domain-containing protein 1, and phosphatidylinositol-3-kinase/Akt activation. HDLs from des-fluoro-anacetrapib-treated animals also inhibited proinflammatory cytokine-induced human aortic smooth muscle cell proliferation and stent-induced vascular inflammation. Inhibiting cholesteryl ester transfer protein activity in New Zealand White rabbits with iliac artery balloon injury and stent deployment increases HDL levels, inhibits vascular smooth muscle cell proliferation, and reduces neointimal hyperplasia in an scavenger receptor-B1, PDZ domain-containing protein 1- and phosphatidylinositol-3-kinase/Akt-dependent manner. © 2017 American Heart Association, Inc.

  20. Modélisation de matériaux chiraux à structures hétérogènes (modèle MTWC) : théorie, validations expérimentales et applications

    NASA Astrophysics Data System (ADS)

    Mariotte, F.; Sauviac, B.; Héliot, J. Ph.

    1995-10-01

    After a brief overview of the concept of electromagnetic chirality, this paper deals with a numerical simulation of isotropic composites with metallic chiral inclusions: computations of permittivity, permeability and chirality parameter as functions of frequency are presented. The theoretical results are, step by step, compared with measurements of chiral composites at microwave frequencies. The application of such media in Radar Cross-Section (RCS) management and control is discussed. The introduction of chiral inclusions seems to make impedance matching possible and may lead to attractive shields with lower reflectivity and larger bandwidth. However the optimization of material characteristics necessary to get a specific absorber remains a difficult task. Après un bref rappel du principe de la chiralité, cet article présente une modélisation des propriétés effectives des matériaux hétérogènes à inclusions chirales métalliques : calcul de la permittivité, perméabilité et coefficient de chiralité du composite en fonction de la fréquence. Les résultats théoriques sont validés, pas à pas, par des mesures effectuées sur des composites chiraux de natures différentes. L'application de tels matériaux à la conception de matériaux absorbant les ondes électromagnétiques est ensuite envisagée. Les inclusions chirales semblent offrir la possibilité de régler l'impédance à l'interface air-milieu absorbant permettant ainsi de concevoir des absorbants micro-ondes plus performants en terme d'atténuation ou de largeur de bande. L'optimisation des caractéristiques des matériaux pour obtenir des performances données restent néanmoins très délicate.

  1. Estrogen-Induced Maldevelopment of the Penis Involves Down-Regulation of Myosin Heavy Chain 11 (MYH11) Expression, a Biomarker for Smooth Muscle Cell Differentiation1

    PubMed Central

    Okumu, L.A.; Bruinton, Sequoia; Braden, Tim D.; Simon, Liz; Goyal, Hari O.

    2012-01-01

    ABSTRACT Cavernous smooth muscle cells are essential components in penile erection. In this study, we investigated effects of estrogen exposure on biomarkers for smooth muscle cell differentiation in the penis. Neonatal rats received diethylstilbestrol (DES), with or without the estrogen receptor (ESR) antagonist ICI 182,780 (ICI) or the androgen receptor (AR) agonist dihydrotestosterone (DHT), from Postnatal Days 1 to 6. Tissues were collected at 7, 10, or 21 days of age. The smooth muscle cell biomarker MYH11 was studied in depth because microarray data showed it was significantly down-regulated, along with other biomarkers, in DES treatment. Quantitative real time-PCR and Western blot analyses showed 50%–80% reduction (P ≤ 0.05) in Myh11 expression in DES-treated rats compared to that in controls; and ICI and DHT coadministration mitigated the decrease. Temporally, from 7 to 21 days of age, Myh11 expression was onefold increased (P ≥ 0.05) in DES-treated rats versus threefold increased (P ≤ 0.001) in controls, implying the long-lasting inhibitory effect of DES on smooth muscle cell differentiation. Immunohistochemical localization of smooth muscle alpha actin, another biomarker for smooth muscle cell differentiation, showed fewer cavernous smooth muscle cells in DES-treated animals than in controls. Additionally, DES treatment significantly up-regulated Esr1 mRNA expression and suppressed the neonatal testosterone surge by 90%, which was mitigated by ICI coadministration but not by DHT coadministration. Collectively, results provided evidence that DES treatment in neonatal rats inhibited cavernous smooth muscle cell differentiation, as shown by down-regulation of MYH11 expression at the mRNA and protein levels and by reduced immunohistochemical staining of smooth muscle alpha actin. Both the ESR and the AR pathways probably mediate this effect. PMID:22976277

  2. 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

  3. The origin of dwarf early-type galaxies

    NASA Astrophysics Data System (ADS)

    Toloba, E.

    2013-05-01

    We have conducted a spectrophotometric study of dwarf early-type galaxies (dEs) in the Virgo cluster and in regions of lower density. We have found that these galaxies show many properties in common with late-type galaxies but not with more massive early-types (E/S0). The properties of the dEs in Virgo show gradients within the cluster. dEs in the outer parts of the Virgo cluster are kinematically supported by rotation, while those in the center are supported by the random motions of their stars (i.e. pressure supported). The rotationally supported dEs have disky isophotes and faint underlying spiral/irregular substructures, they also show younger ages than those pressure supported, which have boxy isophotes and are smooth and regular, without any substructure. We compare the position of these dEs with massive early-type galaxies in the Faber-Jackson and Fundamental Plane relations, and we find that, although there is no difference between the position of rotationally and pressure supported dEs, both deviate from the relations of massive early-type galaxies in the direction of dwarf spheroidal systems (dSphs). We have used their offset with respect to the Fundamental Plane of E/S0 galaxies to estimate their dark matter fraction. All the properties studied in this work agree with a ram pressure stripping scenario, where late-type galaxies infall into the cluster, their interaction with the intergalactic medium blows away their gas and, as a result, they are quenched in a small amount of time. However, those dEs in the center of the cluster seem to have been fully transformed leaving no trace of their possible spiral origin, thus, if that is the case, they must have experienced a more violent mechanism in combination with ram pressure stripping, the open problem is that even galaxy harassment does not fully explain the observed properties for the pressure supported dEs in the center of the Virgo cluster.

  4. Comparison of the long-term safety and efficacy of drug-eluting and bare-metal stent implantation in saphenous vein grafts.

    PubMed

    Latib, Azeem; Ferri, Luca; Ielasi, Alfonso; Cosgrave, John; Godino, Cosmo; Bonizzoni, Erminio; Romagnoli, Enrico; Chieffo, Alaide; Valgimigli, Marco; Penzo, Carlo; Carlino, Mauro; Michev, Iassen; Sangiorgi, Giuseppe M; Montorfano, Matteo; Airoldi, Flavio; Colombo, Antonio

    2010-06-01

    Concerns about the long-term safety of drug-eluting stents (DES) in saphenous vein grafts has become an area of controversy and uncertainty. In this retrospective registry, we compared the outcomes in 127 patients (143 lesions) treated with DES from April 2002 to June 2006 (DES group) with 131 patients (160 lesions) treated with bare-metal stents in the preceding 36 months (bare-metal stent group). End points analyzed were cumulative death, myocardial infarction, and target vessel revascularization at 2 years after stent implantation. The DES group was significantly (P<0.05) more complex with a greater frequency of diabetes (33.1%versus 15.3%), older grafts (11.6+/-5.3 years versus 9.6+/-5.2 years), restenotic lesions (23.8% versus 4.4%), total occlusions (7.7% versus 1.2%), and smaller grafts (3.16+/-0.66 mm versus 3.44+/-0.76 mm) treated with longer stents (34.1+/-25.1 mm versus 22.7+/-11.6 mm). At 2 years, there was no statistical difference in death (8.7% versus 7.8%), myocardial infarction (6.3% versus 9.4%), or target vessel revascularization (19.7% versus 24.2%) between DES and bare-metal stents, respectively. A propensity analysis to adjust for baseline differences suggested that there was no observed association between DES and increased mortality (hazard ratio, 0.72; 95% CI, 0.21 to 2.44; P=0.60) but possibly an association with a reduction in target vessel revascularization (hazard ratio, 0.31; 95% CI, 0.14 to 0.66; P=0.002). Despite being implanted in patients and lesions more complex than the bare-metal stent group, there was no observed association between DES implantation in saphenous vein grafts and an increase in late mortality. DES may maintain their efficacy in reducing revascularization rates in diseased saphenous vein grafts over a 2-year follow-up period.

  5. Concordance et apports de l'hystérosalpingographie et de la cœlioscopie dans l'exploration tubaire et pelvienne en cas d'infertilité

    PubMed Central

    Kehila, Mehdi; Ben Hmid, Rim; Ben Khedher, Sonia; Mahjoub, Sami; Channoufi, Mohamed Bedis

    2014-01-01

    Introduction La coelioscopie et l'hystérosalpingographie sont les deux procédures usuellement admises pour l'exploration tubaire et pelvienne en cas d'infertilité. Les objectifs de ce travail etaient de comparer les données de l'Hystérosalpingographie à celles de la coelioscopie chez des patientes explorées pour infertilité et voir l'apport de l'une par rapport à l'autre. Méthodes Etude prospective menée au service C du centre de maternité et de néonatologie de Tunis, s’étendant sur 15 mois, colligeant 120 patientes suivies pour infertilité ayant bénéficié d'une HSG suivie d'une coelioscopie. Résultats L’âge moyen de nos patientes était de 35,3 ans. L'infertilité était primaire dans 56,7% des cas et secondaire dans 43,7% des cas. Sa durée moyenne était de 48,9 mois. Le test statistique de concordance Kappa entre les 2 examens était de 0.42 pour les obstructions tubaires en général, de 0.48 pour les obstructions tubaires proximales et de 0.53 pour les obstructions tubaires distales indiquant une concordance modérée dans tous les cas. La coelioscopie a permis d'objectiver en plus une endométriose pelvienne dans 7% des cas, des adhérences pelviennes dans 33% des cas et des trompes perméables mais d'aspect pathologique dans 20% des cas. Conclusion Il existe un intérêt d′associer, chaque fois que c′est possible, l'HSG et la coelioscopie dans l'exploration du pelvis féminin dans le cadre de l'infertilité. Aucun de ces deux examens n'est parfait. Leurs résultats sont complémentaires. PMID:25374631

  6. [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.

  7. Gastroprotective effect of desmosdumotin C isolated from Mitrella kentii against ethanol-induced gastric mucosal hemorrhage in rats: possible involvement of glutathione, heat-shock protein-70, sulfhydryl compounds, nitric oxide, and anti-Helicobacter pylori activity

    PubMed Central

    2013-01-01

    Background Mitrella kentii (M. kentii) (Bl.) Miq, is a tree-climbing liana that belongs to the family Annonaceae. The plant is rich with isoquinoline alkaloids, terpenylated dihydrochalcones and benzoic acids and has been reported to possess anti-inflammatory activity. The purpose of this study is to assess the gastroprotective effects of desmosdumotin C (DES), a new isolated bioactive compound from M. kentii, on gastric ulcer models in rats. Methods DES was isolated from the bark of M. kentii. Experimental rats were orally pretreated with 5, 10 and 20 mg/kg of the isolated compound and were subsequently subjected to absolute ethanol-induced acute gastric ulcer. Gross evaluation, mucus content, gastric acidity and histological gastric lesions were assessed in vivo. The effects of DES on the anti-oxidant system, non-protein sulfhydryl (NP-SH) content, nitric oxide (NO)level, cyclooxygenase-2 (COX-2) enzyme activity, bcl-2-associated X (Bax) protein expression and Helicabacter pylori (H pylori) were also investigated. Results DES pre-treatment at the administered doses significantly attenuated ethanol-induced gastric ulcer; this was observed by decreased gastric ulcer area, reduced or absence of edema and leucocytes infiltration compared to the ulcer control group. It was found that DES maintained glutathione (GSH) level, decreased malondialdehyde (MDA) level, increased NP-SH content and NO level and inhibited COX-2 activity. The compound up regulated heat shock protein-70 (HSP-70) and down regulated Bax protein expression in the ulcerated tissue. DES showed interesting anti-H pylori effects. The efficacy of DES was accomplished safely without any signs of toxicity. Conclusions The current study reveals that DES demonstrated gastroprotective effects which could be attributed to its antioxidant effect, activation of HSP-70 protein, intervention with COX-2 inflammatory pathway and potent anti H pylori effect. PMID:23866830

  8. Impact of stent length on clinical outcomes of first-generation and new-generation drug-eluting stents.

    PubMed

    Konishi, Hirokazu; Miyauchi, Katsumi; Dohi, Tomotaka; Tsuboi, Shuta; Ogita, Manabu; Naito, Ryo; Kasai, Takatoshi; Tamura, Hiroshi; Okazaki, Shinya; Isoda, Kikuo; Daida, Hiroyuki

    2016-04-01

    The aim of this study is to compare first- and new-generation drug-eluting stents (DESs) which are implanted in long lesion. Stent length is known to be a predictor of adverse events after percutaneous coronary intervention (PCI), even with the first-generation DESs. The introduction of new-generation DESs has reduced the rates of adverse clinical events. However, the impact of stent length on long-term clinical outcomes is not well known. A total of 1181 consecutive patients who underwent PCI using either a first-generation DES (n = 885) or a new-generation DES (n = 296) between 2004 and 2011 were investigated. In each of the stent groups, the patients were divided into two groups by stent length (>32 and ≤32 mm) and compared. During the follow-up period, the incidence of major adverse cardiac events (MACEs) was significantly higher for patients with long stents implanted than with short stents (P < 0.01; log-rank test) in the first-generation DES group. However, there was no difference in the incidence of MACEs between the long- and short-stent groups in the new-generation DES group (P = 0.24; log-rank test). On multivariate Cox regression analysis, stent length was not associated with adverse events in the new-generation DES groups [hazard ratio (HR) 0.87; 95 % confidence interval (95 % CI) 0.71-1.04; P = 0.14]. Implanted stent length was significantly associated with a higher risk of MACEs in patients who received first-generation DESs, but not in patients who received the new-generation DESs.

  9. Type 2 diabetes elicits lower nitric oxide, bradykinin concentration and kallikrein activity together with higher DesArg(9)-BK and reduced post-exercise hypotension compared to non-diabetic condition.

    PubMed

    Simões, Herbert Gustavo; Asano, Ricardo Yukio; Sales, Marcelo Magalhães; Browne, Rodrigo Alberto Vieira; Arsa, Gisela; Motta-Santos, Daisy; Puga, Guilherme Morais; Lima, Laila Cândida de Jesus; Campbell, Carmen Sílvia Grubert; Franco, Octavio Luiz

    2013-01-01

    This study compared the plasma kallikrein activity (PKA), bradykinin concentration (BK), DesArg(9)-BK production, nitric oxide release (NO) and blood pressure (BP) response after moderate-intensity aerobic exercise performed by individuals with and without type 2 diabetes. Ten subjects with type 2 diabetes (T2D) and 10 without type 2 diabetes (ND) underwent three sessions: 1) maximal incremental test on cycle ergometer to determine lactate threshold (LT); 2) 20-min of constant-load exercise on cycle ergometer, at 90% LT and; 3) control session. BP and oxygen uptake were measured at rest and at 15, 30 and 45 min post-exercise. Venous blood samples were collected at 15 and 45 minutes of the recovery period for further analysis of PKA, BK and DesArg(9)-BK. Nitrite plus nitrate (NOx) was analyzed at 15 minutes post exercise. The ND group presented post-exercise hypotension (PEH) of systolic blood pressure and mean arterial pressure on the 90% LT session but T2D group did not. Plasma NOx increased ~24.4% for ND and ~13.8% for T2D group 15 min after the exercise session. Additionally, only ND individuals showed increases in PKA and BK in response to exercise and only T2D group showed increased DesArg(9)-BK production. It was concluded that T2D individuals presented lower PKA, BK and NOx release as well as higher DesArg(9)-BK production and reduced PEH in relation to ND participants after a single exercise session.

  10. Type 2 Diabetes Elicits Lower Nitric Oxide, Bradykinin Concentration and Kallikrein Activity Together with Higher DesArg9-BK and Reduced Post-Exercise Hypotension Compared to Non-Diabetic Condition

    PubMed Central

    Browne, Rodrigo Alberto Vieira; Arsa, Gisela; Motta-Santos, Daisy; Puga, Guilherme Morais; Lima, Laila Cândida de Jesus; Campbell, Carmen Sílvia Grubert; Franco, Octavio Luiz

    2013-01-01

    This study compared the plasma kallikrein activity (PKA), bradykinin concentration (BK), DesArg9-BK production, nitric oxide release (NO) and blood pressure (BP) response after moderate-intensity aerobic exercise performed by individuals with and without type 2 diabetes. Ten subjects with type 2 diabetes (T2D) and 10 without type 2 diabetes (ND) underwent three sessions: 1) maximal incremental test on cycle ergometer to determine lactate threshold (LT); 2) 20-min of constant-load exercise on cycle ergometer, at 90% LT and; 3) control session. BP and oxygen uptake were measured at rest and at 15, 30 and 45 min post-exercise. Venous blood samples were collected at 15 and 45 minutes of the recovery period for further analysis of PKA, BK and DesArg9-BK. Nitrite plus nitrate (NOx) was analyzed at 15 minutes post exercise. The ND group presented post-exercise hypotension (PEH) of systolic blood pressure and mean arterial pressure on the 90% LT session but T2D group did not. Plasma NOx increased ~24.4% for ND and ~13.8% for T2D group 15min after the exercise session. Additionally, only ND individuals showed increases in PKA and BK in response to exercise and only T2D group showed increased DesArg9-BK production. It was concluded that T2D individuals presented lower PKA, BK and NOx release as well as higher DesArg9-BK production and reduced PEH in relation to ND participants after a single exercise session. PMID:24265812

  11. [Effects of acupuncture on bone metabolism and serum estradiol level in ovariectomy-induced osteoporosis rats].

    PubMed

    Ma, Jie; Yun-guang, Hu; Zhang, Da-hui

    2008-08-01

    To observe the effect of acupuncture (Acu) on bone metabolism and serum estradiol (E2) in ovariectomized (OVX) rats for studying its underlying mechanism in treating osteoporosis. Forty female SD rats of six months were randomized into sham operation (sham), model, Acu and Diethylstibestrol (DES) groups, with 10 cases in each. Postmenopausal osteoporosis model was established by removing ovaries under anesthesia. In Acu group, bilateral "Dazhu" (BL 11), "Shenshu" (BL 23) and "Pishu" (BL 20) were punctured and stimulated for 30 minutes, once daily for 60 days. Rats of DES group were drenched with saline+DES (22.5 microg/ml) 1 ml/100 g, once daily for 60 days. At the end of experiments, blood samples were collected from femoral artery for assaying serum alkaline phosphatase (ALP), tartrate-resistant acid phosphatase (TRAP) contents by using biochemistry, and serum bone gla protein (BGP) and E2 levels by immunoradioassay. Compared with sham group, uterus wet weight, serum E2 content in model group decreased significantly (P < 0.01) while body weight, serum ALP, BGP and TRAP levels in model group increased significantly (P < 0.01, 0.05). Compared with model group, uterus wet weight and serum Ez content in Acu and DES groups increased significantly (P < 0.01); while body weight, serum ALP, BGP and TRAP levels decreased considerably (P < 0.01). No significant differences were found between Acu and DES groups in serum E2, ALP, BGP and TRAP levels (P > 0.05). Acupuncture can suppress abnormal increase of body weight and decrease of serum E2 level, and significantly downregulate serum ALP, BGP and TRAP levels in OVX rats, which may contribute to its effect in relieving osteoporosis.

  12. Impact of Chronic Renal Failure on Safety and Effectiveness of Paclitaxel-Eluting Stents for Femoropopliteal Artery Disease: Subgroup Analysis from Zilver PTX Post-Market Surveillance Study in Japan.

    PubMed

    Ogawa, Yukihisa; Yokoi, Hiroyoshi; Ohki, Takao; Kichikawa, Kimihiko; Nakamura, Masato; Komori, Kimihiro; Nanto, Shinsuke; O'Leary, Erin E; Lottes, Aaron E; Saunders, Alan T; Dake, Michael D

    2017-11-01

    Favorable long-term outcomes of the Zilver PTX drug-eluting stent (DES) in femoropopliteal lesions have been demonstrated. Chronic renal failure (CRF) has been shown to be a risk factor for restenosis and decreased limb salvage. The results of the DES in patients with CRF have not previously been reported. This study compares the results with the DES in patients with CRF and those without CRF. This retrospective analysis from the Zilver PTX Japan Post-Market Surveillance Study included 321 patients with CRF and 584 patients without CRF. Outcomes included freedom from target lesion revascularization (TLR) and patency. Of the patients included in this subgroup analysis, 2-year data were available for 209 patients in the CRF group and 453 patients in the non-CRF group. The two groups were similar in terms of lesion length and the frequency of in-stent restenosis. Critical limb ischemia, severe calcification, and diabetes were more common in patients with CRF, whereas total occlusion was more common in patients without CRF. Freedom from TLR rates were 81.4 versus 84.9% (p = 0.24), and patency rates were 70.7 versus 70.3% (p = 0.95) in patients with and without CRF at 2 years, respectively. This is the first comparative study of the DES in femoropopliteal artery lesions in patients with and without CRF. These results indicate that the DES placed in femoropopliteal artery lesions of CRF patients is safe and effective with similar patency and TLR rates to patients without CRF. Level 3, Post-Market Surveillance Study.

  13. Intra-stent tissue evaluation within bare metal and drug-eluting stents > 3 years since implantation in patients with mild to moderate neointimal proliferation using optical coherence tomography and virtual histology intravascular ultrasound.

    PubMed

    Kitabata, Hironori; Loh, Joshua P; Pendyala, Lakshmana K; Omar, Alfazir; Ota, Hideaki; Minha, Sa'ar; Magalhaes, Marco A; Torguson, Rebecca; Chen, Fang; Satler, Lowell F; Pichard, Augusto D; Waksman, Ron

    2014-04-01

    We aimed to compare neointimal tissue characteristics between bare-metal stents (BMS) and drug-eluting stents (DES) at long-term follow-up using optical coherence tomography (OCT) and virtual histology intravascular ultrasound (VH-IVUS). Neoatherosclerosis in neointima has been reported in BMS and in DES. Thirty patients with 36 stented lesions [BMS (n=17) or DES (n=19)] >3years after implantation were prospectively enrolled. OCT and VH-IVUS were performed and analyzed independently. Stents with ≥70% diameter stenosis were excluded. The median duration from implantation was 126.0months in the BMS group and 60.0months in the DES group (p <0.001). Lipid-laden intima (58.8% vs. 42.1%, p=0.317), thrombus (17.6% vs. 5.3%, p=0.326), and calcification (35.3% vs. 26.3%, p=0.559) did not show significant differences between BMS and DES. When divided into 3 time periods, the cumulative incidence of lipid-laden neointima from >3years to <9years was similar between BMS and DES (42.9% vs. 42.1%, p=1.000). Furthermore, it continued to gradually increase over time in both groups. OCT-derived thin-cap fibroatheroma (TCFA) was observed in 17.6% of BMS- and 5.3% of DES-treated lesions (p=0.326). No stents had evidence of intimal disruption. The percentage volume of necrotic core (16.1% [9.7, 20.3] vs. 9.7% [7.0, 16.5], p=0.062) and dense calcium (9.5% [3.8, 13.6] vs. 2.7% [0.4, 4.9], p=0.080) in neointima tended to be greater in BMS-treated lesions. Intra-stent VH-TCFA (BMS vs. DES 45.5% vs. 18.2%, p=0.361) did not differ significantly. At long-term follow-up beyond 3 years after implantation, the intra-stent neointimal tissue characteristics appeared similar for both BMS and DES. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. Percutaneous coronary intervention with second-generation drug-eluting stent versus bare-metal stent: Systematic review and cost-benefit analysis.

    PubMed

    Poder, Thomas G; Erraji, Jihane; Coulibaly, Lucien P; Koffi, Kouamé

    2017-01-01

    Drug-eluting stents (DESs) were considered as ground-breaking technology promising to eradicate restenosis and the necessity to perform multiple revascularization procedures subsequent to percutaneous coronary intervention. Soon after DESs were released on the market, however, there were reports of a potential increase in mortality and of early or late thrombosis. In addition, DESs are far more expensive than bare-metal stents (BMSs), which has led to their limited use in many countries. The technology has improved over the last few years with the second generation of DESs (DES-2). Moreover, costs have come down and an improved safety profile with decreased thrombosis has been reported. Perform a cost-benefit analysis of DES-2s versus BMSs in the context of a publicly funded university hospital in Quebec, Canada. A systematic review of meta-analyses was conducted between 2012 and 2016 to extract data on clinical effectiveness. The clinical outcome of interest for the cost-benefit analysis was target-vessel revascularization (TVR). Cost units are those used in the Quebec health-care system. The cost-benefit analysis was based on a 2-year perspective. Deterministic and stochastic models (discrete-event simulation) were used, and various risk factors of reintervention were considered. DES-2s are much more effective than BMSs with respect to TVR rate ratio (i.e., 0.29 to 0.62 in more recent meta-analyses). DES-2s seem to cause fewer deaths and in-stent thrombosis than BMSs, but results are rarely significant, with the exception of the cobalt-chromium everolimus DES. The rate ratio of myocardial infraction is systematically in favor of DES-2s and very often significant. Despite the higher cost of DES-2s, fewer reinterventions can lead to huge savings (i.e., -$479 to -$769 per patient). Moreover, the higher a patient's risk of reintervention, the higher the savings associated with the use of DES-2s. Despite the higher purchase cost of DES-2s compared to BMSs, generalizing their use, in particular for patients at high risk of reintervention, should enable significant savings.

  15. Percutaneous coronary intervention with second-generation drug-eluting stent versus bare-metal stent: Systematic review and cost–benefit analysis

    PubMed Central

    Erraji, Jihane; Coulibaly, Lucien P.; Koffi, Kouamé

    2017-01-01

    Background Drug-eluting stents (DESs) were considered as ground-breaking technology promising to eradicate restenosis and the necessity to perform multiple revascularization procedures subsequent to percutaneous coronary intervention. Soon after DESs were released on the market, however, there were reports of a potential increase in mortality and of early or late thrombosis. In addition, DESs are far more expensive than bare-metal stents (BMSs), which has led to their limited use in many countries. The technology has improved over the last few years with the second generation of DESs (DES-2). Moreover, costs have come down and an improved safety profile with decreased thrombosis has been reported. Objective Perform a cost–benefit analysis of DES-2s versus BMSs in the context of a publicly funded university hospital in Quebec, Canada. Methods A systematic review of meta-analyses was conducted between 2012 and 2016 to extract data on clinical effectiveness. The clinical outcome of interest for the cost–benefit analysis was target-vessel revascularization (TVR). Cost units are those used in the Quebec health-care system. The cost–benefit analysis was based on a 2-year perspective. Deterministic and stochastic models (discrete-event simulation) were used, and various risk factors of reintervention were considered. Results DES-2s are much more effective than BMSs with respect to TVR rate ratio (i.e., 0.29 to 0.62 in more recent meta-analyses). DES-2s seem to cause fewer deaths and in-stent thrombosis than BMSs, but results are rarely significant, with the exception of the cobalt–chromium everolimus DES. The rate ratio of myocardial infraction is systematically in favor of DES-2s and very often significant. Despite the higher cost of DES-2s, fewer reinterventions can lead to huge savings (i.e., -$479 to -$769 per patient). Moreover, the higher a patient’s risk of reintervention, the higher the savings associated with the use of DES-2s. Conclusion Despite the higher purchase cost of DES-2s compared to BMSs, generalizing their use, in particular for patients at high risk of reintervention, should enable significant savings. PMID:28498849

  16. Globular cluster systems as tracers of environmental effects on Virgo early-type dwarfs

    NASA Astrophysics Data System (ADS)

    Sánchez-Janssen, R.; Aguerri, J. A. L.

    2012-08-01

    Early-type dwarfs (dEs) are by far the most abundant galaxy population in nearby clusters. Whether these objects are primordial, or the recent end products of the different physical mechanisms that can transform galaxies once they enter these high-density environments, is still a matter of debate. Here we present a novel approach to test these scenarios by comparing the properties of the globular cluster systems (GCSs) of Virgo dEs and their potential progenitors with simple predictions from gravitational and hydrodynamical interaction models. We show that low-mass (M★ ≲ 2 × 108 M⊙) dEs have GCSs consistent with the descendants of gas-stripped late-type dwarfs. On the other hand, higher mass dEs have properties - including the high mass specific frequencies of their GCSs and their concentrated spatial distribution within Virgo - incompatible with a recent, environmentally driven evolution. They mostly comprise nucleated systems, but also dEs with recent star formation and/or disc features. Bright, nucleated dEs appear to be a population that has long resided within the cluster potential well, but have surprisingly managed to retain very rich and spatially extended GCSs - possibly an indication of high total masses. Our analysis does not favour violent evolutionary mechanisms that result in significant stellar mass-losses, but more gentle processes involving gas removal by a combination of internal and external factors, and highlights the relevant role of initial conditions. Additionally, we briefly comment on the origin of luminous cluster S0 galaxies.

  17. Percutaneous coronary intervention strategies and prognosis for graft lesions following coronary artery bypass grafting

    PubMed Central

    LIU, YIN; ZHOU, XIUJUN; JIANG, HUA; GAO, MINGDONG; WANG, LIN; SHI, YUTIAN; GAO, JING

    2015-01-01

    The purpose of this study was to compare the prognosis of graft-percutaneous coronary intervention (PCI) and native vessel (NV)-PCI, drug-eluting stents (DESs) and bare-metal stents (BMSs) for the treatment of graft lesions following coronary artery bypass grafting (CABG), and to determine the risk factors for major adverse cardiac events (MACEs). A total of 289 patients who underwent PCI following CABG between August 2005 and March 2010 were retrospectively analyzed. The effects on survival were compared among patients who underwent NV- and graft-PCI, and DES and BMS implantation. Additionally, the risk factors for MACEs following PCI for graft lesions were analyzed. The findings showed that MACE-free and revascularization-free survival rates were significantly higher in the NV-PCI group compared with those in the graft-PCI group. There were 63 cases (29.0%) of MACEs in the DES group and 25 cases (52.1%) in the BMS group. In patients undergoing NV-PCI, the DES group had significantly fewer MACEs and less target vessel revascularization (TVR) than the BMS group. In patients undergoing graft-PCI, the DES group showed a tendency for fewer MACEs and a lower incidence of cardiac mortality, myocardial infarction and TVR compared with the BMS group. Diabetes, an age of >70 years and graft-PCI were independent risk factors for MACEs in patients post-PCI. It is concluded that NV-PCI has superior long-term outcomes compared with graft-PCI, and should therefore be considered as the first-line treatment for graft disease following CABG. Despite this, graft-PCI remains a viable option. DESs are the first choice for graft-PCI due to their safety and efficacy and their association with reduced mortality and MACE rate. Diabetes, older age and graft-PCI are independent risk factors for MACEs in patients post-CABG who are undergoing revascularization. PMID:26136874

  18. Diagnostic exome sequencing provides a molecular diagnosis for a significant proportion of patients with epilepsy.

    PubMed

    Helbig, Katherine L; Farwell Hagman, Kelly D; Shinde, Deepali N; Mroske, Cameron; Powis, Zöe; Li, Shuwei; Tang, Sha; Helbig, Ingo

    2016-09-01

    To assess the yield of diagnostic exome sequencing (DES) and to characterize the molecular findings in characterized and novel disease genes in patients with epilepsy. In an unselected sample of 1,131 patients referred for DES, overall results were compared between patients with and without epilepsy. DES results were examined based on age of onset and epilepsy diagnosis. Positive/likely positive results were identified in 112/293 (38.2%) epilepsy patients compared with 210/732 (28.7%) patients without epilepsy (P = 0.004). The diagnostic yield in characterized disease genes among patients with epilepsy was 33.4% (105/314). KCNQ2, MECP2, FOXG1, IQSEC2, KMT2A, and STXBP1 were most commonly affected by de novo alterations. Patients with epileptic encephalopathies had the highest rate of positive findings (43.4%). A likely positive novel genetic etiology was proposed in 14/200 (7%) patients with epilepsy; this frequency was highest in patients with epileptic encephalopathies (17%). Three genes (COQ4, DNM1, and PURA) were initially reported as likely positive novel disease genes and were subsequently corroborated in independent peer-reviewed publications. DES with analysis and interpretation of both characterized and novel genetic etiologies is a useful diagnostic tool in epilepsy, particularly in severe early-onset epilepsy. The reporting on novel genetic etiologies may further increase the diagnostic yield.Genet Med 18 9, 898-905.

  19. Conception, elaboration et mise a l'essai d'un simulateur interactif permettant une approche modelisante: Application aux lois de la genetique mendelienne

    NASA Astrophysics Data System (ADS)

    Lasri, Abdel-Halim

    Dans cette recherche-developpement, nous avons concu, developpe et mis a l'essai un simulateur interactif pour favoriser l'apprentissage des lois probabilistes impliqees dans la genetique mendelienne. Cet environnement informatise devra permettre aux etudiants de mener des experiences simulees, utilisant les statistiques et les probebilites comme outils mathematiques pour modeliser le phenomene de la transmission des caracteres hereditaires. L'approche didactique est essentiellement orientee vers l'utilisation des methodes quantitatives impliquees dans l'experimentation des facteurs hereditaires. En incorporant au simulateur le principe de la "Lunette cognitive" de Nonnon (1986), l'etudiant fut place dans une situation ou il a pu synchroniser la perception de la representation iconique (concrete) et symbolique (abstraite) des lois probabilistes de Mendel. A l'aide de cet environnement, nous avons amene l'etudiant a identifier le(s) caractere(s) hereditaire(s) des parents a croiser, a predire les frequences phenotypiques probables de la descendance issue du croisement, a observer les resultats statistiques et leur fluctuation au niveau de l'histogramme des frequences, a comparer ces resultats aux predictions anticipees, a interpreter les donnees et a selectionner en consequence d'autres experiences a realiser. Les etapes de l'approche inductive sont privilegiees du debut a la fin des activites proposees. L'elaboration, du simulateur et des documents d'accompagnement, a ete concue a partir d'une vingtaine de principes directeurs et d'un modele d'action. Ces principes directeurs et le modele d'action decoulent de considerations theoriques psychologiques, didactiques et technologiques. La recherche decrit la structure des differentes parties composant le simulateur. L'architecture de celui-ci est construite autour d'une unite centrale, la "Principale", dont les liens et les ramifications avec les autres unites confere a l'ensemble du simulateur sa souplesse et sa facilite d'utilisation. Le simulateur "Genetique", a l'etat de prototype, et la documentation qui lui est afferente ont ete soumis a deux mises a l'essai: l'une fonctionnelle, l'autre empirique. La mise a l'essai fonctionnelle, menee aupres d'un groupe d'enseignants experts, a permis d'identifier les lacunes du materiel elabore afin de lui apporter les reajustements qui s'imposaient. La mise a l'essai empirique, conduite par un groupe de onze (11) etudiants de niveau secondaire, avait pour but, d'une part, de tester la facilite d'utilisation du simulateur "Genetique" ainsi que les documents d'accompagnement et, d'autre part, de verifier si les participants retiraient des avantages pedagogiques de cet environnement. Trois techniques furent exploitees pour recolter les donnees de la mise a l'essai empirique. L'analyse des resultats a permis de faire un retour critique sur les productions concretes de cette recherche et d'apporter les modifications necessaires tant au simulateur qu'aux documents d'accompagnement. Cette analyse a permis egalement de conclure que notre simulateur interactif favorise une approche inductive permettant aux etudiants de s'approprier les lois probabilistes de Mendel. Enfin, la conclusion degage des pistes de recherches destinees aux etudes ulterieures, plus particulierement celles qui s'interessent a developper des simulateurs, afin d'integrer a ceux-ci des representations concretes et abstraites presentees en temps reel. Les disquettes du simulateur "Genetique" et les documents d'accompagnement sont annexes a la presente recherche.

  20. Interactions électron-électron dans les fils mésoscopiques

    NASA Astrophysics Data System (ADS)

    Pierre, F.

    Electron-electron interactions in mesoscopic wires In metallic thin films, the screening of Coulomb interactions is less efficient than in bulk metals because of electron elastic scattering from film boundaries, lattice defects, and impurities. As a consequence, at sub-kelvin temperatures, electron-electron interactions are expected to be the dominant inelastic process undergone by electrons, which determines energy exchange and limits the electronic phase coherence. We present in this book three experiments that probe inelastic collisions experienced by electrons at low temperature, in order to find out their mechanism. In the first part, we present a series of measurements of the energy distribution function of electrons in copper, gold and silver wires driven in a steady-state, out of equilibrium situation. These experiments reveal the rate at which electrons exchange energy. These results are compared in the second part with the temperature dependence of the phase coherence time of electrons tau_{φ}, which is deduced from the magnetoresistance of long wires. The phase coherence of electrons is limited by all inelastic collisions, independently of the energy exchanged. Different mechanisms to account for the energy exchange rate and dephasing times are proposed and compared with experiments. In the third part, we present measurements of the conductance of a long tunnel junction between an aluminum wire and a ground plane. The dip in the conductance at zero voltage is expected from the theory of electron-electron interactions. To compare measurements and theoretical predictions, we rephrase the microscopic theory of electron-electron interactions in terms of an electromagnetic impedance, as is done for the phenomenological theory of Coulomb blockade. Dans les couches minces métalliques, l'écrantage des interactions coulombiennes entre électrons est moins efficace que dans les métaux massifs en raison des chocs élastiques que subissent les électrons sur les parois, les défauts du réseau cristallin et les impuretés. Aux températures inférieures au kelvin, il est prédit que ces interactions électron-électron sont à l'origine de la plupart des collisions inélastiques subies par les électrons, et déterminent donc les échanges d'énergie et l'extension de la cohérence de phase. Nous présentons dans cet ouvrage trois expériences qui sondent les interactions inélastiques subies par les électrons dans les métaux diffusifs à basse température, afin d'en élucider le mécanisme. Dans la première partie, nous présentons une série de mesures de la fonction de distribution en énergie des électrons dans des fils mésoscopiques d'argent, de cuivre et d'or placés dans un régime stationnaire hors-équilibre. Ces expériences permettent d'accéder au taux d'échange d'énergie entre électrons. Ces résultats sont comparés dans la deuxième partie avec la dépendance en température du temps de cohérence de phase des électrons tau_{φ}, que l'on déduit de la mesure de la magnétorésistance de longs fils. La cohérence de phase des électrons dépend du taux total de collisions inélastiques, indépendamment de l'énergie échangée. Nous discutons divers mécanismes d'interaction pour rendre compte à la fois des mesures des taux d'échange d'énergie et du temps de cohérence de phase, et les comparons quantitativement aux résultats expérimentaux. La troisième partie est consacrée à la mesure de la conductance d'une longue jonction tunnel entre un fil d'aluminium et un plan de masse. La diminution de cette conductance à tension nulle est un effet attendu des interactions électron-électron. Pour comparer mesures et prédictions théoriques, nous avons reformulé les prédictions du calcul microscopique des interactions entre électrons en terme d'impédance électromagnétique, dans un langage similaire à celui utilisé pour la théorie phénoménologique du blocage de Coulomb.

  1. Apport des moyens endoscopiques dans la dilatation des sténoses caustiques de l’œsophage

    PubMed Central

    Seydou, Togo; Abdoulaye, Ouattara Moussa; xing, Li; Zi, Sanogo Zimogo; sekou, Koumaré; Wen, Yang Shang; Ibrahim, Sankare; Sekou, Toure Cheik Ahmed; Boubacar, Maiga Ibrahim; Saye, Jacque; Jerome, Dakouo Dodino; Dantoumé, Toure Ousmane; Sadio, Yena

    2016-01-01

    Introduction Toutes les sténoses symptomatiques de l’œsophage peuvent être dilatées par voie endoscopique. Nous évaluons l'apport des moyens endoscopiques dans la prise en charge de la dilatation œsophagienne pour sténose caustique de l’œsophage (SCO) au Mali. Méthodes IL s'agissait d'une étude descriptive et prospective réalisée dans le service de chirurgie thoracique à l'hôpital du Mali. Au total 46 dossiers cliniques de patients on été enregistrés et subdivisés en 4 groupes en fonction de la topographie des lésions cicatricielles. Le nombre de cas d'assistance endoscopique réalisé a été déterminé afin de comprendre l'apport des moyens endoscopiques dans le succès de la dilatation des SCO. Pour les 2 différentes méthodes de dilatation utilisées, le résultat du traitement et le coût ont comparés. Résultats La FOGD a été utilisée dans 19 cas (41.30%) de dilatation avec la bougie de Savary Guillard et dans 47.82% des cas dans la dilatation de Lerut. La vidéo-laryngoscopie a été utilisé 58.69% des cas de dilatation à la bougie de Lerut. Le passage de guide métallique et / ou de fil-guide a été réalisée dans 39.13% avec la vidéo laryngoscopie et dans 58.68% avec la FOGD. Dans la comparaison des deux méthodes, il existe une différence significative dans la survenue des complications (p=0.04075), l'anesthésie générale (p=0.02287), l'accessibilité à la méthode (p=0.04805) et la mortalité (p=0.00402). Conclusion La SCO est une pathologie grave et sous évaluée au Mali. Les moyens endoscopiques contribuent considérablement au succès de la dilatation œsophagienne pour sténose caustique dans les différentes méthodes utilisées. PMID:27200129

  2. Production du baryon Sigma+ dans les collisions e+e- au LEP

    NASA Astrophysics Data System (ADS)

    Joly, Andre

    Les mécanismes de production des baryons dans les interactions e+e- font l'objet de nombreuses études. De plus, les modes de production des baryons étranges semblent faire appel A des processus spécifiques, qui sont encore mal compris. Notre étude de la production des baryons Σ+ dans les interactions e+e- nous permet de formuler certaines remarques sur l'état des connaîssances acquises sur le sujet. Une methode de reconstruction originale et des critères de sélection spécifiques ont été développés afin d'identifier des baryons Σ+ de haute Energie ( ES+ > 5 GeV), partir de leur canal de désintégration en un proton et un π0 (S+-->p+p0 ). Trois mesures principales sont réalisées à partir de notre échantillon de baryons reconstruits. Le nombre mesuré de baryons Σ+ produits par événement e +e- à 91 GeV est de: =0.102+/-0.006(stat.) +/-0.008(syst.) +/-0.003(extrap.) où les erreurs sont dues à la statistique, aux systématiques et à la procédure d'extrapolation. Ce résultat est en accord avec ceux obtenus précédemment, mais avec des erreurs réduites. La section efficace différentielle en fonction de l'energie est mesurée et comparée aux prédictions des principaux générateurs Monte-Carlo (JETSET7.4(MOPS), JETSET7.4 et HERWIG5.9). A haute énergie, HERWIG ne semble pas reproduire les mesures, aussi bien que les deux versions de JETSET. Enfin, la position du maximum de la section efficace différentielle de production des baryons Σ+ en fonction de l'impulsion est mesurée. On trouve: overlinexoverlineS+=2.32+/- 0.47 Une étude spécifique du générateur JETSET7.4(MOPS) est réalisee, afin de mieux comprendre les mécanismes de production de l'étrangeté et du spin dans la production des baryons. Aucun générateur ne semble capable de décrire de manière simultanée la production du spin et de l'étrangeté.

  3. Activités physiques libres ou encadrées et condition physique liée à la santé chez des adultes burundais: étude transversale

    PubMed Central

    Bizimana, Jean Berchmans; Lawani, Mansourou Mohamed; Akplogan, Barnabé; Gaturagi, Charles

    2016-01-01

    Introduction l’activité physique régulière a un impact positif sur la santé. Cette étude a pour objet de comparer la condition physique liée à la santé des adultes qui s’exercent librement avec celle des adultes bénéficiant d’un encadrement professionnel. Elle tente aussi d’établir une relation entre le niveau d’activité physique et les paramètres de la condition liée à la santé. Méthodes nous avons évalué le niveau d’activité physique et les paramètres de la condition physique liée à la santé. Par le test t pour échantillons indépendants, nous avons comparé les moyennes et avons par le calcul du coefficient de corrélation r de Pearson analysé la relation entre le niveau d’activité physique et les paramètres de la condition physique. Résultats des écarts significatifs (p < 0,05) de niveau d’activité physique, de souplesse, de V˙O2max et de la FC de repos ont été enregistrés en faveur du groupe encadré. Le niveau d’activité physique est positivement corrélé (p < 0,05) au V˙O2max et à la force de préhension mais négativement corrélé à la FC de repos et au cholestérol LDL. La prévalence des facteurs de risque cardiovasculaire n’est pas élevée excepté pour le cholestérol HDL. Conclusion les résultats de cette étude montrent que l’activité physique libre est aussi efficace que l’activité physique encadrée dans le maintien des profils lipidique et physiologique favorables à la santé chez l’adulte burundais. Cependant, l’activité physique encadrée apporte des bénéfices supplémentaires pour le V˙O2max, la fréquence cardiaque de repos, la souplesse antérieure et la détente verticale PMID:28203315

  4. Drug-eluting versus bare-metal stents in unprotected left main coronary artery stenosis a meta-analysis.

    PubMed

    Pandya, Sanjay B; Kim, Young-Hak; Meyers, Sheridan N; Davidson, Charles J; Flaherty, James D; Park, Duk-Woo; Mediratta, Anuj; Pieper, Karen; Reyes, Eric; Bonow, Robert O; Park, Seung-Jung; Beohar, Nirat

    2010-06-01

    We undertook a meta-analysis to assess outcomes for drug-eluting stents (DES) and bare-metal stents (BMS) in percutaneous coronary intervention for unprotected left main coronary artery (ULMCA) stenosis. Uncertainty exists regarding the relative performance of DES versus BMS in percutaneous coronary intervention for unprotected left main coronary stenosis. Of a total of 838 studies, 44 met inclusion criteria (n = 10,342). The co-primary end points were mortality, myocardial infarction (MI), target vessel/lesion revascularization (TVR/TLR), and major adverse cardiac events (MACE: mortality, MI, TVR/TLR). Event rates for DES and BMS were calculated at 6 to 12 months, at 2 years, and at 3 years. Crude event rates at 3 years were mortality (8.8% and 12.7%), MI (4.0% and 3.4%), TVR/TLR (8.0% and 16.4%), and MACE (21.4% and 31.6%). Nine studies were included in a comparative analysis (n = 5,081). At 6 to 12 months the adjusted odds ratio (OR) for DES versus BMS were: mortality 0.94 (95% confidence interval [CI]: 0.06 to 15.48; p = 0.97), MI 0.64 (95% CI: 0.19 to 2.17; p = 0.47), TVR/TLR 0.10 (95% CI: 0.01 to 0.84; p = 0.01), and MACE 0.34 (95% CI: 0.15 to 0.78; p = 0.01). At 2 years, the OR for DES versus BMS were: mortality 0.42 (95% CI: 0.28 to 0.62; p < 0.01), MI 0.16 (95% CI: 0.01 to 3.53; p = 0.13), and MACE 0.31 (95% CI: 0.15 to 0.66; p < 0.01). At 3 years, the OR for DES versus BMS were: mortality 0.70 (95% CI: 0.53 to 0.92; p = 0.01), MI 0.49 (95% CI: 0.26 to 0.92; p = 0.03), TVR/TLR 0.46 (95% CI: 0.30 to 0.69; p < 0.01), and MACE 0.78 (95% CI: 0.57 to 1.07; p = 0.12). Our meta-analysis suggests that DES is associated with favorable outcomes for mortality, MI, TVR/TLR, and MACE as compared to BMS in percutaneous coronary intervention for unprotected left main coronary artery stenosis. Copyright 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  5. Numerical model of ice melange expansion during abrupt ice-shelf collapse

    NASA Astrophysics Data System (ADS)

    Guttenberg, N.; Abbot, D. S.; Amundson, J. M.; Burton, J. C.; Cathles, L. M.; Macayeal, D. R.; Zhang, W.

    2010-12-01

    Satellite imagery of the February 2008 Wilkins Ice-Shelf Collapse event reveals that a large percentage of the involved ice shelf was converted to capsized icebergs and broken fragments of icebergs over a relatively short period of time, possibly less than 24 hours. The extreme violence and short time scale of the event, and the considerable reduction of gravitational potential energy between upright and capsized icebergs, suggests that iceberg capsize might be an important driving mechanism controlling both the rate and spatial extent of ice shelf collapse. To investigate this suggestion, we have constructed an idealized, 2-dimensional model of a disintegrating ice shelf composed of a large number (N~100 to >1000) of initially well-packed icebergs of rectangular cross section. The model geometry consists of a longitudinal cross section of the idealized ice shelf from grounding line (or the upstream extent of ice-shelf fragmentation) to seaward ice front, and includes the region beyond the initial ice front to cover the open, ice-free water into which the collapsing ice shelf expands. The seawater in which the icebergs float is treated as a hydrostatic fluid in the computation of iceberg orientation (e.g., the evaluation of buoyancy forces and torques), thereby eliminating the complexities of free-surface waves, but net horizontal drift of the icebergs is resisted by a linear drag law designed to energy dissipation by viscous forces and surface-gravity-wave radiation. Icebergs interact via both elastic and inelastic contacts (typically a corner of one iceberg will scrape along the face of its neighbor). Ice-shelf collapse in the model is embodied by the mass capsize of a large proportion of the initially packed icebergs and the consequent advancement of the ice front (leading edge). Model simulations are conducted to examine (a) the threshold of stability (e.g., what density of initially capsizable icebergs is needed to allow a small perturbation to the system evolve into full-blown collapse of the ice shelf? What proportion of uncapsizable icebergs prevent a collapse?), (b) the rates of mobilization and their dependence on iceberg geometry (e.g., what determines the speed at which the expanding ice melange moves into the open, ice-free water?), and (c) the factors that promote the arrest of the system (e.g., are there circumstances where only partial collapses can occur?). Results of simulations are compared with observational parameters derived from satellite imagery, seismic analysis and laboratory experiment to determine what aspects of the numerical model's physical formulation may have most relevance to the disappearance of ice shelves.

  6. Fluid-related inclusions in Alpine high-pressure peridotite reveal trace element recycling during subduction-zone dehydration of serpentinized mantle (Cima di Gagnone, Swiss Alps)

    NASA Astrophysics Data System (ADS)

    Scambelluri, Marco; Pettke, Thomas; Cannaò, Enrico

    2015-11-01

    Serpentinites release at sub-arc depths volatiles and several fluid-mobile trace elements found in arc magmas. Constraining element uptake in these rocks and defining the trace element composition of fluids released upon serpentinite dehydration can improve our understanding of mass transfer across subduction zones and to volcanic arcs. The eclogite-facies garnet metaperidotite and chlorite harzburgite bodies embedded in paragneiss of the subduction melange from Cima di Gagnone derive from serpentinized peridotite protoliths and are unique examples of ultramafic rocks that experienced subduction metasomatism and devolatilization. In these rocks, metamorphic olivine and garnet trap polyphase inclusions representing the fluid released during high-pressure breakdown of antigorite and chlorite. Combining major element mapping and laser-ablation ICP-MS bulk inclusion analysis, we characterize the mineral content of polyphase inclusions and quantify the fluid composition. Silicates, Cl-bearing phases, sulphides, carbonates, and oxides document post-entrapment mineral growth in the inclusions starting immediately after fluid entrapment. Compositional data reveal the presence of two different fluid types. The first (type A) records a fluid prominently enriched in fluid-mobile elements, with Cl, Cs, Pb, As, Sb concentrations up to 103 PM (primitive mantle), ∼102 PM Tl, Ba, while Rb, B, Sr, Li, U concentrations are of the order of 101 PM, and alkalis are ∼2 PM. The second fluid (type B) has considerably lower fluid-mobile element enrichments, but its enrichment patterns are comparable to type A fluid. Our data reveal multistage fluid uptake in these peridotite bodies, including selective element enrichment during seafloor alteration, followed by fluid-rock interaction along with subduction metamorphism in the plate interface melange. Here, infiltration of sediment-equilibrated fluid produced significant enrichment of the serpentinites in As, Sb, B, Pb, an enriched trace element pattern that was then transferred to the fluid released at greater depth upon serpentine dehydration (type A fluid). The type B fluid hosted by garnet may record the composition of the chlorite breakdown fluid released at even greater depth. The Gagnone study-case demonstrates that serpentinized peridotites acquire water and fluid-mobile elements during ocean floor hydration and through exchange with sediment-equilibrated fluids in the early subduction stages. Subsequent antigorite devolatilization at subarc depths delivers aqueous fluids to the mantle wedge that can be prominently enriched in sediment-derived components, potentially triggering arc magmatism without the need of concomitant dehydration/melting of metasediments or altered oceanic crust.

  7. Etude de la flore bactérienne contaminant les téléphones mobiles avant et après la désinfection: comparaison entre les professionnels soignants de l'hôpital militaire d'instruction Mohammed V de Rabat et les témoins

    PubMed Central

    Uwingabiye, Jean; Moustanfii, Wafaa; Chadli, Meryem; Sekhsokh, Yassine

    2015-01-01

    Introduction L'objectif de notre travail était évaluer la contamination microbienne des téléphones mobiles utilisés par les personnels soignants des différents services de l'hôpital militaire d'instructions Mohammed V de Rabat et la comparer à celui d'une population témoin et aussi démontrer l'efficacité des solutions hydroalcoolique dans la désinfection de ces téléphones mobiles. Méthodes Il s'agit d'une étude descriptive transversale réalisée sur une période de 9 mois entre septembre 2010 et juin 2011, dans le service de bactériologie de l'hôpital militaire d'Instruction Mohammed V. Résultats L’étude bactériologique a été faite sur 240 téléphones mobiles dont 50% provenaient de personnels de sante. Le taux de contamination bactérienne de tous les téléphones mobiles était de 100%. Les cultures des bactéries isolées au niveau des téléphones mobiles du personnel médical étaient plus polymorphes que celles de la population témoin (p=0,028). Parmi 437 bactéries isolées: 223(51%) provenaient de téléphones de personnels de santé et 214(49%) de téléphones de la population témoin avec une différence qui n’était pas statistiquement significative(p>0,05) sauf pour les isolats de Staphylocoque à coagulase négative et Staphylococcus aureus. Les bactéries isolées étaient représentées par: Staphylocoque à coagulase (57,7%), Staphylococcus aureus (18,1%), Corynebacterium sp (18,8%), Bacillus sp (2,3%) et autres (2,2%). La différence entre la prévalence des bactéries isolées selon les services et les fonctions des personnels de santé n’était pas statistiquement significative (p>0,05). La désinfection des téléphones portables par la solution hydroalcoolique a réduit à 99,5% le nombre des colonies. Conclusion Ce travail montre que les téléphones portables pourraient jouer un rôle dans la transmission des infections nosocomiales et communautaires. Dans le cadre de prévention de ces risques, il faut sensibiliser les utilisateurs des téléphones mobiles l'importance du lavage des mains et l'utilisation des solutions hydro alcoolique pour désinfecter aussi bien les téléphones portables que les mains. PMID:26977234

  8. Comparateur d'étalons de masse: une étude expérimentale des coefficients de corrélation des paramètres mesurés

    NASA Astrophysics Data System (ADS)

    Pinot, P.

    1991-01-01

    The mass comparator for primary standards of the INM is a high level metrological set. Recently, its balance has been put into a thermally isolated and airtight chamber and this has led us to engage in an experimental study concerning the independence of the measured parameters. This study has revealed that the independence hypothesis must be rejected. The different correlation coefficients have been determined.

  9. Multiscale Architecture of a Subduction Complex and Insight into Large-scale Material Movement in Subduction Systems

    NASA Astrophysics Data System (ADS)

    Wakabayashi, J.

    2014-12-01

    The >1000 km by >100 km Franciscan complex of California records >100 Ma of subduction history that terminated with conversion to a transform margin. It affords an ideal natural laboratory to study the rock record of subduction-interface and related processes exhumed from 10-70 km. The Franciscan comprises coherent and block-in-matrix (mélange) units forming a nappe stack that youngs structurally downward in accretion age, indicating progressive subduction accretion. Gaps in accretion ages indicate periods of non-accretion or subduction erosion. The Franciscan comprises siliciclastic trench fill rocks, with lesser volcanic and pelagic rocks and serpentinite derived from the downgoing plate, as well as serpentinite and felsic-intermediate igneous blocks derived as detritus from the upper plate. The Franciscan records subduction, accretion, and metamorphism (including HP), spanning an extended period of subduction, rather than a single event superimposed on pre-formed stratigraphy. Melanges (serpentinite and siliciclastic matrix) with exotic blocks, that include high-grade metamorphic blocks, and felsic-intermediate igneous blocks from the upper plate, are mostly/entirely of sedimentary origin, whereas block-in-matrix rocks formed by tectonism lack exotic blocks and comprise disrupted ocean plate stratigraphy. Mélanges with exotic blocks are interbedded with coherent sandstones. Many blocks-in-melange record two HP burial events followed by surface exposure, and some record three. Paleomegathrust horizons, separating nappes accreted at different times, appear restricted to narrow fault zones of <100's of m thickness, and <50 m in best constrained cases; these zones lack exotic blocks. Large-scale displacements, whether paleomegathrust horizons, shortening within accreted nappes, or exhumation structures, are accommodated by discrete faults or narrow shear zones, rather than by significant penetrative strain. Exhumation of Franciscan HP units, both coherent and mélange, was accommodated by significant extension of the overlying plate, and possibly extension within the subduction complex, with cross-sectional extrusion, and like subduction burial, took place at different times.

  10. Deep eutectic solvent and inorganic salt pretreatment of lignocellulosic biomass for improving xylose recovery.

    PubMed

    Loow, Yu-Loong; Wu, Ta Yeong; Yang, Ge Hoa; Ang, Lin Yang; New, Eng Kein; Siow, Lee Fong; Md Jahim, Jamaliah; Mohammad, Abdul Wahab; Teoh, Wen Hui

    2018-02-01

    Deep eutectic solvents (DESs) have received considerable attention in recent years due to their low cost, low toxicity, and biodegradable properties. In this study, a sequential pretreatment comprising of a DES (choline chloride:urea in a ratio of 1:2) and divalent inorganic salt (CuCl 2 ) was evaluated, with the aim of recovering xylose from oil palm fronds (OPF). At a solid-to-liquid ratio of 1:10 (w/v), DES alone was ineffective in promoting xylose extraction from OPF. However, a combination of DES (120°C, 4h) and 0.4mol/L of CuCl 2 (120°C, 30min) resulted in a pretreatment hydrolysate containing 14.76g/L of xylose, remarkably yielding 25% more xylose than the CuCl 2 -only pretreatment (11.87g/L). Characterization studies such as FE-SEM, BET, XRD, and FTIR confirmed the delignification of OPF when DES was implemented. Thus, the use of this integrated pretreatment system enabled xylose recoveries which were comparable with other traditional pretreatments. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Carbon Dioxide Capture by Deep Eutectic Solvent Impregnated Sea Mango Activated Carbon

    NASA Astrophysics Data System (ADS)

    Zulkurnai, N. Z.; Ali, U. F. Md.; Ibrahim, N.; Manan, N. S. Abdul

    2018-03-01

    The increment amount of the CO2 emission by years has become a major concern worldwide due to the global warming issue. However, the influence modification of activated carbon (AC) has given a huge revolution in CO2 adsorption capture compare to the unmodified AC. In the present study, the Deep Eutectic Solvent (DES) modified surface AC was used for Carbon Dioxide (CO2) capture in the fixed-bed column. The AC underwent pre-carbonization and carbonization processes at 519.8 °C, respectively, with flowing of CO2 gas and then followed by impregnation with 53.75% phosphoric acid (H3PO4) at 1:2 precursor-to-activant ratios. The prepared AC known as sea mango activated carbon (SMAC) was impregnated with DES at 1:2 solid-to-liquid ratio. The DES is composing of choline chloride and urea with ratio 1:2 choline chloride to urea. The optimum adsorption capacity of SMAC was 33.46 mgco2/gsol and 39.40 mgco2/gsol for DES modified AC (DESAC).

  12. Recovery of radiation-induced dry eye and corneal damage by pretreatment with adenoviral vector-mediated transfer of erythropoietin to the salivary glands in mice.

    PubMed

    Rocha, Eduardo M; Cotrim, Ana P; Zheng, Changyu; Riveros, Paola Perez; Baum, Bruce J; Chiorini, John A

    2013-04-01

    Therapeutic doses of radiation (RTx) causes dry eye syndrome (DES), dry mouth, and as in other sicca syndromes, they are incurable. The aims of this work are as follows: (a) to evaluate a mouse model of DES induced by clinically relevant doses of radiation, and (b) to evaluate the protective effect of erythropoietin (Epo) in preventing DES. C3H female mice were subjected to five sessions of RTx, with or without pre-RTx retroductal administration of the AdLTR2EF1a-hEPO (AdEpo) vector in the salivary glands (SG), and compared with naïve controls at Day 10 (10d) (8 Gy fractions) and 56 days (56d) (6 Gy fractions) after RTx treatment. Mice were tested for changes in lacrimal glands (LG), tear secretion (phenol red thread), weight, hematocrit (Hct), and markers of inflammation, as well as microvessels and oxidative damage. Tear secretion was reduced in both RTx groups, compared to controls, by 10d. This was also seen at 56d in RTx but not AdEpo+RTx group. Hct was significantly higher in all AdEpo+RTx mice at 10d and 56d. Corneal epithelium was significantly thinner at 10d in the RTx group compared with AdEpo+RTx or the control mice. There was a significant reduction at 10d in vascular endothelial growth factor (VEGF)-R2 in LG in the RTx group that was prevented in the AdEpo+RTx group. In conclusion, RTx is able to induce DES in mice. AdEpo administration protected corneal epithelia and resulted in some recovery of LG function, supporting the value of further studies using gene therapy for extraglandular diseases.

  13. Can discrete event simulation be of use in modelling major depression?

    PubMed Central

    Le Lay, Agathe; Despiegel, Nicolas; François, Clément; Duru, Gérard

    2006-01-01

    Background Depression is among the major contributors to worldwide disease burden and adequate modelling requires a framework designed to depict real world disease progression as well as its economic implications as closely as possible. Objectives In light of the specific characteristics associated with depression (multiple episodes at varying intervals, impact of disease history on course of illness, sociodemographic factors), our aim was to clarify to what extent "Discrete Event Simulation" (DES) models provide methodological benefits in depicting disease evolution. Methods We conducted a comprehensive review of published Markov models in depression and identified potential limits to their methodology. A model based on DES principles was developed to investigate the benefits and drawbacks of this simulation method compared with Markov modelling techniques. Results The major drawback to Markov models is that they may not be suitable to tracking patients' disease history properly, unless the analyst defines multiple health states, which may lead to intractable situations. They are also too rigid to take into consideration multiple patient-specific sociodemographic characteristics in a single model. To do so would also require defining multiple health states which would render the analysis entirely too complex. We show that DES resolve these weaknesses and that its flexibility allow patients with differing attributes to move from one event to another in sequential order while simultaneously taking into account important risk factors such as age, gender, disease history and patients attitude towards treatment, together with any disease-related events (adverse events, suicide attempt etc.). Conclusion DES modelling appears to be an accurate, flexible and comprehensive means of depicting disease progression compared with conventional simulation methodologies. Its use in analysing recurrent and chronic diseases appears particularly useful compared with Markov processes. PMID:17147790

  14. Can discrete event simulation be of use in modelling major depression?

    PubMed

    Le Lay, Agathe; Despiegel, Nicolas; François, Clément; Duru, Gérard

    2006-12-05

    Depression is among the major contributors to worldwide disease burden and adequate modelling requires a framework designed to depict real world disease progression as well as its economic implications as closely as possible. In light of the specific characteristics associated with depression (multiple episodes at varying intervals, impact of disease history on course of illness, sociodemographic factors), our aim was to clarify to what extent "Discrete Event Simulation" (DES) models provide methodological benefits in depicting disease evolution. We conducted a comprehensive review of published Markov models in depression and identified potential limits to their methodology. A model based on DES principles was developed to investigate the benefits and drawbacks of this simulation method compared with Markov modelling techniques. The major drawback to Markov models is that they may not be suitable to tracking patients' disease history properly, unless the analyst defines multiple health states, which may lead to intractable situations. They are also too rigid to take into consideration multiple patient-specific sociodemographic characteristics in a single model. To do so would also require defining multiple health states which would render the analysis entirely too complex. We show that DES resolve these weaknesses and that its flexibility allow patients with differing attributes to move from one event to another in sequential order while simultaneously taking into account important risk factors such as age, gender, disease history and patients attitude towards treatment, together with any disease-related events (adverse events, suicide attempt etc.). DES modelling appears to be an accurate, flexible and comprehensive means of depicting disease progression compared with conventional simulation methodologies. Its use in analysing recurrent and chronic diseases appears particularly useful compared with Markov processes.

  15. Avant-Propos

    NASA Astrophysics Data System (ADS)

    Ollivier, J.; Farhi, E.; Ferrand, M.; Benoit, M.

    2005-11-01

    L'École Thématique “Neutrons et Biologie” s'est tenue du 22 au 26 Mai 2004 à Praz/Arly (Haute-Savoie, France), dans le cadre des 12 èmes Journees de la Diffusion Neutronique de la Societe Française de Neutronique. Cette école a ete organisee avec le concours financier du CNRS (formation permanente), du Laboratoire Léon Brillouin (CEA Saclay), de la region Rhône-Alpes, du conseil général de Haute-Savoie et de l'Université Joseph Fourier de Grenoble. Une cinquantaine de participants, dont une vingtaine d'intervenants, ont largement contribué à la réussite de l'École. D'un point de vue scientifique, l'École s'est déclinée en sept sessions thématiques majeures: - une première session introductive a été consacrée à une revue globale des méthodes biophysiques ayant un fort impact pour l'étude de la structure et de la dynamique des macromolécules biologiques (J. Parello). Un accent tout particulier à été apporté pour décrire les neutrons en tant que composante importante de la panoplie des techniques couramment utilisées en biophysique moléculaire (J. Schweitzer). - une session dédiée aux mesures dynamiques par diffusion incohérente de neutrons a été largement developpée. Qu'ils s'agissent de vibrations et de relaxations moléculaires dans les protéines (J.M. Zanotti), de dynamique globale des protéines (G. Zaccaï), ainsi que de dynamique de l'eau d'hydratation (F. Gabel), de nombreux exemples ont permis d'illustrer la pertinence des neutrons pour étudier la dynamique fonctionnelle des protéines sur l'échelle de temps picosecond nanoseconde. L'analyse des données de diffusion inélastique de neutrons ne peut se passer de modélisation théorique analytique des propriétés dynamique des biomolécules (D. Bicout). - une large place avait été réservée aux études structurales en biologie. Cette troisième session a rassemblé des contributions en diffusion aux petits angles de neutrons pour l'étude structurale en solution (D. Lairez), en réflectométrie de neutrons pour l'étude de systèmes des membranes ou de protéines en interaction avec des membranes (G. Fragneto), ainsi qu'en diffraction de fibres appliquée à l'étude de l'ADN (T. Forsyth). - les simulations de dynamique moléculaire constituent une méthode théorique unique pour étudier, au niveau atomique, les mouvements internes des macromolécules biologiques, que ce soit à l'équilibre (G. Kneller, S. Crouzy) ou hors équilibre (B. Gilquin). Les trajectoires de dynamique moléculaire s'étendent aujourd'hui à la centaine de nanosecondes, et peuvent être de ce fait utilisées par certains programmes pour calculer les observables expérimentales fournies par la diffusion de neutrons (G. Kneller, T. Hinsen). - l'ouverture des neutrons à des techniques instrumentales permettant d'approcher, d'une part, des états hors-équilibre par le biais d'études cinétiques couplées à des mélanges rapides pour des études de croissance de phases (I. Grillo) ou de repliement de protéines, d'autre part, des conditions expérimentales extrèmes (hautes-pressions, M. Plazanet), nous ont semblé constituer des émergences prometteuses. À ce titre, une revue sur le repliement des protéines (V. Forge) a précisé l'importance de nombreuses techniques (fluorescence intrinsèque, dichroïsme, infra-rouge, RMN) dans le domaine, tout en permettant d'entrevoir l'intérêt des études par neutrons. - en marge des sessions purement “neutrons”, il nous semblait important de pouvoir présenter des techniques et méthodes souvent reconnues comme très complémentaires des neutrons, en privilégiant un volet “études structurales” et un volet “études dynamiques”. Côté méthodes dynamiques, la RMN (M. Blackledge) a été positionnée comme une technique permettant d'étudier la flexibilité moléculaire sur des echelles de temps plus lentes (ms). Côté méthodes structurales, la bio-cristallographie des RX appliquée à l'études des structures virales (P. Gouet) a permis de mettre en évidence des aspects complémentaires entre RX et neutrons, et de souligner les avantages et inconvenients respectifs de ces techniques. - l'École Thématique s'est achevée par une session commune avec les Journées Rossat-Mignod, au cours de laquelle J. Helliwell a établi une revue comparative RX/neutrons sur les développements récents en bio-cristallographie des protéines, suivi de deux presentations portant sur la dynamique incohérente et cohérente de systèmes membranaires (F. Natali, M. Rheinstadter). Contrairement aux années précédentes, le contenu de cet ouvrage se veut davantage refléter les applications des neutrons en biologie et biophysique moléculaire, en se reportant à des travaux scientifiques précis, plutôt que d'être constitué d'un recueil de cours, certes trés pédagogiques, mais quelquefois trop éloignés de l'expérience. Nous espérons que ce choix saura satisfaire le lecteur et encourager de nouveaux biologistes à utiliser les neutrons dès que possible pour leurs systèmes d'intérêt. Bonne lecture et bonnes manips !!!!

  16. Surface Water Qualit: Revisiting Nitrate Concentrations in the Des Moines River: 1945 and 1976-2001

    USGS Publications Warehouse

    McIsaac, G.F.; Libra, R.D.

    2003-01-01

    Recent compilations of historical and contemporary riverine nitrate (NO3) concentrations indicate that concentrations in many rivers in the north-central USA increased during the second half of the 20th century. The Des Moines River near Des Moines, Iowa, however, was reported to have had similar NO3 concentrations in 1945 and the 1980s, in spite of substantially greater N input to the watershed during the latter period. The objective of this study was to reconsider the comparison of historical and contemporary NO3 concentrations in the Des Moines River near Des Moines in light of the following: (i) possible errors in the historical data used, (ii) variations in methods of sample collection, (iii) variations in location of sampling, and (iv) additional data collected since 1990. We discovered that an earlier study had compared the flow-weighted average concentration in 1945 to arithmetic annual average concentrations in the 1980s. The intertemporal comparison also appeared to be influenced by differences in sample collection methods and locations used at different times. Depending on the model used and the estimated effects of composite sample collection, the 1945 arithmetic average NO3 concentration was between 44 and 57% of the expected mean value at a similar water yield during 1976-2001. The flow-weighted average NO3 concentration for 1945 was between 54 and 73% of the expected mean value at a similar water yield during 1976-2001. The difference between NO3 concentrations in 1945 and the contemporary period are larger than previously reported for the Des Moines River.

  17. 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.

  18. Chronometric Electrical Stimulation of Right Inferior Frontal Cortex Increases Motor Braking

    PubMed Central

    Conner, Christopher R.; Aron, Adam R.; Tandon, Nitin

    2013-01-01

    The right inferior frontal cortex (rIFC) is important for stopping responses. Recent research shows that it is also activated when response emission is slowed down when stopping is anticipated. This suggests that rIFC also functions as a goal-driven brake. Here, we investigated the causal role of rIFC in goal-driven braking by using computer-controlled, event-related (chronometric), direct electrical stimulation (DES). We compared the effects of rIFC stimulation on trials in which responses were made in the presence versus absence of a stopping-goal (“Maybe Stop” [MS] vs “No Stop” [NS]). We show that DES of rIFC slowed down responses (compared with control-site stimulation) and that rIFC stimulation induced more slowing when motor braking was required (MS) compared with when it was not (NS). Our results strongly support a causal role of a rIFC-based network in inhibitory motor control. Importantly, the results extend this causal role beyond externally driven stopping to goal-driven inhibitory control, which is a richer model of human self-control. These results also provide the first demonstration of double-blind chronometric DES of human prefrontal cortex, and suggest that—in the case of rIFC—this could lead to augmentation of motor braking. PMID:24336725

  19. Structure, stability and behaviour of nucleic acids in ionic liquids

    PubMed Central

    Tateishi-Karimata, Hisae; Sugimoto, Naoki

    2014-01-01

    Nucleic acids have become a powerful tool in nanotechnology because of their conformational polymorphism. However, lack of a medium in which nucleic acid structures exhibit long-term stability has been a bottleneck. Ionic liquids (ILs) are potential solvents in the nanotechnology field. Hydrated ILs, such as choline dihydrogen phosphate (choline dhp) and deep eutectic solvent (DES) prepared from choline chloride and urea, are ‘green’ solvents that ensure long-term stability of biomolecules. An understanding of the behaviour of nucleic acids in hydrated ILs is necessary for developing DNA materials. We here review current knowledge about the structures and stabilities of nucleic acids in choline dhp and DES. Interestingly, in choline dhp, A–T base pairs are more stable than G–C base pairs, the reverse of the situation in buffered NaCl solution. Moreover, DNA triplex formation is markedly stabilized in hydrated ILs compared with aqueous solution. In choline dhp, the stability of Hoogsteen base pairs is comparable to that of Watson–Crick base pairs. Moreover, the parallel form of the G-quadruplex is stabilized in DES compared with aqueous solution. The behaviours of various DNA molecules in ILs detailed here should be useful for designing oligonucleotides for the development of nanomaterials and nanodevices. PMID:25013178

  20. Deep eutectic solvent formation: a structural view using molecular dynamics simulations with classical force fields

    NASA Astrophysics Data System (ADS)

    Mainberger, Sebastian; Kindlein, Moritz; Bezold, Franziska; Elts, Ekaterina; Minceva, Mirjana; Briesen, Heiko

    2017-06-01

    Deep eutectic solvents (DES) have gained a reputation as inexpensive and easy to handle ionic liquid analogues. This work employs molecular dynamics (MD) to simulate a variety of DES. The hydrogen bond acceptor (HBA) choline chloride was paired with the hydrogen bond donors (HBD) glycerol, 1,4-butanediol, and levulinic acid. Levulinic acid was also paired with the zwitterionic HBA betaine. In order to evaluate the reliability of data MD simulations can provide for DES, two force fields were compared: the Merck Molecular Force Field and the General Amber Force Field with two different sets of partial charges for the latter. The force fields were evaluated by comparing available experimental thermodynamic and transport properties against simulated values. Structural analysis was performed on the eutectic systems and compared to non-eutectic compositions. All force fields could be validated against certain experimental properties, but performance varied depending on the system and property in question. While extensive hydrogen bonding was found for all systems, details about the contribution of individual groups strongly varied among force fields. Interaction potentials revealed that HBA-HBA interactions weaken linearly with increasing HBD ratio, while HBD-HBD interactions grew disproportionally in magnitude, which might hint at the eutectic composition of a system.

  1. Le role du phytoplancton de petite taille (<20 mum) dans les variations des proprietes optiques des eaux du Saint-Laurent

    NASA Astrophysics Data System (ADS)

    Mas, Sebastien

    Les mesures satellitaires de couleur des oceans sont largement determinees par les proprietes optiques inherentes (IOPs) des eaux de surface. D'autre part, le phytoplancton de petite taille (<20 mum) est le plus souvent dominant dans les oceans, et peut donc etre une source importante de variation des IOPs dans les oceans. Dans ce contexte, le but principal de ce doctorat etait de definir l'impact du phytoplancton (<20 mum) sur les variations des proprietes optiques de l'Estuaire et du Golfe du Saint-Laurent (Canada). Afin d'atteindre cet objectif, il etait necessaire de determiner en milieu controle les facteurs de variabilite des proprietes optiques cellulaires et des IOPs du phytoplancton (<20 mum) des eaux du Saint-Laurent, et d'evaluer la contribution du phytoplancton (<20 mum) aux proprietes optiques totales des eaux du Saint-Laurent. Des experiences en laboratoire ont montre que les variations des proprietes optiques des cellules phytoplanctoniques soumises a un cycle jour-nuit, ainsi qu'a des changements concomitants d'intensite lumineuse, peuvent contribuer significativement a la variabilite des proprietes optiques observee en milieu naturel. D'autres experiences ont, quant a elles, mis en evidence que les variations des proprietes optiques des cellules phytoplanctoniques dues aux phases de croissance peuvent alterer les IOPs des oceans, particulierement pendant les periodes de floraison. De plus, la presence de bacteries et de particules detritiques peut egalement affecter la variabilite des IOPs totales, notamment la diffusion. Au printemps, dans l'Estuaire et le Golfe du Saint-Laurent, la contribution du phytoplancton <20 mum aux IOPs presentait des differences regionales evidentes pour les proprietes d'absorption et de diffusion. En plus de la variabilite spatiale, les proprietes optiques cellulaires presentaient des variations journalieres, et ce particulierement pour le picophytoplancton. Enfin, la plupart des differences observees dans les proprietes biooptiques, particulierement l'absorption, etaient attribuables a la contribution du phytoplancton <20 mum. Ceci confirme l'importance de la structure de taille des communautes phytoplanctoniques dans les modeles bio-optiques appliques au Saint-Laurent. L'ensemble des resultats a permis de mettre en evidence l'importance des mecanismes de photoacclimatation et de synchronisation du cycle cellulaire du phytoplancton sur les variations journalieres des IOPs, ainsi que de l'etat physiologique relie au stade de croissance sur les variations temporelles a long terme des IOPs. De plus, le phytoplancton <20 mum contribue de maniere importante aux IOPs et a leur variabilite dans l'Estuaire et le Golfe du St-Laurent, et ce particulierement pour l'absorption. Cette etude de doctorat souligne donc l'importance du phytoplancton <20 mum sur la variabilite des IOPs des oceans.

  2. La planification préalable des soins pour les patients en pédiatrie

    PubMed Central

    2008-01-01

    RÉSUMÉ Les progrès médicaux et technologiques ont permis d’ac-croître les taux de survie et d’améliorer la qualité de vie des nourrissons, des enfants et des adolescents ayant des maladies chroniques mettant la vie en danger. La planifi-cation préalable des soins inclut le processus relié aux discussions sur les traitements essentiels au maintien de la survie et la détermination des objectifs des soins de longue durée. Les dispensateurs de soins pédiatriques ont l’obligation éthique d’assimiler cet aspect des soins médicaux. Le présent document de principes vise à aider les dispensateurs de soins à discuter de la planification préalable des soins des patients pédiatriques dans diverses situations. La planification préalable des soins exige des communications efficaces afin de clarifier les objectifs des soins et de s’entendre sur les traitements pertinents ou non pour réaliser ces objectifs, y compris les mesures de réanimation et les mesures palliatives.

  3. Études par diffraction haute résolution et réflectivité de films minces épitaxiés

    NASA Astrophysics Data System (ADS)

    Baulès, P.; Casanove, M. J.; Roucau, C.; Ousset, J. C.; Bobo, J. F.; Snoeck, E.; Magnoux, D.; Gatel, C.

    2002-07-01

    The studies we present concern the general researches involved in order to understand the growth mechanisms of thin films deposited on oriented substrates. Among the different investigation technics of the thin layers, X-ray diffraction and reflectivity will be discussed through two applications. In a first step, thediffraction presented, illustrated by reciprocal space mapping, will give information about the layer state of stress and the lattice distorsion of La{1-x}SrxMnO3 deposited on SrTiO3. The results obtained are discussed and compared to those given by electron microscopy. In a second step, we will present an application of reflectivity concerning a very roughness surface of platinum deposited on MgO showing an island growth process. We will verify that reflectivity can lead to the determination of the recovered rate of the surface, even if some problems exist in the simulation of the whole data set. Results obtained in electron microscopy will complete those issued from reflectivity. Les études que nous allons présenter sont à replacer dans le contexte général de la compréhension des mécanismes de croissance des films minces déposés sur des substrats orientés. Parmi les diverses techniques d'investigations des couches minces, la diffraction et la réflectivité des rayons X vont être abordées à travers deux applications. Nous verrons tout d'abord que la diffraction, illustrée par la cartographie en deux dimension du réseau réciproque, permet de remonter à l'état de contrainte ainsi qu'à la déformation de la maille de La{1-x}SrxMnO3 déposé sur SrTiO3. Les résultats déduits de ces mesures seront discutés et comparés à ceux obtenus en microscopie électronique. Dans la suite de l'article, nous verrons une des applications de la réflectivité, sur une surface très perturbée de platine déposé sur MgO et présentant une croissance en îlots. Nous verrons que la réflectivité permet d'estimer le taux de recouvrement de la surface, mais que des problèmes persistent dans la simulation de l'intégralité des données expérimentales. Les résultats obtenus en MET viendront compléter ceux issus de la réflectivité.

  4. Dry eyes and AIs: If you don't ask you won't find out.

    PubMed

    Inglis, Holly; Boyle, Frances M; Friedlander, Michael L; Watson, Stephanie L

    2015-12-01

    Our objective was to investigate the hypothesis that women on adjuvant aromatase inhibitors (AIs) for treatment of breast cancer have a higher prevalence of dry eye syndrome (DES) compared with controls. Exposure and control groups were recruited. A cross sectional questionnaire-based study was performed. Demographic data and medical histories were collected. The presence of dry eye syndrome was determined by the ocular surface disease index (OSDI). The Functional Assessment of Cancer Treatment - Endocrine Subscale (FACT-ES) was performed to investigate correlations with other side effects of AIs. 93 exposure group and 100 control group questionnaires were included. The groups were similar in all demographic variables. The prevalence of dry eye syndrome was 35% (exposure) and 18% (control) (p < 0.01, OR 2.5). AIs were the only factor associated with dry eyes. The OSDI score was negatively correlated with the total FACT-ES score and positively correlated with duration of treatment. Our study is the first to use a validated questionnaire to assess for DES in this population. DES is significantly more prevalent in women on AIs compared with controls. This is a newly emerging, and easily treated side effect of AIs. Self-reporting of dry eye symptoms underestimates the prevalence of DES with AIs. We recommend routine screening of patients on AIs with the OSDI with the aim of improving patient quality of life and possibly adherence. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Enhanced and green extraction polyphenols and furanocoumarins from Fig (Ficus carica L.) leaves using deep eutectic solvents.

    PubMed

    Wang, Tong; Jiao, Jiao; Gai, Qing-Yan; Wang, Peng; Guo, Na; Niu, Li-Li; Fu, Yu-Jie

    2017-10-25

    Nowadays, green extraction of bioactive compounds from medicinal plants has gained increasing attention. As green solvent, deep eutectic solvent (DES) have been highly rated to replace toxic organic solvents in extraction process. In present study, to simultaneous extraction five main bioactive compounds from fig leaves, DES was tailor-made. The tailor-made DES composed of a 3:3:3 molar ratio of glycerol, xylitol and D-(-)-Fructose showed enhanced extraction yields for five target compounds simultaneously compared with traditional methanol and non-tailor DESs. Then, the tailor-made DES based extraction methods have compared and microwave-assisted extraction was selected and optimized due to its high extraction yields with lower time consumption. The influencing parameters including extraction temperature, liquid-solid ratio, and extraction time were optimized using response surface methodology (RSM). Under optimal conditions the extraction yield of caffeoylmalic acid, psoralic acid-glucoside, rutin, psoralen and bergapten was 6.482mg/g, 16.34mg/g, 5.207mg/g, 15.22mg/g and 2.475mg/g, respectively. Macroporous resin D101 has been used to recovery target compounds with recovery yields of 79.2%, 83.4%, 85.5%, 81.2% and 75.3% for caffeoylmalic acid, psoralic acid-glucoside, rutin, psoralen and bergapten, respectively. The present study suggests that DESs are truly designer and efficient solvents and the method we developed was efficient and sustainable for extraction main compounds from Fig leaves.mg/g. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. High-density two-dimensional electron system induced by oxygen vacancies in ZnO

    NASA Astrophysics Data System (ADS)

    Rödel, T. C.; Dai, J.; Fortuna, F.; Frantzeskakis, E.; Le Fèvre, P.; Bertran, F.; Kobayashi, M.; Yukawa, R.; Mitsuhashi, T.; Kitamura, M.; Horiba, K.; Kumigashira, H.; Santander-Syro, A. F.

    2018-05-01

    We realize a two-dimensional electron system (2DES) in ZnO by simply depositing pure aluminum on its surface in ultrahigh vacuum and characterize its electronic structure by using angle-resolved photoemission spectroscopy. The aluminum oxidizes into alumina by creating oxygen vacancies that dope the bulk conduction band of ZnO and confine the electrons near its surface. The electron density of the 2DES is up to two orders of magnitude higher than those obtained in ZnO heterostructures. The 2DES shows two s -type subbands, that we compare with the d -like 2DESs in titanates, with clear signatures of many-body interactions that we analyze through a self-consistent extraction of the system self-energy and a modeling as a coupling of a two-dimensional Fermi liquid with a Debye distribution of phonons.

  7. Kinin B1 receptor antagonists containing alpha-methyl-L-phenylalanine: in vitro and in vivo antagonistic activities.

    PubMed

    Gobeil, F; Charland, S; Filteau, C; Perron, S I; Neugebauer, W; Regoli, D

    1999-03-01

    -To protect from metabolism and to improve potency of the AcLys-[D-betaNal7,Ile8]desArg9-bradykinin (BK) (R 715), we prepared and tested 3 analogues containing alpha-methyl-L-Phe ([alphaMe]Phe) in position 5: these are the AcLys-[(alphaMe)Phe5,D-betaNal7, Ile8]desArg9BK (R 892), Lys-Lys-[(alphaMe)Phe5,D-betaNal7, Ile8]desArg9BK (R 913), and AcLys-Lys-[(alphaMe)Phe5,D-betaNal7, Ile8]desArg9BK (R 914). The new compounds were tested against the contractile effect induced by desArg9BK on 2 B1 receptor bioassays, the human umbilical vein, and the rabbit aorta. Their antagonistic activities were compared with those of the early prototypes (Lys-[Leu8]desArg9BK and [Leu8]desArg9BK) and with other recently described peptide antagonists. The 3 (alphaMe)Phe analogues showed high antagonistic potencies (pA2) at both the human (8.8, 7.7, and 8. 7, respectively) and rabbit (8.6, 7.8, and 8.6, respectively) B1 receptors. No antagonistic effects (pA2<5) were observed on the B2 receptors that mediate the contractile effects of BK on the human umbilical vein, the rabbit jugular vein, and the guinea pig ileum. Moreover, these new B1 antagonists were found to be resistant to in vitro degradation by purified angiotensin-converting enzyme from rabbit lung. The Nalpha-acetylated forms, R 892 and R 914, were resistant to aminopeptidases from human plasma. In vivo antagonistic potencies (ID50) of B1 receptor antagonists were evaluated in anesthetized lipopolysaccharide-treated (for B1 receptor) and nontreated (for B2 receptor) rabbits against the hypotensive effects of exogenous desArg9BK and BK. R 892 efficiently inhibited (ID50 2.8 nmol/kg IV) hypotension induced by desArg9BK without affecting that evoked by BK (ID50 >600 nmol/kg IV). Conversely, the peptide antagonists Lys-Lys-[Hyp3,Igl5,D-Igl7,Oic8]desArg9BK (B 9858) and DArg-[Hyp3,Thi5,D-Tic7,Oic8] desArg9BK (S 0765) showed dual B1/B2 receptor antagonism in vitro and in vivo. It is concluded that R 892 and congeners provide selective, highly potent, and metabolically stable B1 kinin receptor antagonists that can be useful for the assessment of the physiological and pathological roles of kinin B1 receptors.

  8. Caracterisation thermique de modules de refroidissement pour la photovoltaique concentree

    NASA Astrophysics Data System (ADS)

    Collin, Louis-Michel

    Pour rentabiliser la technologie des cellules solaires, une reduction du cout d'exploitation et de fabrication est necessaire. L'utilisation de materiaux photovoltaiques a un impact appreciable sur le prix final par quantite d'energie produite. Une technologie en developpement consiste a concentrer la lumiere sur les cellules solaires afin de reduire cette quantite de materiaux. Or, concentrer la lumiere augmente la temperature de la cellule et diminue ainsi son efficacite. Il faut donc assurer a la cellule un refroidissement efficace. La charge thermique a evacuer de la cellule passe au travers du recepteur, soit la composante soutenant physiquement la cellule. Le recepteur transmet le flux thermique de la cellule a un systeme de refroidissement. L'ensemble recepteur-systeme de refroidissement se nomme module de refroidissement. Habituellement, la surface du recepteur est plus grande que celle de la cellule. La chaleur se propage donc lateralement dans le recepteur au fur et a mesure qu'elle traverse le recepteur. Une telle propagation de la chaleur fournit une plus grande surface effective, reduisant la resistance thermique apparente des interfaces thermiques et du systeme de refroidissement en aval vers le module de refroidissement. Actuellement, aucune installation ni methode ne semble exister afin de caracteriser les performances thermiques des recepteurs. Ce projet traite d'une nouvelle technique de caracterisation pour definir la diffusion thermique du recepteur a l'interieur d'un module de refroidissement. Des indices de performance sont issus de resistances thermiques mesurees experimentalement sur les modules. Une plateforme de caracterisation est realisee afin de mesurer experimentalement les criteres de performance. Cette plateforme injecte un flux thermique controle sur une zone localisee de la surface superieure du recepteur. L'injection de chaleur remplace le flux thermique normalement fourni par la cellule. Un systeme de refroidissement est installe a la surface opposee du recepteur pour evacuer la chaleur injectee. Les resultats mettent egalement en evidence l'importance des interfaces thermiques et les avantages de diffuser la chaleur dans les couches metalliques avant de la conduire au travers des couches dielectriques du recepteur. Des recepteurs de multiples compositions ont ete caracterises, demontrant que les outils developpes peuvent definir la capacite de diffusion thermique. La repetabilite de la plateforme est evaluee par l'analyse de l'etendue des mesures repetees sur des echantillons selectionnes. La plateforme demontre une precision et reproductibilite de +/- 0.14 ° C/W. Ce travail fournit des outils pour la conception des recepteurs en proposant une mesure qui permet de comparer et d'evaluer l'impact thermique de ces recepteurs integres a uri module de refroidissement. Mots-cles : cellule solaire, photovoltaique, transfert de chaleur, concentration, resistances thermiques, plateforme de caracterisation, refroidissement

  9. Encéphalopathie pancréatique: à propos de deux cas

    PubMed Central

    Doghmi, Nawfal; Benakrout, Aziz; Meskine, Amine; Bensghir, Mustaphja; Baite, Abdelouah; Haimeur, Charki

    2016-01-01

    L'encéphalopathie pancréatique, est une complication rare de la pancréatite aiguë, notre étude porte sur 02 cas d'encéphalopathie pancréatique, hospitalisés et traités au sein du service de Réanimation chirurgicale de l'Hôpital Militaire d'Instruction Mohamed V de Rabat. L'âge des patients était compris entre 43 ans et 54 ans, nos 02 cas sont repartis en une femme et un homme. Le mécanisme physiopathologique de l'EP n'est pas encore bien élucidé, de nombreuses hypothèses ont été rapportées dans la littérature, certains auteurs suggèrent que la lipase et la Phospholipase A2 jouent un rôle dans le processus pathologique de l'EP. D'autres facteurs tels que les infections, les troubles hydroélectrolytiques, l'hypoxémie et la perturbation de la glycémie, peuvent être déclencheurs. Le diagnostic de l'encéphalopathie pancréatique est facile à établir, la symptomatologie clinique se résume le plus souvent à une confusion, avec stupeur, et agitation psychomotrice, Il s'y ajoute parfois des atteintes neurologiques comme des convulsions, une céphalée, des hémiparésies passagères, une dysarthrie, enfin des difficultés d'expression verbale et une amnésie. Les examens paracliniques, notamment L'IRM cérébrale et l'électroencéphalogramme, permettent de confirmer le diagnostic. Le traitement est d'abord symptomatique, il a comme objectif de lutter contre les facteurs qui favorisent l'apparition des signes neurologiques par les mesures de réanimation que réclame la gravité de la situation. L'évolution de l'EP est le plus souvent favorable, avec une disparition progressive des symptômes, cependant la persistance de quelques séquelles, est décrite dans la littérature. Le pronostic est fonction de la gravité de la pancréatite aigüe et des complications associées. Dans notre étude les données sont globalement comparables à celles publiées actuellement par la majorité des auteurs. PMID:28292109

  10. Fissuration d'un composite a matrice ceramique dans une application de piece statique de turbine a gaz

    NASA Astrophysics Data System (ADS)

    Lebel, Larry

    Une procedure experimentale a ete developpee pour caracteriser les mecanismes de deterioration et la durabilite de materiaux composites a matrice ceramique (CMC) dans une application de piece statique de turbine a gaz. Tandis que la plupart des essais de caracterisation publies sur les materiaux CMC ont ete realises sous des conditions de chargement controle, la presente recherche tente de reproduire la relaxation des contraintes qui se produit normalement dans une piece statique a haute temperature. Dans l'experience proposee, un echantillon planaire de forme haltere est chauffe de facon cyclique sur une de ses faces et refroidi sur l'autre, tout en etant contraint dans ses deplacements. La contrainte de flexion resultante au centre de l'echantillon, mesuree par une cellule de charge, correspond a la contrainte de flexion qui a ete prealablement predite au centre des panneaux d'une chambre a combustion generique. Un materiau CMC multicouche compose d'une matrice d'alumine poreuse et de fibres NextelMD 720 a ete utilise pour developper l'experience. Des essais de calibration ont d'abord ete realises en utilisant un systeme de chauffage par lampe infrarouge, atteignant jusqu'a 1160 °C a la surface de l'echantillon. Un systeme laser au CO2 a par la suite ete utilise pour realiser des essais de deterioration a haute puissance, atteignant en fin d'essai des temperatures de surface excedant la limite de 1200 °C du materiau et des differences de temperature a travers l'epaisseur de plus de 1000 °C. Sous la puissance de chauffage imposee a amplitude constante, l'accumulation de dommage a fait en sorte d'augmenter la temperature en surface et les gradients de temperature a travers le materiau. Une reduction de la contrainte dans le temps a ete observee a cause du fluage, de la fissuration et de la delamination du materiau sous la condition de confinement du deplacement, menant a une stabilisation du niveau de dommage a une certaine profondeur dependant de la contrainte thermique initiale. La procedure de caracterisation developpee s'avere etre un outil prometteur pour developper de nouveaux types de materiaux, de meme que pour comparer la durabilite de materiaux existants sous des conditions representatives de pieces statiques de turbine a gaz. None

  11. Comparative analysis of mitotic aberrations induced by diethyl sulphate (DES) and sodium azide (SA) in Vicia faba L. (Fabaceae).

    PubMed

    Bhat, Tariq Ahmad; Sharma, Monika; Anis, M

    2007-03-01

    The present investigation provides a comparative account of different concentrations (0.01, 0.02, 0.03, 0.04, 0.05 and 0.06%) of diethylsulphate (DES) and Sodium Azide (SA) on mitotic aberrations, seed germination, seedling survival, plant height and mitotic index in Vicia faba L. variety major. The control plants were normal while as treated ones showed significant alterations. The mutagens caused dose dependent decrease in seed germination, seedling survival, plant height and mitotic index. All the parameters were found negatively affected and were positively correlated with mutagenic concentrations. The cytological study revealed various types of mitotic aberrations, among them the dominant were fragments, stickiness, precocious separation, c-metaphase, ring chromosomes, unequal separation, laggards, bridges, micronuclei, disturbed anaphase etc. Stickiness and fragments were more frequent as compared to other types.

  12. In vivo evaluation of axial integrity of coronary stents using intravascular ultrasound: Insights on longitudinal stent deformation.

    PubMed

    Dvir, Danny; Kitabata, Hironori; Barbash, Israel M; Minha, Sa'ar; Badr, Salem; Loh, Joshua P; Chen, Fang; Torguson, Rebecca; Waksman, Ron

    2014-09-01

    To evaluate the axial integrity of different coronary stents using intravascular ultrasound (IVUS). Longitudinal stent deformation was recently reported. Consecutive patients who underwent IVUS analysis after drug-eluting stent (DES) implantation for de novo coronary lesions were evaluated. Stent length was compared with label length for calculation of absolute change and relative difference (absolute change divided by label length). A total of 233 DES utilizing five different platforms were included. The median absolute change in stent length was 0.90 mm (interquartile range [IQR] 0.48-1.39) and the relative difference was 5.24% (IQR 2.55-8.29). There was no significant difference among the groups in median absolute or relative change: Cypher 0.89 mm/3.89%, Taxus 0.88 mm/5.39%, Endeavor 1.16 mm/6.77%, Xience V 0.86 mm/5.80%, and PROMUS Element 0.79 mm/5.34% (P = 0.085, P = 0.072, respectively). Multivariate logistic regression revealed that the Cypher stent was independently correlated with a lower change in length, whereas stent label length and deployment pressure were correlated with higher absolute change. The axial integrity of DES platforms examined in vivo was high, with only mild changes in stent length after implantation. While there are differences between first- and second-generation DES, axial integrity among second-generation DES was similar. © 2013 Wiley Periodicals, Inc.

  13. Detached-Eddy Simulations of Separated Flow Around Wings With Ice Accretions: Year One Report

    NASA Technical Reports Server (NTRS)

    Choo, Yung K. (Technical Monitor); Thompson, David; Mogili, Prasad

    2004-01-01

    A computational investigation was performed to assess the effectiveness of Detached-Eddy Simulation (DES) as a tool for predicting icing effects. The AVUS code, a public domain flow solver, was employed to compute solutions for an iced wing configuration using DES and steady Reynolds Averaged Navier-Stokes (RANS) equation methodologies. The configuration was an extruded GLC305/944-ice shape section with a rectangular planform. The model was mounted between two walls so no tip effects were considered. The numerical results were validated by comparison with experimental data for the same configuration. The time-averaged DES computations showed some improvement in lift and drag results near stall when compared to steady RANS results. However, comparisons of the flow field details did not show the level of agreement suggested by the integrated quantities. Based on our results, we believe that DES may prove useful in a limited sense to provide analysis of iced wing configurations when there is significant flow separation, e.g., near stall, where steady RANS computations are demonstrably ineffective. However, more validation is needed to determine what role DES can play as part of an overall icing effects prediction strategy. We conclude the report with an assessment of existing computational tools for application to the iced wing problem and a discussion of issues that merit further study.

  14. The in vitro effect of nonylphenol, propranolol, and diethylstilbestrol on quality parameters and oxidative stress in sterlet (Acipenser ruthenus) spermatozoa.

    PubMed

    Shaliutina, Olena; Shaliutina-Kolešová, Anna; Lebeda, Ievgen; Rodina, Marek; Gazo, Ievgeniia

    2017-09-01

    The sturgeon is a highly endangered fish mostly due to over-fishing, habitat destruction, and water pollution. Nonylphenol (NP), propranolol (PN), and diethylstilbestrol (DES) are multifunctional xenobiotic compounds used in a variety of commercial and industrial products. The mechanism by which these xenobiotic compounds interfere with fish reproduction is not fully elucidated. This study assessed the effect of NP, PN, and DES on motility parameters, membrane integrity, and oxidative/antioxidant status in sterlet Acispenser ruthenus spermatozoa. Spermatozoa were incubated with several concentrations of target substances for 1h. Motility rate and velocity of spermatozoa decreased in the presence of xenobiotics in a dose-dependent manner compared with controls. A significant decrease in membrane integrity was recorded with exposure to 5μM of NP, 25μM of PN, and 50μM of DES. After 1h exposure at higher tested concentrations NP (5-25μM), PN (25-100μM), and DES (50-200μM), oxidative stress was apparent, as reflected by significantly higher levels of protein and lipid oxidation and significantly greater superoxide dismutase activity. The results demonstrated that NP, PN, and DES can induce reactive oxygen species stress in fish spermatozoa, which could impair sperm quality and the antioxidant defence system and decrease the percentage of intact sperm cells. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. External adjustment sensitivity analysis for unmeasured confounding: an application to coronary stent outcomes, Pennsylvania 2004-2008.

    PubMed

    Huesch, Marco D

    2013-06-01

    Assessing the real-world comparative effectiveness of common interventions is challenged by unmeasured confounding. To determine whether the mortality benefit shown for drug-eluting stents (DES) over bare metal stents (BMS) in observational studies persists after controls for/tests for confounding. Retrospective observational study involving 38,019 patients, 65 years or older admitted for an index percutaneous coronary intervention receiving DES or BMS in Pennsylvania in 2004-2005 followed up for death through 3 years. Analysis was at the patient level. Mortality was analyzed with Cox proportional hazards models allowing for stratification by disease severity or DES use propensity, accounting for clustering of patients. Instrumental variables analysis used lagged physician stent usage to proxy for the focal stent type decision. A method originating in work by Cornfield and others in 1954 and popularized by Greenland in 1996 was used to assess robustness to confounding. DES was associated with a significantly lower adjusted risk of death at 3 years in Cox and in instrumented analyses. An implausibly strong hypothetical unobserved confounder would be required to fully explain these results. Confounding by indication can bias observational studies. No strong evidence of such selection biases was found in the reduced risk of death among elderly patients receiving DES instead of BMS in a Pennsylvanian state-wide population. © Health Research and Educational Trust.

  16. Geologic map of the Snoqualmie Pass 30 x 60 minute quadrangle, Washington

    USGS Publications Warehouse

    Tabor, R.W.; Frizzell, V.A.; Booth, D.B.; Waitt, R.B.

    2000-01-01

    The Snoqualmie Pass quadrangle lies at the north edge of a Tertiary volcanic and sedimentary cover, where the regional structural uplift to the north elevated the older rocks to erosional levels. Much of the quadrangle is underlain by folded Eocene volcanic rocks and fluvial deposts of an extensional event, and these rocks are overlain by Cascade arc volcanic rocks: mildly deformed Oligocene-Miocene rocks and undeformed younger volcanic rocks. Melanges of Paleozoic and Mesozoic rocks are exposed in structural highs in the northern part of the quadrangle. The quadrangle is traversed north to south by the Straight Creek Fault, and the probably partially coincident Darringon-Devils Mountain Fault. A rich Quaternary stratigraphy reveals events of the Frazer glaciation.

  17. Lignes directrices canadiennes sur l’utilisation sécuritaire et efficace des opioïdes pour la douleur chronique non cancéreuse

    PubMed Central

    Kahan, Meldon; Wilson, Lynn; Mailis-Gagnon, Angela; Srivastava, Anita

    2011-01-01

    Résumé Objectif Présenter aux médecins de famille un résumé clinique pratique sur la prescription d’opioïdes à des populations particulières en se fondant sur les recommandations faites dans les lignes directrices canadiennes sur l’utilisation sécuritaire et efficace des opioïdes pour la douleur chronique non cancéreuse. Qualité des données Pour produire les lignes directrices, les chercheurs ont effectué une synthèse critique de la littérature médicale en insistant plus précisément sur les études de l’efficacité et de la sécurité des opioïdes dans des populations particulières. Message principal Les médecins de famille peuvent atténuer les risques de surdose, de sédation, d’usage abusif et de dépendance grâce à des stratégies adaptées à l’âge et à l’état de santé des patients. Dans le cas de patients à risque de dépendance, on devrait réserver les opioïdes aux douleurs nociceptives ou neuropathiques bien définies qui n’ont pas répondu aux traitements de première intention. Il faut procéder lentement au titrage des opioïdes, avec des dispensations fréquentes et une étroite surveillance pour dépister tout signe d’usage abusif. Une dépendance aux opioïdes suspectée est prise en charge au moyen d’une thérapie structurée aux opioïdes, d’un traitement à la méthadone ou à la buprénorphine ou encore d’un traitement fondé sur l’abstinence. Les patients souffrant de troubles de l’humeur ou d’anxiété ont tendance à avoir une réponse analgésique atténuée aux opioïdes, sont à risque plus élevé d’usage abusif et prennent souvent des sédatifs qui interagissent défavorablement avec les opioïdes. Il faut prendre des précautions semblables à celles utilisées avec d’autres patients à risque élevé. Il faut faire un sevrage progressif si la douleur du patient demeure sévère même avec un essai adéquat de thérapie aux opioïdes. Chez les personnes âgées, la sédation, les chutes et la surdose peuvent être minimisées en utilisant des doses initiales faibles, un titrage plus lent, un sevrage des benzodiazépines et une bonne éducation des patients. Dans le cas des femmes enceintes qui prennent des opioïdes chaque jour, il faut faire un sevrage progressif et cesser complètement. Si ce n’est pas possible, il faut administrer la dose efficace la plus faible. Les femmes enceintes qui ont une dépendance aux opioïdes devraient recevoir un traitement à la méthadone. Les adolescents sont à risque élevé de surdose d’opioïdes, d’usage abusif et de dépendance. Les patients qui ont des adolescents qui vivent à la maison devraient entreposer leurs opioïdes dans un lieu sûr. Les adolescents ont rarement besoin d’une thérapie à long terme aux opioïdes. Conclusion Les médecins de famille doivent tenir compte de l’âge, de la condition psychiatrique, du degré de risque de dépendance du patient et d’autres facteurs quand ils prescrivent des opioïdes pour la douleur chronique.

  18. DES13S2cmm: The first superluminous supernova from the Dark Energy Survey

    DOE PAGES

    Papadopoulos, A.; Plazas, A. A.; D"Andrea, C. B.; ...

    2015-03-23

    We present DES13S2cmm, the first spectroscopically-confirmed superluminous supernova (SLSN) from the Dark Energy Survey (DES). We briefly discuss the data and search algorithm used to find this event in the first year of DES operations, and outline the spectroscopic data obtained from the European Southern Observatory (ESO) Very Large Telescope to confirm its redshift (z = 0.663 ± 0.001 based on the host-galaxy emission lines) and likely spectral type (type I). Using this redshift, we find M peak U = –21.05 +0.10 –0.09 for the peak, rest-frame U-band absolute magnitude, and find DES13S2cmm to be located in a faint, low-metallicitymore » (sub-solar), low stellar-mass host galaxy (log(M/M⊙) = 9.3 ± 0.3), consistent with what is seen for other SLSNe-I. We compare the bolometric light curve of DES13S2cmm to fourteen similarly well-observed SLSNe-I in the literature and find it possesses one of the slowest declining tails (beyond +30 days rest frame past peak), and is the faintest at peak. Moreover, we find the bolometric light curves of all SLSNe-I studied herein possess a dispersion of only 0.2–0.3 magnitudes between +25 and +30 days after peak (rest frame) depending on redshift range studied; this could be important for ‘standardising’ such supernovae, as is done with the more common type Ia. We fit the bolometric light curve of DES13S2cmm with two competing models for SLSNe-I – the radioactive decay of ⁵⁶Ni, and a magnetar – and find that while the magnetar is formally a better fit, neither model provides a compelling match to the data. Although we are unable to conclusively differentiate between these two physical models for this particular SLSN-I, further DES observations of more SLSNe-I should break this degeneracy, especially if the light curves of SLSNe-I can be observed beyond 100 days in the rest frame of the supernova.« less

  19. Les leishmanioses cutanées à Leishmania major et à Leishmania tropica au Maroc: aspects épidémio-cliniques comparatifs de 268 cas

    PubMed Central

    Chiheb, Soumia; Slaoui, Widad; Mouttaqui, Tarik; Riyad, Meriem; Benchikhi, Hakima

    2014-01-01

    Introduction Depuis 1995, le Maroc a connu une réactivation des foyers de leishmanioses cutanées (LC) à L. major et une nouvelle répartition géographique des foyers à L. tropica. Le but de cette étude est de comparer les aspects épidémio-cliniques associés aux LC potentiellement dûes à L. major et à L. tropica. Méthodes Une étude rétrospective a colligé 268 cas de LC au service de dermatologie du CHU Ibn Rochd de Casablanca entre Janvier 1995 et Septembre 2010. Les données étaient analysées par Epi info version 3.5.1. Le test X2 était appliqué (Différence significative = p< 0,05). Résultats Deux cent soixante-huit cas de LC ont été colligés, dont 160 femmes et 108 hommes. Ils ont été répartis en 123 patients originaires des foyers à L.major et 145 patients originaires des foyers à L. tropica. L'aspect ulcéronodulaire, ulcérovégétant ou végétant était retrouvé dans 58 cas (47,2%) des cas de LC à L. major versus 24 cas (16,7%) dans la L.C à L. tropica. L'aspect papulonodulaire était retrouvé dans 84 cas (58%) de LC à L. tropica contre 41 cas (33,3%) de LC à L. major. Conclusion Dans la LC à L. major, l'atteinte des membres et les aspects cliniques végétant ou ulcéro-végétant restent toujours prédominants. Dans la L.C à L. tropica, l'atteinte papulonodulaire unique du visage reste prédominante mais des formes ulcéronodulaires, végétantes ou ulcérovégétantes existent également dans les foyers récents à L. tropica, prêtant à confusion cliniquement avec des LC à L. major. PMID:25810796

  20. Minimisation des inductances propres des condensateurs à film métallisé

    NASA Astrophysics Data System (ADS)

    Joubert, Ch.; Rojat, G.; Béroual, A.

    1995-07-01

    In this article, we examine the different factors responsible for the equivalent series inductance in metallized capacitors and we propose structures for capacitors that reduce this inductance. After recalling the structure of metallized capacitors we compare, by experimental measurements, the inductance due to the winding and that one added by the connections. The latter can become preponderant. In order to explain the experimental evolution of the winding impedance vs. frequency, we describe an analytical model which gives the current density in the winding and its impedance. This model enables us to determine the self resonant frequency for different types of capacitors. From where, we can infer the influence of the height of capacitors and their internal and external radius upon performances, It appears that to reduce the equivalent series inductance, it is better to use flat windings and annular windings. Dans cet article nous examinons les différents facteurs responsables de l'inductance équivalente série dans les condensateurs à film métallisé et proposons des géométries de condensateurs qui réduisent cette inductance. Après avoir rappelé la structure des condensateurs à film métallisé, nous comparons, par des mesures expérimentales, l'inductance due au bobinage et l'inductance ajoutée par les connexions. Cette dernière peut devenir prépondérante. Afin d'expliquer l'évolution de l'impédance du bobinage en fonction de la fréquence, nous décrivons un modèle analytique qui donne la densité du courant dans le bobinage et l'impédance de ce dernier. En outre, ce modèle permet de déterminer la fréquence de résonance série de divers types de condensateurs ce qui permet de déduire l'influence de la hauteur des condensateurs et de leurs rayons interne et externe sur les performances. Il apparaît ainsi que, pour diminuer l'inductance équivalente série, il vaut mieux employer des bobinages plats et des bobinages annulaires.

  1. 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

  2. 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

  3. Qualité des certificats de coups et blessures volontaires sur adultes à Dakar et Diourbel, Sénégal

    PubMed Central

    Soumah, Mohamed Maniboliot; Ngwa, Hugues Elie Elame; Ndiaye, Mor; Sow, Mamadou Lamine

    2011-01-01

    Introduction Le certificat médical est une attestation écrite, destinée à constater un fait d'ordre médical. L'intérêt de cette étude résultait de la fréquence du contentieux entre représentants de la loi et médecins à propos des certificats médicaux descriptifs de coups et blessures volontaires. Les objectifs étaient d’étudier les critères d’établissement des certificats médicaux dans les cas de coups et blessures volontaires, d’évaluer la qualité des certificats médicaux dans les procédures judiciaires dans les régions de Dakar et de Diourbel, d'apprécier l’évaluation de l'Incapacité Totale de Travail fixée par les médecins et leurs implications judiciaires. Méthodes Nous avons étudié 201 certificats descriptifs de constatation de coups et blessures volontaires. L'incapacité totale de travail (ITT) au sens pénal a été revue par un médecin légiste. Les données recueillies ont été saisies et analysées par logiciel Epi Data version 3.1 et Epi Info 6.04. Résultats Le nom et les prénoms du médecin étaient mentionnés sur les 201 certificats. Sur les 201 certificats étudiés, 170 mentionnaient les faits rapportés par la victime. En proposant de manière comparative pour chacune des ITT fixées par le médecin, une ITT pénale, nous trouvions des erreurs entre ITT pénale et ITT civile (dans 95% des cas). Conclusion Les certificats médicaux délivrés sont incomplets. Les recommandations concernent la création d'unités médico-judiciaires et de centres d'accueil des victimes d'agression. PMID:22384305

  4. DES Science Portal: Computing Photometric Redshifts

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

    Gschwend, Julia

    An important challenge facing photometric surveys for cosmological purposes, such as the Dark Energy Survey (DES), is the need to produce reliable photometric redshifts (photo-z). The choice of adequate algorithms and configurations and the maintenance of an up-to-date spectroscopic database to build training sets, for example, are challenging tasks when dealing with large amounts of data that are regularly updated and constantly growing. In this paper, we present the first of a series of tools developed by DES, provided as part of the DES Science Portal, an integrated web-based data portal developed to facilitate the scientific analysis of the data,more » while ensuring the reproducibility of the analysis. We present the DES Science Portal photometric redshift tools, starting from the creation of a spectroscopic sample to training the neural network photo-z codes, to the final estimation of photo-zs for a large photometric catalog. We illustrate this operation by calculating well calibrated photo-zs for a galaxy sample extracted from the DES first year (Y1A1) data. The series of processes mentioned above is run entirely within the Portal environment, which automatically produces validation metrics, and maintains the provenance between the different steps. This system allows us to fine tune the many steps involved in the process of calculating photo-zs, making sure that we do not lose the information on the configurations and inputs of the previous processes. By matching the DES Y1A1 photometry to a spectroscopic sample, we define different training sets that we use to feed the photo-z algorithms already installed at the Portal. Finally, we validate the results under several conditions, including the case of a sample limited to i<22.5 with the color properties close to the full DES Y1A1 photometric data. This way we compare the performance of multiple methods and training configurations. The infrastructure presented here is an effcient way to test several methods of calculating photo-zs and use them to create different catalogs for portal science workflows« less

  5. Revisiting the role of durable polymers in cardiovascular devices.

    PubMed

    Mori, Hiroyoshi; Otsuka, Fumiyuki; Gupta, Anuj; Jinnouchi, Hiroyuki; Torii, Sho; Harari, Emanuel; Virmani, Renu; Finn, Aloke V

    2017-11-01

    Polymers are an essential component of drug-eluting stents (DES) used to control drug release but remain the most controversial component of DES technology. There are two types of polymers employed in DES: durable polymer based DES (DP-DES) and biodegradable polymer DES (BP-DES). First-generation DES were exclusively composed of DP and demonstrated increased rates of late stent failure due in part to poor polymer biocompatibility. Newer generations DES use more biocompatible durable polymers or biodegradable polymers. Areas covered: We will cover issues identified with 1st-generation DP-DES, areas of success and failure in 2nd-generation DP-DES and examine the promise and shortcomings of BP-DES. Briefly, fluorinated polymers used in 2nd-generation DP-DES have excellent anti-thrombogenicity and better biocompatibility than 1st-generation DES polymers. However, these devices lead to persistent drug exposure to the endothelium which impairs endothelial function and predisposes towards neoatherosclerosis. Meanwhile, BP-DES has shortened the duration of drug exposure which might be beneficial for endothelial functional recovery leading to less neoatherosclerosis. However, it remains uncertain whether the long-term biocompatibility of bare metal surfaces is better than that of polymer-coated metals. Expert commentary: Each technology has distinct advantages, which can be optimized depending upon the particular characteristics of the patient being treated.

  6. Risk factors for the development of ocular graft-versus-host disease (GVHD) dry eye syndrome in patients with chronic GVHD.

    PubMed

    Wang, Jay Ching Chieh; Teichman, Joshua C; Mustafa, Majd; O'Donnell, Heather; Broady, Raewyn; Yeung, Sonia N

    2015-11-01

    To investigate the factors associated with the development of ocular graft-versus-host disease (oGVHD) dry eye syndrome (DES) in patients with chronic GVHD (cGVHD) after receiving allogenic haematopoietic stem cell transplantation (AHSCT) METHODS: A retrospective chart review of patients receiving AHSCT between 1998 and 2013 at the Bone Marrow Transplant Unit of the British Columbia Cancer Agency was carried out. Demographic and clinical data from both donors and recipients were obtained. The diagnostic criteria for the development of oGVHD DES from the National Institutes of Health were used to identify patients with the disease. Descriptive and inferential statistics were carried out. A total of 146 patients with a median follow-up time of 24.0 months (range 11.3-249.7 months) were included in this study. Sixty-six (45.2%) patients were women. Seventy-seven (52.7%) patients had oGVHD DES. The median age of patients was 57 years (range 25-71 years). Compared with other ethnicities, Caucasian patients were less likely to develop oGVHD DES, with an OR of 0.29 (p=0.01). Patients who received a transplant from Epstein-Barr-positive donors had a higher prevalence of oGVHD DES (OR=4.39, p=0.01). This was also found in patients with the following systemic involvement of cGVHD: grade 1-3 cGVHD skin involvement (OR=1.57, p=0.01), oral involvement (OR=2.51, p=0.01) and liver involvement (p=0.04). Patients with grade 2-3 overall cGVHD were also more susceptible to oGVHD DES (OR=2.72, p<0.001). This study identified risk factors associated with a higher prevalence of oGVHD DES in post-AHSCT patients with cGVHD. 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/

  7. The effect of deep eutectic solvent on the pharmacokinetics of salvianolic acid B in rats and its acute toxicity test.

    PubMed

    Chen, Jue; Wang, Qi; Liu, Mengjun; Zhang, Liwei

    2017-09-15

    Deep eutectic solvent (DES), the benign green solvent with uniquely physical properties, has been widely applied in various fields. Our previous study indicated that DES could improve the stability and extraction efficiency of salvianolic acid B (SAB). In this work, with SAB as a model drug, the feasibility of DES as a drug carrier for oral preparation was investigated by evaluating the influence of DES on the pharmacokinetics of SAB and the toxicity of DES. Acute oral toxicity test illustrated that choline chloride-glycerol (ChCl-GL, molar ratio 1:2) was non-toxic with the median lethal dose of 7733mg/kg. To comparison the difference of pharmacokinetics between SAB dissolved in ChCl-GL (1:2) and in water, a rapid and sensitive ultra-performance liquid chromatography coupled with mass spectrum was established to determine SAB and its metabolites in rat plasma. The method validation was also tested for the specificity, linearity (r 2 >0.9980 over two orders of magnitude), precision (intra-day relative standard deviation (RSD)<2.73% and inter-day RSD<7.72%), extraction recovery (70.96-80.78%) and stability under three different situations. Compared to water, the pharmacokinetic parameters clarified that ChCl-GL (1:2) could promote the absorption of SAB, the peak concentration (C max ) of 0.308±0.020mg/L was slightly higher than 0.277±0.024mg/L (SAB dissolved in water), and the peak time (T max ) was significantly decreased from 30min (SAB dissolved in water) to 20min. There was no significant difference on the metabolites between SAB dissolved in ChCl-GL (1:2) and in water. This is the first report on the pharmacokinetic study of DES as a candidate of drug carrier, and the results provide a meaningful basis for the application of DES in pharmaceutical preparation. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. Biological effect on drug distribution and vascular healing via paclitaxel-coated balloon technology in drug eluting stent restenosis swine model.

    PubMed

    Li, Yan; Tellez, Armando; Rousselle, Serge D; Dillon, Krista N; Garza, Javier A; Barry, Chris; Granada, Juan F

    2016-07-01

    To evaluate the biological effect of a paclitaxel-coated balloon (PCB) technology on vascular drug distribution and healing in drug eluting stent restenosis (DES-ISR) swine model. The mechanism of action and healing response via PCB technology in DES-ISR is not completely understood. A total of 27 bare metal stents were implanted in coronary arteries and 30 days later the in-stent restenosis was treated with PCB. Treated segments were harvested at 1 hr, 14 days and 30 days post treatment for the pharmacokinetic analysis. In addition, 24 DES were implanted in coronary arteries for 30 days, then all DES-ISRs were treated with either PCB (n = 12) or uncoated balloon (n = 12). At day 60, vessels were harvested for histology following angiography and optical coherence tomography (OCT). The paclitaxel level in neointimal tissue was about 18 times higher (P = 0.0004) at 1 hr Cmax , and retained about five times higher (P = 0.008) at day 60 than that in vessel wall. A homogenous distribution of paclitaxel in ISR was demonstrated by using fluorescently labeled paclitaxel. Notably, in DES-ISR, both termination OCT and quantitative coronary angioplasty showed a significant neointimal reduction and less late lumen loss (P = 0.05 and P = 0.03, respectively) post PCB versus post uncoated balloon. The PES-ISR + PCB group displayed higher levels of peri-strut inflammation and fibrin scores compared to the -limus DES-ISR + PCB group. In ISR, paclitaxel is primarily deposited in neointimal tissue and effectively retained over time following PCB use. Despite the presence of metallic struts, a uniform distribution was characterized. PCB demonstrated an equivalent biological effect in DES-ISR without significantly increasing inflammation. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

  9. Caractéristiques cliniques des jeunes déprimés en pédopsychiatrie

    PubMed Central

    Breton, Jean-Jacques; Labelle, Réal; Huynh, Christophe; Berthiaume, Claude; St-Georges, Marie; Guilé, Jean-Marc

    2012-01-01

    Résumé Objectif Décrire le profil clinique de jeunes déprimés selon le groupe d’âge et le sexe. Méthodologie L’étude a été réalisée à l’aide d’une grille d’analyse sur 75 dossiers de jeunes de 6–17 ans enregistrés en pédopsychiatrie en 2002–2003 et présentant un diagnostic de trouble dépressif. Des statistiques descriptives et des tests d’association pour comparer les garçons 6–11 ans, les garçons 12–17 ans et les filles 12–17 ans ont été complétés. Résultats Un jeune sur deux à l’adolescence a doublé une année scolaire. Près de 60% des garçons de 6–11 ans déprimés sont dirigés en pédopsychiatrie pour des difficultés comportementales et 71% des garçons de ce groupe d’âge présentent un trouble dépressif en comorbidité avec un trouble du comportement perturbateur. Les filles et garçons à l’adolescence présentent en plus grande proportion une symptomatologie intériorisée. Les idées suicidaires sont cependant aussi présentes chez les enfants (71%) que chez les adolescents (72%) et les adolescentes (85%). Les problèmes parent-enfant se retrouvent chez la majorité des jeunes, particulièrement chez les adolescentes. Conclusion Il est tout aussi important d’évaluer la dépression et l’idéation suicidaire chez les jeunes garçons avec troubles de comportement que chez les adolescents et les adolescentes et la dimension familiale est importante à considérer dans l’évaluation et le traitement. PMID:22299011

  10. Simulation d'ecoulements internes compressibles laminaires et turbulents par une methode d'elements finis

    NASA Astrophysics Data System (ADS)

    Rebaine, Ali

    1997-08-01

    Ce travail consiste en la simulation numerique des ecoulements internes compressibles bidimensionnels laminaires et turbulents. On s'interesse, particulierement, aux ecoulements dans les ejecteurs supersoniques. Les equations de Navier-Stokes sont formulees sous forme conservative et utilisent, comme variables independantes, les variables dites enthalpiques a savoir: la pression statique, la quantite de mouvement et l'enthalpie totale specifique. Une formulation variationnelle stable des equations de Navier-Stokes est utilisee. Elle est base sur la methode SUPG (Streamline Upwinding Petrov Galerkin) et utilise un operateur de capture des forts gradients. Un modele de turbulence, pour la simulation des ecoulements dans les ejecteurs, est mis au point. Il consiste a separer deux regions distinctes: une region proche de la paroi solide, ou le modele de Baldwin et Lomax est utilise et l'autre, loin de la paroi, ou une formulation nouvelle, basee sur le modele de Schlichting pour les jets, est proposee. Une technique de calcul de la viscosite turbulente, sur un maillage non structure, est implementee. La discretisation dans l'espace de la forme variationnelle est faite a l'aide de la methode des elements finis en utilisant une approximation mixte: quadratique pour les composantes de la quantite de mouvement et de la vitesse et lineaire pour le reste des variables. La discretisation temporelle est effectuee par une methode de differences finies en utilisant le schema d'Euler implicite. Le systeme matriciel, resultant de la discretisation spatio-temporelle, est resolu a l'aide de l'algorithme GMRES en utilisant un preconditionneur diagonal. Les validations numeriques ont ete menees sur plusieurs types de tuyeres et ejecteurs. La principale validation consiste en la simulation de l'ecoulement dans l'ejecteur teste au centre de recherche NASA Lewis. Les resultats obtenus sont tres comparables avec ceux des travaux anterieurs et sont nettement superieurs concernant les ecoulements turbulents dans les ejecteurs.

  11. Etude numerique et experimentale de la reponse vibro-acoustique des structures raidies a des excitations aeriennes et solidiennes

    NASA Astrophysics Data System (ADS)

    Mejdi, Abderrazak

    Les fuselages des avions sont generalement en aluminium ou en composite renforces par des raidisseurs longitudinaux (lisses) et transversaux (cadres). Les raidisseurs peuvent etre metalliques ou en composite. Durant leurs differentes phases de vol, les structures d'avions sont soumises a des excitations aeriennes (couche limite turbulente : TBL, champs diffus : DAF) sur la peau exterieure dont l'energie acoustique produite se transmet a l'interieur de la cabine. Les moteurs, montes sur la structure, produisent une excitation solidienne significative. Ce projet a pour objectifs de developper et de mettre en place des strategies de modelisations des fuselages d'avions soumises a des excitations aeriennes et solidiennes. Tous d'abord, une mise a jour des modeles existants de la TBL apparait dans le deuxieme chapitre afin de mieux les classer. Les proprietes de la reponse vibro-acoustique des structures planes finies et infinies sont analysees. Dans le troisieme chapitre, les hypotheses sur lesquelles sont bases les modeles existants concernant les structures metalliques orthogonalement raidies soumises a des excitations mecaniques, DAF et TBL sont reexamines en premier lieu. Ensuite, une modelisation fine et fiable de ces structures est developpee. Le modele est valide numeriquement a l'aide des methodes des elements finis (FEM) et de frontiere (BEM). Des tests de validations experimentales sont realises sur des panneaux d'avions fournis par des societes aeronautiques. Au quatrieme chapitre, une extension vers les structures composites renforcees par des raidisseurs aussi en composites et de formes complexes est etablie. Un modele analytique simple est egalement implemente et valide numeriquement. Au cinquieme chapitre, la modelisation des structures raidies periodiques en composites est beaucoup plus raffinee par la prise en compte des effets de couplage des deplacements planes et transversaux. L'effet de taille des structures finies periodiques est egalement pris en compte. Les modeles developpes ont permis de conduire plusieurs etudes parametriques sur les proprietes vibro-acoustiques des structures d'avions facilitant ainsi la tache des concepteurs. Dans le cadre de cette these, un article a ete publie dans le Journal of Sound and Vibration et trois autres soumis, respectivement aux Journal of Acoustical Society of America, International Journal of Solid Mechanics et au Journal of Sound and Vibration Mots cles : structures raidies, composites, vibro-acoustique, perte par transmission.

  12. Propagation d'impulsions femtosecondes térawatts dans l'atmosphère et applications

    NASA Astrophysics Data System (ADS)

    Méjean, G.

    2005-11-01

    Propagation of femtosecond terawatt laser in atmosphere and applications When ultrasshort and high-power laser pulses propagate across the atmosphere, self-guided filaments of 100 μm radius are formed. They result from a balance between Kerr self-focusing and defocusing by the plasma generated by multiphoton ionisation. During this work, we showed that the white light spectrum generated in filament spans from the infrared (4.5 μm) to the ultraviolet (230 nm) thanks to Third Harmonic Generation and self-phase modulation. We charaterized the propagation under different conditions (rain, smog, turbulence) to developp different atmospheric applications. In particular, we demostrated multi-parameters LIDAR for relative humidity as well as atmospheric pollution remote sensing. Furthermore, it is possible to detect and to identify biological aerosols or solid targets (LIBS) at remote distances, by non-linear processes induced in situ by the high intensity delivered by filaments. Moreover, we demonstrated that guiding and triggering high-voltage discharge thanks to a femsecond high-powered pulse is possible even under a rain with an efficiency comparable to that observed in dry air. We also impoved the efficiency of a two pulses configurations (a femtosecond pulse and a subsequent nanosecond pulse). These results raise hope that lightning could be triggered and guided by laser pulses in the future. Les impulsions laser ultra-brèves (fs) et ultra-intenses (TW) forment, au cours de leur propagation non-linéaire dans l'atmosphère, des structures auto-guidées, d'une centaine de microns de diamètre, appelées filaments. Ces filaments résultent d'un équilibre dynamique entre l'effet Kerr qui focalise le faisceau et la défocalisation due au plasma généré au sein de ceux-ci. Au cours des différentes études rapportées ici, nous avons mesuré que le spectre de lumière blanche issue de l'automodulation de phase et de la génération de troisième harmonique s'étend de l'ultraviolet (230 nm) à l'infrarouge (4,5 μm). De même, la propagation dans l'air, sous différentes conditions (pluie, brouillard, turbulence), des faisceaux térawatts femtosecondes a été caractérisée afin de développer des applications atmosphériques. Il nous a ainsi été possible de développer le LIDAR à lumière blanche pour réaliser des mesures préliminaires d'ozone et d'aérosols simultanément. De même, grâce à la propagation fortement non-linéaire du faisceau qui permet de transporter des hautes intensités sur de longue distance, nous avons pu détecter et identifier, à distance, des aérosols biologiques et des cibles solides (LIBS) en induisant in situ des effets non-linéaires. Enfin, nous avons montré que le déclenchement et le guidage de décharges de haute tension par une impulsion laser femtoseconde sous la pluie reste possible avec une efficacité comparable à l'atmosphère sèche. D'autre part, une configuration à double impulsion laser augmente l'efficacité de déclenchement des décharges. Ces résultats nous rapproche de la perspective de déclenchement et guidage de foudre par laser.

  13. Retour vers le futur: l'expérience des patients et le lien avec la qualité, la sécurité et le rendement financier.

    PubMed

    Cochrane, Bonnie S; Hagins, Mitch; King, John A; Picciano, Gino; McCafferty, Maureen M; Nelson, Brian

    2015-11-01

    Au Canada, l'amélioration de l'expérience des patients est devenue une priorité des politiques de santé. Le perfectionnement et la normalisation des outils et systèmes pour surveiller les mesures de l'expérience des patients augmentent, tandis que la tendance vers une plus grande reddition de compte sur des améliorations durables et abordables se confirme. Pour de nombreux professionnels de la santé, ce phénomène fait foi d'un intérêt renouvelé pour les besoins et priorités fondamentaux des patients, après des décennies où les changements structurels et technologiques ont dominé les programmes de santé. Pour les leaders en santé canadiens, l'amélioration de l'expérience des patients comporte actuellement de grands défis et de belles possibilités. À cet égard, l'expérience des organisations partenaires du groupe Studer au Canada est à la fois pertinente et instructive. Ces organisations ont adopté un modèle, du nom de Evidence-Based Leadership (EBL, ou leadership fondé sur des données probantes), qui favorise et soutient l'harmonisation de l'ensemble des activités et des comportements, conformément à des objectifs organisationnels précis, y compris des améliorations mesurables de l'expérience des patients. Le présent article expose des études de cas d'organisations qui ont adopté l'EBL. Ces organisations ont réalisé des progrès rapides en matière d'indicateurs de l'expérience des patients, ainsi que dans des secteurs essentiels comme les résultats cliniques, la sécurité et le rendement financier. Les données émergentes sur les facteurs et processus qui sous-tendent ces améliorations sont également abordées. © 2015 Collège canadien des leaders en santé

  14. Ocean Thermal Analysis and Related Naval Operational Considerations in the Ionian Sea - June 1980.

    DTIC Science & Technology

    1981-09-01

    oceanography and XBT sampl- ing procedures are made. 4 RESUME L’analyse synoptique de la mer Ionienne en Juin 1980 r~v~le des structures thermiques...varides, et en particulier, un tourbillon chaud comparable en taille et position A celui trouv6 aui cours de MILOC-68. Les fonctions de corr~1ation...spatiale en temp~rature sont anisotropiques dans la partie sud, avec des 6chelles respectives de 30 et 40 A 80 km dans les directions Est/Quest et Nord/Sud

  15. Using Discrete Event Simulation to predict KPI's at a Projected Emergency Room.

    PubMed

    Concha, Pablo; Neriz, Liliana; Parada, Danilo; Ramis, Francisco

    2015-01-01

    Discrete Event Simulation (DES) is a powerful factor in the design of clinical facilities. DES enables facilities to be built or adapted to achieve the expected Key Performance Indicators (KPI's) such as average waiting times according to acuity, average stay times and others. Our computational model was built and validated using expert judgment and supporting statistical data. One scenario studied resulted in a 50% decrease in the average cycle time of patients compared to the original model, mainly by modifying the patient's attention model.

  16. Stent coverage and neointimal proliferation in bare metal stents postdilated with a Paclitaxel-eluting balloon versus everolimus-eluting stents: prospective randomized study using optical coherence tomography at 6-month follow-up.

    PubMed

    Poerner, Tudor C; Otto, Sylvia; Gassdorf, Johannes; Nitsche, Kristina; Janiak, Florian; Scheller, Bruno; Goebel, Björn; Jung, Christian; Figulla, Hans R

    2014-12-01

    In this randomized trial, strut coverage and neointimal proliferation of a therapy of bare metal stents (BMSs) postdilated with the paclitaxel drug-eluting balloon (DEB) was compared with everolimus drug-eluting stents (DESs) at 6-month follow-up using optical coherence tomography. We hypothesized sufficient stent coverage at follow-up. A total of 105 lesions in 90 patients were treated with either XIENCE V DES (n=51) or BMS postdilated with the SeQuent Please DEB (n=54). At follow-up, comparable results on the primary optical coherence tomography end point (percentage uncovered struts 5.64±9.65% in BMS+DEB versus 4.93±9.29% in DES; P=0.366) were found. Thus, BMS+DEB achieved the prespecified noninferiority margin of 5% uncovered struts versus DES (difference between treatment means, 0.71%; one-sided upper 95% confidence interval, 4.14%; noninferiority P=0.04). Optical coherence tomography analysis showed significantly more global neointimal proliferation in the BMS+DEB group (15.7±7.8 versus 11.0±5.2 mm(3) proliferation volume/cm stent length; P=0.002). No significant focal in-stent stenosis analyzed with angiography (percentage diameter stenosis at follow-up, 22.8±11.9 versus 16.9±10.4; P=0.014) and optical coherence tomography (peak local area stenosis, 39.5±13.8% versus 36.8±15.6%; P=0.409) was found. Good stent strut coverage of >94% was found in both therapy groups. Despite greater suppression of global neointimal growth in DES, both DES and BMS+DEB effectively prevented clinically relevant focal restenosis at 6-month follow-up. http://www.clinicaltrials.gov. Unique identifier: NCT01056744. © 2014 American Heart Association, Inc.

  17. Eight ultra-faint galaxy candidates discovered in year two of the Dark Energy Survey

    DOE PAGES

    Drlica-Wagner, A.

    2015-11-04

    Here, we report the discovery of eight new ultra-faint dwarf galaxy candidates in the second year of optical imaging data from the Dark Energy Survey (DES). Six of these candidates are detected at high confidence, while two lower-confidence candidates are identified in regions of non-uniform survey coverage. The new stellar systems are found by three independent automated search techniques and are identified as overdensities of stars, consistent with the isochrone and luminosity function of an old and metal-poor simple stellar population. The new systems are faint (M V > –4.7more » $$\\mathrm{mag}$$) and span a range of physical sizes (17 $$\\mathrm{pc}$$ < r 1/2 < 181 $$\\mathrm{pc}$$) and heliocentric distances (25 kpc < D ⊙ < 214 kpc). All of the new systems have central surface brightnesses consistent with known ultra-faint dwarf galaxies (μ ≳ 27.5 $$\\mathrm{mag}$$ $$\\mathrm{arcsec}$$ –2). Roughly half of the DES candidates are more distant, less luminous, and/or have lower surface brightnesses than previously known Milky Way satellite galaxies. Most of the candidates are found in the southern part of the DES footprint close to the Magellanic Clouds. We find that the DES data alone exclude (p < 10 –3) a spatially isotropic distribution of Milky Way satellites and that the observed distribution can be well, though not uniquely, described by an association between several of the DES satellites and the Magellanic system. Our model predicts that the full sky may hold ~100 ultra-faint galaxies with physical properties comparable to the DES satellites and that 20%–30% of these would be spatially associated with the Magellanic Clouds.« less

  18. DES14X3taz: A TYPE I SUPERLUMINOUS SUPERNOVA SHOWING A LUMINOUS, RAPIDLY COOLING INITIAL PRE-PEAK BUMP

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

    Smith, M.; Sullivan, M.; D’Andrea, C. B.

    2016-02-03

    We present DES14X3taz, a new hydrogen-poor superluminous supernova (SLSN-I) discovered by the Dark Energy Survey (DES) supernova program, with additional photometric data provided by the Survey Using DECam for Superluminous Supernovae. Spectra obtained using Optical System for Imaging and low-Intermediate-Resolution Integrated Spectroscopy on the Gran Telescopio CANARIAS show DES14X3taz is an SLSN-I at z = 0.608. Multi-color photometry reveals a double-peaked light curve: a blue and relatively bright initial peak that fades rapidly prior to the slower rise of the main light curve. Our multi-color photometry allows us, for the first time, to show that the initial peak cools frommore » 22,000 to 8000 K over 15 rest-frame days, and is faster and brighter than any published core-collapse supernova, reaching 30% of the bolometric luminosity of the main peak. No physical Ni-56-powered model can fit this initial peak. We show that a shock-cooling model followed by a magnetar driving the second phase of the light curve can adequately explain the entire light curve of DES14X3taz. Models involving the shock-cooling of extended circumstellar material at a distance of similar or equal to 400 R-circle dot are preferred over the cooling of shock-heated surface layers of a stellar envelope. We compare DES14X3taz to the few double-peaked SLSN-I events in the literature. Although the rise. times and characteristics of these initial peaks differ, there exists the tantalizing possibility that they can be explained by one physical interpretation« less

  19. DES14X3taz: A type I superluminous supernova showing a luminous, rapidly cooling initial pre-peak bump

    DOE PAGES

    Smith, M.

    2016-02-03

    Here, we present DES14X3taz, a new hydrogen-poor superluminous supernova (SLSN-I) discovered by the Dark Energy Survey (DES) supernova program, with additional photometric data provided by the Survey Using DECam for Superluminous Supernovae. Spectra obtained using Optical System for Imaging and low-Intermediate-Resolution Integrated Spectroscopy on the Gran Telescopio CANARIAS show DES14X3taz is an SLSN-I at z = 0.608. Multi-color photometry reveals a double-peaked light curve: a blue and relatively bright initial peak that fades rapidly prior to the slower rise of the main light curve. Our multi-color photometry allows us, for the first time, to show that the initial peak cools from 22,000more » to 8000 K over 15 rest-frame days, and is faster and brighter than any published core-collapse supernova, reaching 30% of the bolometric luminosity of the main peak. No physical (56)Ni-powered model can fit this initial peak. We show that a shock-cooling model followed by a magnetar driving the second phase of the light curve can adequately explain the entire light curve of DES14X3taz. Models involving the shock-cooling of extended circumstellar material at a distance of ≃400 R ⊙ are preferred over the cooling of shock-heated surface layers of a stellar envelope. We compare DES14X3taz to the few double-peaked SLSN-I events in the literature. Although the rise times and characteristics of these initial peaks differ, there exists the tantalizing possibility that they can be explained by one physical interpretation.« less

  20. CO2 laser irradiation enhances CaF2 formation and inhibits lesion progression on demineralized dental enamel-in vitro study.

    PubMed

    Zancopé, Bruna R; Rodrigues, Lívia P; Parisotto, Thais M; Steiner-Oliveira, Carolina; Rodrigues, Lidiany K A; Nobre-dos-Santos, Marinês

    2016-04-01

    This study evaluated if Carbon dioxide (CO2) (λ 10.6 μm) laser irradiation combined with acidulated phosphate fluoride gel application (APF gel) enhances "CaF2" uptake by demineralized enamel specimens (DES) and inhibits enamel lesion progression. Thus, two studies were conducted and DES were subjected to APF gel combined or not with CO2 laser irradiation (11.3 or 20.0 J/cm(2), 0.4 or 0.7 W) performed before, during, or after APF gel application. In study 1, 165 DES were allocated to 11 groups. Fluoride as "CaF2 like material" formed on enamel was determined in 100 DES (n = 10/group), and the surface morphologies of 50 specimens were evaluated by scanning electron microscopy (SEM) before and after "CaF2" extraction. In study 2, 165 DES (11 groups, n = 15), subjected to the same treatments as in study 1, were further subjected to a pH-cycling model to simulate a high cariogenic challenge. The progression of demineralization in DES was evaluated by cross-sectional microhardness and polarized light microscopy analyses. Laser at 11.3 J/cm(2) applied during APF gel application increased "CaF2" uptake on enamel surface. Laser irradiation and APF gel alone arrested the lesion progression compared with the control (p < 0.05). Areas of melting, fusion, and cracks were observed. CO2 laser irradiation, combined with a single APF application enhanced "CaF2" uptake on enamel surface and a synergistic effect was found. However, regarding the inhibition of caries lesion progression, no synergistic effect could be demonstrated. In conclusion, the results have shown that irradiation with specific laser parameters significantly enhanced CaF2 uptake by demineralized enamel and inhibited lesion progression.

  1. Quantification of free and total desmosine and isodesmosine in human urine by liquid chromatography tandem mass spectrometry: a comparison of the surrogate-analyte and the surrogate-matrix approach for quantitation.

    PubMed

    Ongay, Sara; Hendriks, Gert; Hermans, Jos; van den Berge, Maarten; ten Hacken, Nick H T; van de Merbel, Nico C; Bischoff, Rainer

    2014-01-24

    In spite of the data suggesting the potential of urinary desmosine (DES) and isodesmosine (IDS) as biomarkers for elevated lung elastic fiber turnover, further validation in large-scale studies of COPD populations, as well as the analysis of longitudinal samples is required. Validated analytical methods that allow the accurate and precise quantification of DES and IDS in human urine are mandatory in order to properly evaluate the outcome of such clinical studies. In this work, we present the development and full validation of two methods that allow DES and IDS measurement in human urine, one for the free and one for the total (free+peptide-bound) forms. To this end we compared the two principle approaches that are used for the absolute quantification of endogenous compounds in biological samples, analysis against calibrators containing authentic analyte in surrogate matrix or containing surrogate analyte in authentic matrix. The validated methods were employed for the analysis of a small set of samples including healthy never-smokers, healthy current-smokers and COPD patients. This is the first time that the analysis of urinary free DES, free IDS, total DES, and total IDS has been fully validated and that the surrogate analyte approach has been evaluated for their quantification in biological samples. Results indicate that the presented methods have the necessary quality and level of validation to assess the potential of urinary DES and IDS levels as biomarkers for the progression of COPD and the effect of therapeutic interventions. Copyright © 2014 Elsevier B.V. All rights reserved.

  2. Drug-eluting stent thrombosis: results from the multicenter Spanish registry ESTROFA (Estudio ESpañol sobre TROmbosis de stents FArmacoactivos).

    PubMed

    de la Torre-Hernández, José M; Alfonso, Fernando; Hernández, Felipe; Elizaga, Jaime; Sanmartin, Marcelo; Pinar, Eduardo; Lozano, Iñigo; Vazquez, Jose M; Botas, Javier; Perez de Prado, Armando; Hernández, Jose M; Sanchis, Juan; Nodar, Juan M Ruiz; Gomez-Jaume, Alfredo; Larman, Mariano; Diarte, Jose A; Rodríguez-Collado, Javier; Rumoroso, Jose R; Lopez-Minguez, Jose R; Mauri, Josepa

    2008-03-11

    This study sought to assess the incidence, predictors, and outcome of drug-eluting stent(DES) thrombosis in real-world clinical practice. The DES thromboses in randomized trials could not be comparable to those observed in clinical practice, frequently including off-label indications. We designed a large-scale, nonindustry-linked multicentered registry, with 20 centers in Spain. The participant centers provided follow-up data for their patients treated with DES, reporting a detailed standardized form in the event of any angiography-documented DES-associated thrombosis occurring. Of 23,500 patients treated with DES, definite stent thrombosis(ST) developed in 301: 24 acute, 125 subacute, and 152 late. Of the late, 62 occurred >1 year(very late ST). The cumulative incidence was 2% at 3 years. Antiplatelet treatment had been discontinued in 95 cases(31.6%). No differences in incidences were found among stent types. Independent predictors for subacute ST analyzed in a subgroup of 14,120 cases were diabetes, renal failure, acute coronary syndrome, ST-segment elevation myocardial infarction, stent length, and left anterior descending artery stenting, and for late ST were ST-segment elevation myocardial infarction, stenting in left anterior descending artery, and stent length. Mortality at 1-year follow-up was 16% and ST recurrence 4.6%. Older age, left ventricular ejection fraction <45%, nonrestoration of Thrombolysis In Myocardial Infarction flow grade 3, and additional stenting were independent predictors for mortality. The cumulative incidence of ST after DES implantation was 2% at 3 years. No differences were found among stent types. Patient profiles differed between early and late ST. Short-term prognosis is poor, especially when restoration of normal flow fails.

  3. Eight ultra-faint galaxy candidates discovered in year two of the Dark Energy Survey

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

    Drlica-Wagner, A.

    Here, we report the discovery of eight new ultra-faint dwarf galaxy candidates in the second year of optical imaging data from the Dark Energy Survey (DES). Six of these candidates are detected at high confidence, while two lower-confidence candidates are identified in regions of non-uniform survey coverage. The new stellar systems are found by three independent automated search techniques and are identified as overdensities of stars, consistent with the isochrone and luminosity function of an old and metal-poor simple stellar population. The new systems are faint (M V > –4.7more » $$\\mathrm{mag}$$) and span a range of physical sizes (17 $$\\mathrm{pc}$$ < r 1/2 < 181 $$\\mathrm{pc}$$) and heliocentric distances (25 kpc < D ⊙ < 214 kpc). All of the new systems have central surface brightnesses consistent with known ultra-faint dwarf galaxies (μ ≳ 27.5 $$\\mathrm{mag}$$ $$\\mathrm{arcsec}$$ –2). Roughly half of the DES candidates are more distant, less luminous, and/or have lower surface brightnesses than previously known Milky Way satellite galaxies. Most of the candidates are found in the southern part of the DES footprint close to the Magellanic Clouds. We find that the DES data alone exclude (p < 10 –3) a spatially isotropic distribution of Milky Way satellites and that the observed distribution can be well, though not uniquely, described by an association between several of the DES satellites and the Magellanic system. Our model predicts that the full sky may hold ~100 ultra-faint galaxies with physical properties comparable to the DES satellites and that 20%–30% of these would be spatially associated with the Magellanic Clouds.« less

  4. Preface: Materiaux 2010

    NASA Astrophysics Data System (ADS)

    Cheikhrouhou, Abdelwaheb

    2012-02-01

    The national conference 'MATERIAUX 2010', which took place in Mahdia (Tunisia), from 4-7 November 2010 was organized by The 'Tunisian Materials Research Society: Tu-MRS' in collaboration with the Materials Physics Laboratory of Sfax 'LPM', Faculty of Sciences, Sfax University and the Research Unit ' Physique, Informatique et Mathématiques ', Faculty of Sciences, Gafsa University The First National Conference on Materials 'MATERIAUX 2006' was organized in Douz (Tunisia) in December 2006. This was followed by 'MATERIAUX 2007' held in Hammamet (Tunisia) in April 2007 and the National Conference 'MATERIAUX 2009' organized jointly with the Second 'Journées Internationales de la Physique des Matériaux et Applications: JIPMA 2009' in Gafsa (Tunisia) from 20-24 December 2009. 'MATERIAUX 2010' is intended to provide an excellent opportunity for National, Maghreb and International researchers to make their own work on materials known to a wider audience and to have discussions with other participants. This conference will also be an opportunity to exchange experiences, create and consolidate cooperation between different research structures in the Maghreb countries and also the countries around the Mediterranean. This conference will equally promote research development, contribution to collaboration between universities and the socio-economical milieu. More than 300 senior researchers, Professors, PhD and Masters students attended this conference from Tunisia, Algeria, Morocco, France, Spain and Canada. Several researchers, engineers and managers from industrial firms also attended. The conference consisted of plenary talks (8), oral contributions (40) and poster presentations (250). The topics of the Conference were: Nano-materials, nano-systems, thin films, surfaces and interfaces, applications Multifunctionnal materials, magnetic materials, dielectric materials, superconducting materials, applications,... Materials for electronics, informatics and communication Ceramics, glasses, polymers Natural materials (phosphates, clay,...) Metallic materials, alloys, metallurgy,... Others (materials and environment, materials and energy, biomaterials,...) I want to thank the scientific committee, the organizing committee, the local committee and everyone who contributed to the organization of this meeting for their invaluable efforts in order to guarantee the complete success of this conference. Abdelwaheb Cheikhrouhou President of 'Tu-MRS' Chairman of the Conference 'MATERIAUX 2010' Conference photograph Committies Organizing Committee Chairman CHEIKHROUHOU Abdelwaheb (Faculté des Sciences de Sfax) Members ALAYA Sahbi (Faculté des Sciences de Gabès) BENNACEUR Raouf (Faculté des Sciences de Tunis) BEN SALEM Mohamed (Faculté des Sciences de Bizerte) CHEIKHROUHOU-KOUBAA Wissem (Faculté des Sciences de Sfax) EL JANI Belgacem (Faculté des Sciences de Monastir) EZZAOUIA Hatem (Centre de Recherches et de Technologies de l'Energie, Technopole de Borj Cédria) LAMLOUMI Jilani (Ecole Supérieure des Sciences et Techniques de Tunis) REZIG Bahri (Ecole Nationale d'Ingénieurs de Tunis) Local Committee Chairman CHEIKHROUHOU Abdelwaheb (Faculté des Sciences de Sfax) Members CHEIKHROUHOU-KOUBAA Wissem (Faculté des Sciences de Sfax) KOUBAA Mohamed (Institut Supérieur de Biotechnologie de Sfax) NJEH Anwar (Institut Préparatoire aux Etudes d'Ingénieurs de Sfax) BEN SALAH Issam (Faculté des Sciences de Sfax) TAKKALI Férid (Faculté des Sciences de Sfax) REGAIEG Yassin (Faculté des Sciences de Sfax) OTHMANI Safa (Faculté des Sciences de Sfax) MNASSRI Rafik (Faculté des Sciences de Sfax) Secretariat BEN GHOZLEN Afifa (Faculté des Sciences de Sfax) BOUGHARIOU Sana (Faculté des Sciences de Sfax) Scientific Committee M. ADDOU, Faculté des Sciences de Kénitra (Morocco) N. AMDOUNI, Faculté des Sciences de Tunis (Tunisia) M. BACCOUCHE, Faculté des Sciences d'Annaba (Algeria) H. BATIS, Faculté des Sciences de Tunis (Tunisia) A. BELAFHAL, Faculté des Sciences d'El Jadida (Morocco) M.H. BEN GHOZLEN, Faculté des Sciences de Sfax (Tunisia) R. BENNACEUR, Faculté des Sciences de Tunis (Tunisia) B. BENYOUCEF, Université Abou Bakr Belkaid, Tlemcen (Algeria) M. BEN SALEM, Faculté des Sciences de Bizerte (Tunisia) B. BESSAIES, Centre de Recherches et Technologies de l'Energie (Tunisia) H. BOUCHRIHA, Faculté des Sciences de Tunis (Tunisia) W. BOUJELBEN, Faculté des Sciences de Sfax (Tunisia) A. CHEIKHROUHOU, Faculté des Sciences de Sfax (Tunisia) W. CHEIKHROUHOU-KOUBAA, Faculté des Sciences de Sfax (Tunisia) R. CHTOUROU, Centre de Recherches et Technologies de l'Energie (Tunisia) M. DEBBABI, Ecole Nationale d'Ingénieurs de Monastir (Tunisia) A. DAKHLAOUI, Faculté des Sciences de Bizerte (Tunisia) A. DINIA, Université de Strasbourg (France) B. ELJANI, Faculté des Sciences de Monastir (Tunisia) A. ELJAZOULI, Faculté des Sciences Ben Msik, Casablanca (Morocco) Z. FAKHFAKH, Faculté des Sciences de Sfax (Tunisia) A. GASMI, Faculté des Sciences d'Annaba (Algeria) A. GHARBI, Faculté des Sciences de Tunis (Tunisia) R. GHARBI, Faculté des Sciences de Sfax (Tunisia) K. GUIDARA, Faculté des Sciences de Sfax (Tunisia) H. GUERMAZI, Institut Préparatoire aux Etudes d'Ingénieurs de Sfax (Tunisia) S. GUERMAZI, Faculté des Sciences de Sfax (Tunisia) M. HADDAD, Faculté des Sciences de Meknès (Morocco) A. HAJ AMARA, Faculté des Sciences de Bizerte (Tunisia) D. HAMANA, Faculté des Sciences de Constantine (Algeria) N. KAMOUN, Faculté des Sciences de Tunis (Tunisia) S. KADDOUR-CHARFI, Faculté des Sciences de Tunis (Tunisia) M. KADDOUR, Faculté des Sciences de Sfax (Tunisia) M. KHITOUNI, Faculté des Sciences de Sfax (Tunisia) T. MHIRI, Faculté des Sciences de Sfax (Tunisia) Y. MLIK, Institut Préparatoire aux Etudes Scientifiques et Techniques (Tunisia) N. MLIKI, Faculté des Sciences de Tunis (Tunisia) A. NJAH, Faculté des Sciences de Gafsa (Tunisia) M. OUESLATI, Faculté des Sciences de Tunis (Tunisia) K. ZELLAMA, Faculté des Sciences d'Amiens (France) Invited Speakers AMMAR-MERIAH Souad, ITODYS, Université Paris Diderot (France) BEN SALEM Mohamed, Faculté des Sciences de Bizerte, Université du 7 Novembre á Carthage (Tunisia) CHEIKHROUHOU Abdelwaheb, Faculté des Sciences de Sfax, Université de Sfax (Tunisia) DAKHLAOUI Amel, Faculté des Sciences de Bizerte, Université du 7 Novembre á Carthage (Tunisia) DJABBAR Ahmed, Université des Sciences et des Technologies de Lille (France) DURASTANTI Félix, Centre d'Etudes et Recherche en Thermique, Environnement et Systèmes (C.E.R.T.E.S.), Université Paris Est- Créteil (France) FERY-FORGUES Suzanne, Université Paul Sabatier, Toulouse (France) GIRAUD Romain, Laboratoire de Photonique et de Nanostructures, CNRS/LPN, Marcoussis (France)

  5. Effets potentiels d’un modèle rationnel de prescription sur les dépenses nationales en santé

    PubMed Central

    Littman, Jordan; Halil, Roland

    2016-01-01

    Résumé Objectif Estimer les économies que pourrait engendrer la mise en œuvre d’un modèle rationnel de prescription pour des classes de médicaments équivalents sur les plans de l’efficacité, de la toxicité et de la commodité. Conception L’Institut canadien d’information sur la santé a fourni des renseignements sur les 10 principales classes de médicaments en fonction des dépenses annuelles qui leur sont attribuables. Ces classes ont été examinées en vue de leur inclusion potentielle dans l’étude selon qu’il était possible de comparer les médicaments à l’intérieur d’une même classe. Lorsqu’à la suite d’une recherche documentaire, une équivalence a été établie en fonction de l’efficacité, de la toxicité et de la commodité des médicaments, les données annuelles sur les prescriptions ont été recueillies à partir de la base de données du Système national d’information sur l’utilisation des médicaments prescrits. Les économies potentielles de coûts ont ensuite été calculées en comparant les parts de marché actuelles avec les parts potentielles futures de ce marché. Contexte Le Canada. Principaux paramètres à l’étude Les différences estimées dans les dépenses que produirait un modèle rationnel de prescription. Résultats Une équivalence a été établie sur les plans de l’efficacité, de la toxicité et de la commodité dans les classes de statines, d’inhibiteurs de la pompe à protons, d’inhibiteurs de l’enzyme de conversion de l’angiotensine et d’inhibiteurs sélectifs du recaptage de l’angiotensine. Les dépenses annuelles totales dans ces classes se situent à 856 millions $ dans les programmes publics de médicaments et à 1,97 milliard $ environ à l’échelle nationale. Grâce à des prescriptions rationnelles, on estime que les économies annuelles pourraient atteindre 222 millions $ pour les programmes publics et 521 millions $ à l’échelle nationale. Conclusion La majorité des économies potentielles seraient attribuables à l’abandon des médicaments les plus récents protégés par un brevet dans chaque classe. En évitant de prescrire les plus récents médicaments intraclasses, en particulier en l’absence de recherche établissant leur supériorité dans les résultats cliniques pertinents, on pourrait réaliser des économies considérables dans les dépenses en santé et inciter l’industrie pharmaceutique à innover plutôt qu’à imiter.

  6. Les effets des interfaces sur les proprietes magnetiques et de transport des multicouches nickel/iron et cobalt/silver

    NASA Astrophysics Data System (ADS)

    Veres, Teodor

    Cette these est consacree a l'etude de l'evolution structurale des proprietes magnetiques et de transport des multicouches Ni/Fe et nanostructures a base de Co et de l'Ag. Dans une premiere partie, essentiellement bibliographique, nous introduisons quelques concepts de base relies aux proprietes magnetiques et de transport des multicouches metalliques. Ensuite, nous presentons une breve description des methodes d'analyse des resultats. La deuxieme partie est consacree a l'etude des proprietes magnetiques et de transport des multicouches ferromagnetiques/ferromagnetiques Ni/Fe. Nous montrerons qu'une interpretation coherente de ces proprietes necessite la prise en consideration des effets des interfaces. Nous nous attacherons a mettre en evidence, a evaluer et a etudier les effets de ces interfaces ainsi que leur evolution, et ce, suite a des traitements thermiques tel que le depot a temperature elevee et l'irradiation ionique. Les analyses correlees de la structure et de la magnetoresistance nous permettront d'emettre des conclusions sur l'influence des couches tampons entre l'interface et le substrat ainsi qu'entre les couches elles-memes sur le comportement magnetique des couches F/F. La troisieme partie est consacree aux systemes a Magneto-Resistance Geante (MRG) a base de Co et Ag. Nous allons etudier l'evolution de la microstructure suite a l'irradiation avec des ions Si+ ayant une energie de 1 MeV, ainsi que les effets de ces changements sur le comportement magnetique. Cette partie debutera par l'analyse des proprietes d'une multicouche hybride, intermediaire entre les multicouches et les materiaux granulaires. Nous analyserons a l'aide des mesures de diffraction, de relaxation superparamagnetique et de magnetoresistance, les evolutions structurales produites par l'irradiation ionique. Nous etablirons des modeles qui nous aideront a interpreter les resultats pour une serie des multicouches qui couvrent un large eventail de differents comportements magnetiques et ceci en fonction de l'epaisseur de la couche magnetique de Co. Nous verrons que dans ces systemes les effets de l'irradiation ionique sont fortement influences par l'energie de surface ainsi que par l'enthalpie de formation, largement positive pour le systeme Co/Ag.

  7. Fiabilité des structures mécaniques adaptatives: effet de la panne des actionneurs ou des capteurs sur la stabilité

    NASA Astrophysics Data System (ADS)

    Fall, H.; Charon, W.; Kouta, R.

    2002-12-01

    Ces dernières décennies, des activités significatives dans le monde étaient dirigées autour du contrôle actif. Le but de ces recherches était essentiellement d'améliorer les performances, la fiabilité et la sécurité des systèmes. Notamment dans le cas des structures soumises à des vibrations aléatoires. D'importants travaux ont été consacré à l'utilisation des “matériaux intelligents” comme capteurs et actionneurs. Cette article propose l'analyse de la fiabilité des systèmes mécaniques en étudiant les pannes des actionneurs ou des capteurs. L'effet de ces pannes sur la stabilité et la performance du système y est démontré. Les méthodologies de conception y sont rappelées. Des exemples numériques sont fournis à travers le contrôle d'un panneau sous chargement dynamique pour illustrer la méthode proposée.

  8. Effect of Combination Therapy with Neuroprotective and Vasoprotective Agents on Cerebral Ischemia.

    PubMed

    Yang, Jiping; Yang, Bei; Xiu, Baoxin; Qi, Jinchong; Liu, Huaijun

    2018-05-01

    Because most tested drugs are active against only one of the damaging processes associated with stroke, other mechanisms may cause cellular death. Thus, a combination of protective agents targeting different pathophysiological mechanisms may obtain better effects than a single agent. The major objective of this study was to investigate the effect of combination therapy with vascular endothelial growth factor (VEGF) and nerve growth factor (NGF) after controlled ischemic brain injury in rabbits. Animals were randomly assigned to one of the following groups: sham group, saline-treated control group or NGF+VEGF-treated group. Animals received an intracerebral microinjection of VEGF and NGF or saline at 5 or 8 hours after ischemia. The two specified time points of administration were greater than or equal to the existing therapeutic time window for monoterapy with VEGF or NGF alone (3 or 5 hours of ischemia). Infarct volume, water content, neurological deficits, neural cell apoptosis and the expression of caspase-3 and Bcl-2 were measured. Compared with saline-treated controls, the combination therapy of VEGF and NGF significantly reduced infarct volume, water content, neural cell apoptosis and the expression of caspase-3, up-regulated the expression of Bcl-2 and improved functional recovery (both p<0.01) when administered 5 or 8 hours after ischemia. The earlier the administration the better the neuroprotection. These results showed that the combination therapy with VEGF and NGF provided neuroprotective effects. In addition, the time window of combination treatment should be at least 8 hours after ischemia, which was wider than monotherapy. RÉSUMÉ: Les effets d'une polythérapie combinant agents neuro-protecteurs et agents vasoprotecteurs dans les cas d'ischémie cérébrale. Contexte:Étant donné que la plupart des médicaments préalablement testés tendent à n'agir contre seulement un des processus de dommage associés aux AVC, il est possible que d'autres processus entraînent une mort cellulaire. À cet effet, il se pourrait qu'une combinaison d'agents protecteurs ciblant divers mécanismes physiopathologiques permette d'obtenir de meilleurs résultats qu'un simple agent. Après avoir suscité de façon contrôlée des lésions cérébrales ischémiques chez des lapins, l'objectif principal de la présente étude a donc été de se pencher sur l'impact d'une polythérapie combinant la protéine dite « facteur de croissance de l'endothélium vasculaire » (ou « VEGF » en anglais) avec le « facteur de croissance des nerfs » (ou « NGF » en anglais). Méthodes: Les animaux ont été attribués au hasard à l'un des groupes suivants : ceux ayant reçu un traitement fictif ; ceux, du groupe témoin, ayant bénéficié d'un traitement à base de solution saline ; et finalement ceux ayant été traités au moyen des VEGF et NGF. À noter que les lapins ont reçu une micro-injection intracérébrale de VEGF et de NGF ou de solution saline 5 heures ou 8 heures à la suite de leur AVC. Ces deux délais d'administration des VEGF et NGF sont équivalents ou supérieurs aux délais actuels d'administration des VEGF ou NGF à titre de monothérapie (3 heures ou 5 heures à la suite d'un AVC). Tant le volume des infarctus, le contenu en eau, les déficits neurologiques ainsi causés, l'apoptose des neurones que l'expression des protéases caspase 3 et des protéines Bcl-2 ont été mesurés. Résultats: Si on la compare au traitement à base de solution saline administré au groupe témoin, la polythérapie à base de VEGF et de NGF, lorsqu'administrée 5 heures ou 8 heures à la suite de l'AVC, a su réduire de façon notable le volume des infarctus, le contenu en eau, l'apoptose des neurones et l'expression des protéases caspase 3. Elle a également permis de réguler à la hausse l'expression des protéines Bcl-2 en plus d'entraîner une amélioration de la récupération fonctionnelle (p < 0,01 pour ces deux aspects). Ainsi donc, plus tôt l'on opte pour cette polythérapie, meilleure sera la neuroprotection encourue. Ces résultats démontrent que la polythérapie à base de VEGF et de NGF procure des effets neuroprotecteurs. Quant au délai d'administration de ce traitement combinatoire, il devrait être d'au moins 8 heures à la suite d'un AVC, ce qui est plus élevé que la monothérapie.

  9. Recuit thermique rapide de semi-conducteur par énergie micro-onde

    NASA Astrophysics Data System (ADS)

    Covas, M.; Gay, H. C.

    1993-05-01

    This paper proposes a new technique for rapid thermal annealing of semi-conductors. This technique is based on microwave energy, and offers the same advantages as the rapid thermal annealing by incoherent light, in terms of rapidity, and contamination. However, our technique reduces considerably the required energy for the annealing process. This technique has been compared to the rapid thermal by incoherent light: lab experiments, carried out on boron implanted silicon samples, showed that a power gain ratio of about 10 can be achieved. Nous proposons une méthode de recuit thermique rapide du silicium par énergie micro-onde. Cette technique offre les mêmes avantages que les traitements thermiques rapides par lumière incohérente, c'est-à-dire des durées de chauffage très brèves, limitant ainsi la diffusion des dopants, et un traitement plaquette par plaquette : les risques de contamination de tout un lot sont ainsi éliminés. De plus notre méthode requiert une faible énergie : pour parvenir à des recuits de qualité similaire à celle obtenue dans des fours de recuit rapide à lampes il faut un flux de puissance 10 fois plus faible.

  10. CMB lensing tomography with the DES Science Verification galaxies

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

    Giannantonio, T.

    We measure the cross-correlation between the galaxy density in the Dark Energy Survey (DES) Science Verification data and the lensing of the cosmic microwave background (CMB) as reconstructed with the Planck satellite and the South Pole Telescope (SPT). When using the DES main galaxy sample over the full redshift range 0.2 < z phot < 1.2, a cross-correlation signal is detected at 6σ and 4σ with SPT and Planck respectively. We then divide the DES galaxies into five photometric redshift bins, finding significant (>2σ) detections in all bins. Comparing to the fiducial Planck cosmology, we find the redshift evolution ofmore » the signal matches expectations, although the amplitude is consistently lower than predicted across redshift bins. We test for possible systematics that could affect our result and find no evidence for significant contamination. Finally, we demonstrate how these measurements can be used to constrain the growth of structure across cosmic time. We find the data are fit by a model in which the amplitude of structure in the z < 1.2 universe is 0.73 ± 0.16 times as large as predicted in the LCDM Planck cosmology, a 1.7σ deviation.« less

  11. CMB lensing tomography with the DES Science Verification galaxies

    DOE PAGES

    Giannantonio, T.

    2016-01-07

    We measure the cross-correlation between the galaxy density in the Dark Energy Survey (DES) Science Verification data and the lensing of the cosmic microwave background (CMB) as reconstructed with the Planck satellite and the South Pole Telescope (SPT). When using the DES main galaxy sample over the full redshift range 0.2 < z phot < 1.2, a cross-correlation signal is detected at 6σ and 4σ with SPT and Planck respectively. We then divide the DES galaxies into five photometric redshift bins, finding significant (>2σ) detections in all bins. Comparing to the fiducial Planck cosmology, we find the redshift evolution ofmore » the signal matches expectations, although the amplitude is consistently lower than predicted across redshift bins. We test for possible systematics that could affect our result and find no evidence for significant contamination. Finally, we demonstrate how these measurements can be used to constrain the growth of structure across cosmic time. We find the data are fit by a model in which the amplitude of structure in the z < 1.2 universe is 0.73 ± 0.16 times as large as predicted in the LCDM Planck cosmology, a 1.7σ deviation.« less

  12. Diethylstilbestrol-Induced Mouse Hypospadias: “Window of Susceptibility”

    PubMed Central

    Sinclair, Adriane Watkins; Cao, Mei; Baskin, Laurence; Cunha, Gerald R.

    2016-01-01

    Hypospadias, an abnormality affecting the penile urethra, is one of the most prevalent congenital malformations afflicting human males. The morphology of hypospadias is markedly different in humans versus mice reflecting substantial differences in penile development in humans and mice. Estrogens such as diethylstilbestrol (DES) elicit mouse penile malformations, but the types of penile abnormalities differ depending on whether DES treatment is prenatal or neonatal. To define the actual “window of susceptibility” to the adverse effects of DES, pregnant mice and their neonatal pups were injected subcutaneously with 200ng/gbw DES every other day from embryonic day 12 to 18 (DES E12-E18), postnatal day 0 to 10 (DES P0-P10), embryonic day 12 to postnatal day 10 (DES E12 to P10), postnatal day 5 to 15 (DES P5 to P15), and postnatal day 10 to 20 (DES P10 to P20). Aged-matched controls received sesame oil vehicle. After euthanasia at 10, 15, 20 and 60 days, penises were analyzed by gross morphology, histology and morphometry. Penises of all 5 groups of DES-treated mice were reduced in size, which was confirmed by morphometric analysis of internal penile structures. The most profound effects were seen in the DES E12-P10, DES P0-P10, and DES P5-P15 groups, thus defining a DES “programming window”. For all parameters, DES treatment from P10-P20 showed the most mild of effects. Adverse effects of DES on the MUMP cartilage and erectile bodies observed shortly after the last DES injection reverted to normality in the DES P5-P15, but not in the E12-P10 and P0-P10 groups, in which MUMP cartilage and erectile body malformations persisted into adulthood, again emphasizing a “window of susceptibility” in the early neonatal period. PMID:26810244

  13. La manucure et la pédicure dans la ville de Ouagadougou (Burkina Faso): pratiques et risqué

    PubMed Central

    Korsaga-Somé, Nina; Andonaba, Jean Baptiste; Ouédraogo, Muriel Sidnoma; Tapsoba, Gilbert Patrice; Ilboudo, Léopold; Savadogo, Cérina; Barro-Traoré, Fatou; Niamba, Pascal; Traoré, Adama

    2016-01-01

    La manucure-pédicure est l'ensemble des soins esthétiques des mains, des pieds et des ongles. Au Burkina Faso, l'usage des produits de manucure-pédicure, les techniques utilisées ainsi que les risques encourus restent méconnus. L'objectif de notre étude était d’évaluer la pratique de la manucure-pédicure dans la ville de Ouagadougou. Nous avons mené une étude transversale descriptive de décembre 2010 à novembre 2012 incluant tout les praticiens ayant au moins six mois d'expérience dans l'activité et les clients présents sur les lieux au moment de l'enquête. Nous avons interrogé au total 313 praticiens et 313 clients. L’âge moyen des praticiens était de 19 ans et celui des clients de 32,2 ans. Les praticiens fixes étaient en majorité des femmes (96,87%), ceux mobiles surtout des hommes (68,37%), et 64,53% des clients étaient des femmes. Le pourcentage de praticiens n'ayant pas reçu de formation professionnelle était de 93,92%. 29,7% des praticiens faisaient tremper les instruments pendant au moins dix minutes dans de l'eau de javel; 75,71% savaient que l'utilisation de certains outils étaient dangereux et 26,51% étaient avaient présenté des effets secondaires. Parmi les clients, 40,25% savaient que le matériel utilisé comportait des risques et 30,35% avaient été victimes d'accidents. Les soins de manucure et de pédicure se font dans les salons de coiffure par des coiffeuses non formées à l'exercice de la profession La provenance et la composition des produits n'est pas connues. Des produits non recommandés sont utilisés (shampooing pour trempage des pieds, lame de rasoir et ciseaux pour raclage des pieds). Le recours à la manucure et/ou pédicure est parfois nécessaire mais cela ne doit pas faire perdre de vue les risques encourus. Une sensibilisation des clients et une formation des praticiens semblent nécessaires pour minimiser les risques. PMID:27642448

  14. La prise en charge des troubles de santé mentale par les omnipraticiens du Québec

    PubMed Central

    Fleury, Marie-Josée; Farand, Lambert; Aubé, Denise; Imboua, Armelle

    2012-01-01

    Résumé Objectif Cette recherche vise à documenter la prise en charge des troubles mentaux (TM) par les omnipraticiens. Type d’étude Il s’agit d’une étude mixte intégrant un questionnaire auto-administré et des entrevues qualitatives. La banque de données administratives des actes médicaux de la Régie de l’assurance maladie du Québec a aussi été analysée. Contexte La province de Québec. Participants Un total de 1415 omnipraticiens de différents lieux de pratiques ont été sollicités pour le questionnaire; 970 ont été rejoints. Un sous-groupe de 60 omnipraticiens a été rejoint pour les entrevues. Principaux paramètres à l'étude La prévalence annuelle des consultations reliées à des TM courants (TMC) ou graves (TMG), les pratiques cliniques, les pratiques de collaboration, les facteurs facilitant ou entravant la prise en charge des TM, ainsi que les recommandations pour l’amélioration du système de soins. Résultats Le taux de réponse a été de 41% (n = 398 omnipraticiens) pour le questionnaire et de 63% (n = 60) pour les entrevues. Environ 25 % des visites chez les omnipraticiens sont associées à des TM. Presque tous les omnipraticiens prennent en charge des TMC et se sentent compétents pour le faire, à l’inverse de la situation retrouvée pour les TMG. Près de 20 % des TMC sont référés (principalement à des intervenants psychosociaux), alors que près de 75 % des TMG sont référés (surtout en psychiatrie et à l’urgence). Plus de 50 % des omnipraticiens affirment n’entretenir aucun contact avec l’une ou l’autre des ressources de santé mentale. Plusieurs facteurs influencent la prise en charge des TM: les profils des patients (complexité des TM, troubles concomitants); les caractéristiques des omnipraticiens (réseau informel, formation); la culture professionnelle (travail en silo, mécanismes cliniques formalisés); le milieu institutionnel (multidisciplinarité, salariat); l’organisation des services (ressources; coordination formalisée) et l’environnement (politiques). Conclusion Le rôle clé des omnipraticiens et leur soutien à la prise en charge des TM ont été démontrés, spécifiquement pour les TMC. Pour une prise en charge optimale des soins primaires de santé mentale, des stratégies à composantes multiples, dont les soins partagés, devraient être davantage déployées.

  15. Effets de la formation sur la violence conjugale

    PubMed Central

    Zaher, Eman; Keogh, Kelly; Ratnapalan, Savithiri

    2014-01-01

    Résumé Objectif Décrire et évaluer l’efficacité de la formation concernant la violence conjugale pour améliorer les connaissances et permettre la reconnaissance et la prise en charge par les médecins des femmes victimes de violence. Sources des données On a fait une recension dans la base de données des révisions systématiques de Cochrane, MEDLINE, PubMed, PsycINFO, ERIC et EMBASE pour trouver des articles publiés entre le 1e janvier 2000 et le 1e novembre 2012. Des recherches manuelles ont complété cette recension pour cerner des articles pertinents à l’aide d’une stratégie de recherche combinant des textes, mots et expressions MeSH. Sélection des études On a choisi des études randomisées contrôlées qui portaient sur des interventions éducatives à l’intention des médecins et fournissaient des données sur les effets des interventions. Synthèse On a inclus 9 études randomisées contrôlées qui décrivaient différentes approches pédagogiques et diverses mesures des résultats. Trois études examinaient les effets d’interventions éducatives pour des médecins en formation postdoctorale et ont constaté une augmentation des connaissances, mais il n’y a eu aucun changement dans le comportement en ce qui a trait à l’identification des victimes de violence conjugale. Six études portaient sur des interventions éducatives pour des médecins en pratique active. Trois d’entre elles utilisaient une approche à multiples facettes pour les médecins, qui combinait une formation ainsi que des interventions de soutien de la part du système pour changer les comportements des médecins, comme une sensibilisation générale accrue à la violence conjugale au moyen de brochures et d’affiches, des aide-mémoire pour rappeler aux médecins comment identifier les victimes, des moyens pour faciliter l’accès des médecins à des services de soutien pour les victimes, la réalisation d’audits et la fourniture de rétroaction. Les interventions éducatives à multiples facettes prenaient la forme d’ateliers interactifs, d’apprentissage sur le web et de formation expérientielle. Une autre étude utilisait des discussions de groupes témoins et de la formation et a permis de constater une amélioration dans le signalement de la violence conjugale par les médecins. Les 2 autres études ont relevé une meilleure perception par les médecins en pratique de leur confiance en eux à l’aide d’apprentissage par problèmes en ligne. Conclusion Il a été difficile de déterminer quelle stratégie pédagogique était la plus efficace étant donné que les interventions éducatives et les mesures des résultats variaient entre les études choisies. De brèves interventions pour les médecins en formation postdoctorale amélioraient les connaissances mais ne semblaient pas influencer les comportements. La formation en ligne sous forme d’apprentissage par problèmes améliorait les perceptions des médecins en pratique, leurs connaissances et leurs habiletés quant à la prise en charge de la violence conjugale. La formation des médecins combinée à des interventions de soutien de la part du système semblait bénéfique aux victimes de violence conjugale et augmentait le nombre de demandes de consultations auprès des ressources de soutien à leur intention.

  16. La prévention de l’étouffement et de la suffocation chez les enfants

    PubMed Central

    Cyr, Claude

    2012-01-01

    RÉSUMÉ L’étouffement, la suffocation et la strangulation sont responsables de graves blessures non intentionnelles chez les enfants et constituent des causes importantes de décès non intentionnels chez les nourrissons et les tout-petits. Presque la totalité des décès et des blessures attribuables à un étouffement, une suffocation ou une strangulation sont évitables. Le présent document de principes traite des définitions, de l’épidémiologie et des stratégies de prévention efficaces de ces blessures. Des recommandations qui combinent des démarches pour améliorer la sécurité, incluant des recherches, de la surveillance, des lois et des normes, la conception des produits et l’éducation, sont présentées. Les dispensateurs de soins pédiatriques devraient encourager les parents et autres personnes qui s’occupent d’enfants à apprendre la réanimation cardiorespiratoire (RCR) et les premiers soins en cas d’étouffement, et leur offrir des conseils préventifs adaptés à l’âge de leur enfant lors des bilans de santé réguliers afin de prévenir ces blessures.

  17. 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.

  18. Etude de l’hémogramme dans la drépanocytose homozygote: à propos de 87 patients

    PubMed Central

    Dahmani, Fatima; Benkirane, Souad; Kouzih, Jaafar; Woumki, Aziz; Mamad, Hassan; Masrar, Azlarab

    2016-01-01

    La drépanocytose homozygote, fait partie des hémoglobinopathies les plus fréquentes au Maroc. La drépanocytose est caractérisée par une grande variabilité d’expressions clinique et biologique qui dépendent des facteurs génétiques modulateurs et environnementaux. Elle se manifeste par une anémie régénérative de gravité très variable selon les individus. L’évolution spontanée en l’absence de traitement est le décès précoce. La drépanocytose est caractérisée par une grande variabilité d’expression clinique et biologique qui dépend des facteurs génétiques et environnementaux. Un tableau clinique sévère marqué par une fréquence de transfusion élevée et précoce, des complications infectieuses graves et une mortalité précoce. Un état inflammatoire constant caractérisé par des protéines inflammatoires élevées et état nutritionnel compromis. L’objectif est de déterminer le profil des paramètres hématologiques du drépanocytaire homozygote (SS) marocain au cours des stades stationnaires. Nous avons fait une étude descriptive transversale de 87 patients drépanocytaires (SS). Nous avons réalisé une étude biologique comportant: l’hémogramme avec étude morphologique des globules rouges en coloration MGG et numération automatique des réticulocytes. Les électrophorèses de l’hémoglobine à pH alcalin (8.8) sur gel d’agarose avec intégration densitométrique. L’âge moyen est de 13.22 ans ± 16.36 avec un sex- ratio (H/F) de 1.175 et des extrêmes allant de 0.6 à 36 ans. La répercussion de l’anémie sur le plan biologique, est intense chez 88.5% des patients, 67.8% ont une anémie normocytaire contre 29.9% présentant une microcytose, et 2.3% qui présentaient une macrocytose. Le degré d’anisocytose est lié au degré d’anémie, très évocatrice chez les drépanocytaires homozygotes S/S (95,4%). Une réticulocytose était observée chez nos patients (81,6%) et 52.9% présentaient une thrombocytose. Une leucocytose était observée chez 64.4% des patients et 80.5% ont présenté une neutropénie. Les paramètres de l’hémogramme serviront de base de comparaison lors des crises et permettront d’évaluer l’efficacité de la prise en charge par le clinicien. Les valeurs élevées des globules blancs, plaquettes et CCHM semblent déterminants dans l’expression sévère de la drépanocytose au Maroc. Le profil hématologique du drépanocytaire marocain montre des données semblables à celles rapportées en littérature chez ceux de l’Afrique centrale, avec une leucocytose. Les résultats de notre étude suggèrent que, la drépanocytose est un problème de santé le plus fréquent chez les marocains et que nos résultats sont comparables à ceux décrits dans le syndrome drépanocytaire majeur. PMID:28293356

  19. Measuring Effects and Success in Influence Operations: Challenges, Limitations and Opportunitites

    DTIC Science & Technology

    2011-04-01

    domaines de la psychologie , de l’anthropologie et de la sociologie, ainsi que sur des entrevues menées auprès de pionniers des technologies de...documents issus des domaines de la psychologie , de l’anthropologie et de la sociologie, ainsi que sur des entrevues menées auprès de pionniers des...la psychologie , de l’anthropologie et de la sociologie, ainsi que sur des entrevues menées auprès de pionniers des technologies de l’intelligence

  20. Lesion length impacts long term outcomes of drug-eluting stents and bare metal stents differently.

    PubMed

    Chang, Shang-Hung; Chen, Chun-Chi; Hsieh, Ming-Jer; Wang, Chao-Yung; Lee, Cheng-Hung; Hsieh, I-Chang

    2013-01-01

    Long lesions have been associated with adverse outcomes in percutaneous coronary interventions with bare metal stents (BMS). However, the exact impact of lesion length on the short- and long-term outcomes of drug-eluting stent (DES) implantations is not as clear. This study compared the impact of lesion length on angiographic and clinical outcomes of BMS and DES in a single-center prospective registry. Lesion length was divided into tertiles. The primary endpoints were angiographically defined binary in-stent restenosis (ISR) rate and major adverse cardiac event (MACE). Of the 4,312 de novo lesions in 3,447 consecutive patients in the CAPTAIN registry, 2,791 lesions (of 2,246 patients) received BMS, and the remaining 1,521 lesions (of 1,201 patients) received DES. The mean follow-up duration was 4.5 years. The longer the lesion, the higher the ISR rate (14%, 18%, and 29%, p<0.001) and the lower the MACE-free survivals (p = 0.007) in the BMS group. However, lesion length showed no such correlation with ISR rates (4.7%, 3.3%, and 7.8%, p = 0.67) or MACE-free survivals (p = 0.19) in the DES group. In our single-center prospective registry, lesion length defined in tertiles has no impact on the short-term (ISR) or long-term (MACE) outcomes of patients implanted with DES. In contrast, longer lesion correlates with higher ISR and MACE rates in BMS group.

  1. La maladie de Hirayama: à propos de quatre observations tunisiennes et revue de la literature

    PubMed Central

    Amor, Sana Ben; Hassine, Anis; Chatti, Ines; Khefifi, Anissa; Doggui, Mohamed; Harzallah, Mohamed Salah; Benammou, Sofien

    2015-01-01

    Nous rapportons les aspects cliniques et électriques de la maladie de Hirayama en Tunisie à travers une série de quatre observations diagnostiquées au service de neurologie Sahloul. Il s'agit de quatre femmes. L’âge moyen était 30,25 ans avec des extrêmes de 27 et 37 ans. Une patiente avait un antécédent de traumatisme cervical, trois avaient une profession favorisant la position prolongée du rachis cervical en flexion. Un déficit moteur distal et une amyotrophie de la main et de l'avant bras droits d'installation progressive étaient observés dans tous les cas. Il n'avait ni des troubles sensitifs objectifs ni de modification des reflexes ostéotendineux et cutanés. L'EMG montrait une dénervation motrice dans le territoire des muscles dépendants des racines C7, C8, et D1. L'IRM cervicale était sans anomalie dans tous les cas. L’évolution était marquée par la bilatéralisation de la symptomatologie chez une patiente et une stabilisation clinique chez les autres. Ainsi, les aspects cliniques et électriques de la maladie de Hirayama dans cette série tunisienne sont comparables à ceux rapportés dans la littérature en dehors d'une atteinte strictement féminine. PMID:26185570

  2. Synthese, etude structurale et electrochimique des materiaux d'electrode positive d'oxydes mixtes lithium cobalt nickel oxide (0 /= 1) pour les batteries rechargeables au lithium

    NASA Astrophysics Data System (ADS)

    Grincourt, Yves

    Depuis une dizaine d'annees, on observe un interet grandissant pour les batteries rechargeables au lithium de tension superieure a 4 volts. La commercialisation de ces batteries pour l'electronique grand marche tend de plus en plus a supplanter celle des accumulateurs Ni-Cd et Ni-MH, de tension nominate 1,2 V. Ces batteries au lithium font appel a des materiaux d'electrode positive (cathode a la decharge) du type oxydes mixtes de metaux de transition LiMnO 2, LiMn2O4, LiNiO2 ou LiCoO2. Si le compose LiCoO2 est relativement aise a synthetiser, il n'en demeure pas moins que le cobalt reste un metal plus couteux compare au nickel et au manganese. La synthese de LiNiO2, quart a elle, demeure un probleme du point de vue stoechiometrique. Un defaut de lithium (5 a 10% molaire) conduira a des proprietes electrochimiques mediocres de la batterie. Dans cette etude nous nous proposons donc de preparer par voie humide et par voie seche les materiaux d'electrode positive de la famille LiCoyNi1-yO2 aver (0 ≤ y ≤ 1) et d'etudier en detail l'influence du pourcentage de nickel et de cobalt sur les proprietes electrochimiques des oxydes mixtes Li-Ni-Co. Une des caracteristiques est la morphologie plus fine des poudres de materiaux, observes par microscopie electronique a balayage (MEB). Un traitement thermique a plus basse temperature (750°C) que pour LiCoO2 (850°C) ainsi qu'un leger exces de lithium dans la preparation, ont permis d'aboutir a un materiau de stoechiometrie quasi parfaite. Neanmoins, le role de pilfer joue par 2 a 4% de moles de Ni2+ presents sur les sites lithium, permet de conserver intacte la structure hexagonale de la maille entre deux cycles consecutifs. Afin de mieux comprendre l'influence du vieillissement dune demi-pile Li/LiMeO2 (Me = Ni, Co) a temperature ambiante, des etudes electrochimiques et d'impedance spectroscopique ont ete menees en parallele. Le vieillissement de la cellule s'accompagne seulement dune chute de son potentiel due a son auto-decharge. Neanmoins, il est encore possible de la relancer en cyclage par la suite. Une baisse de la valeur de la resistance totale interfaciale et des frequences au sonnet semble indiquer une modification chimique et/ou structurale des films de passivations, pent-etre due a une transformation de ces films lors du cyclage ou a leur degradation. (Abstract shortened by UMI.)

  3. Modelisation de la Propagation des Ondes Sonores dans un Environnement Naturel Complexe

    NASA Astrophysics Data System (ADS)

    L'Esperance, Andre

    Ce travail est consacre a la propagation sonore a l'exterieur dans un environnement naturel complexe, i.e. en presence de conditions reelles de vent, de gradient de temperature et de turbulence atmospherique. Plus specifiquement ce travail comporte deux objectifs. D'une part, il vise a developper un modele heuristique de propagation sonore (MHP) permettant de prendre en consideration l'ensemble des phenomenes meteorologiques et acoustiques influencant la propagation du son a l'exterieur. D'autre part, il vise a identifier dans quelles circonstances et avec quelle importance les conditions meteorologiques interviennent sur la propagation sonore. Ce travail est divise en cinq parties. Apres une breve introduction identifiant les motivations de cette etude (chapitre 1), le chapitre 2 fait un rappel des travaux deja realises dans le domaine de la propagation du son a l'exterieur. Ce chapitre presente egalement les bases de l'acoustique geometrique a partir desquelles ont ete developpees la partie acoustique du modele heuristique de propagation. En outre, on y decrit comment les phenomenes de refraction et de turbulence atmospherique peuvent etre consideres dans la theorie des rayons. Le chapitre 3 presente le modele heuristique de propagation (MHP) developpe au cours de cet ouvrage. La premiere section de ce chapitre decrit le modele acoustique de propagation, modele qui fait l'hypothese d'un gradient de celerite lineaire et qui est base sur une solution hybride d'acoustique geometrique et de theorie des residus. La deuxieme section du chapitre 3 traite plus specifiquement de la modelisation des aspects meteorologiques et de la determination des profils de celerite et des index de fluctuation associes aux conditions meteorologiques. La section 3 de ce chapitre decrit comment les profils de celerite resultants sont linearises pour les calculs dans le modele acoustique, et finalement la section 4 donne les tendances generales obtenues par le modele. Le chapitre 4 decrit les compagnes de mesures qui ont ete realisees a Rock-Spring (Pennsylvanie, Etats -Unis) au cours de l'ete 90 et a Bouin (Vendee, France) au cours de l'automne 91. La campagne de mesure de Rock -Spring a porte plus specifiquement sur les effets de la refraction alors que la campagne de Bouin a prote plus specifiquement sur les effets de la turbulence. La section 4.1 decrit les equipements et le traitement des donnees meteorologiques realisees dans chaque cas et la section 4.2 fait de meme pour les resultats acoustiques. Finalement, le chapitre 5 compare les resultats experimentaux obtenus avec ceux donnes par le MHP, tant pour les resultats meteorologiques que pour les resultats acoustiques. Des comparaisons avec un autre modele (le Fast Field Program) sont egalement presentees.

  4. Implementation Cryptography Data Encryption Standard (DES) and Triple Data Encryption Standard (3DES) Method in Communication System Based Near Field Communication (NFC)

    NASA Astrophysics Data System (ADS)

    Ratnadewi; Pramono Adhie, Roy; Hutama, Yonatan; Saleh Ahmar, A.; Setiawan, M. I.

    2018-01-01

    Cryptography is a method used to create secure communication by manipulating sent messages during the communication occurred so only intended party that can know the content of that messages. Some of the most commonly used cryptography methods to protect sent messages, especially in the form of text, are DES and 3DES cryptography method. This research will explain the DES and 3DES cryptography method and its use for stored data security in smart cards that working in the NFC-based communication system. Several things that will be explained in this research is the ways of working of DES and 3DES cryptography method in doing the protection process of a data and software engineering through the creation of application using C++ programming language to realize and test the performance of DES and 3DES cryptography method in encrypted data writing process to smart cards and decrypted data reading process from smart cards. The execution time of the entering and the reading process data using a smart card DES cryptography method is faster than using 3DES cryptography.

  5. Préoccupations de carrière chez les médecins de travail des groupements de Médecine de travail en Tunisie

    PubMed Central

    Merchaoui, Irtyah; Chouchène, Asma; Bouanène, Ines; Chaari, Néila; Zrafi, Wassim; Henchi, Adnène; Akrout, Mohamed; Amri, Charfeddine

    2017-01-01

    Introduction L'insatisfaction de carrière des médecins de travail (MT) peut influencer leur performance et la qualité des prestations fournies. L'objectif de notre étude est d'évaluer la satisfaction au travail des MT du terrain de l'ensemble des Groupements de médecine de travail (GMT) de la Tunisie et préciser les facteurs déterminants. Méthodes Il s'agit d'une étude nationale transversale portant sur les MT de 22 GMT, basée sur le questionnaire, validé SAPHORA JOB. Résultats 58% des MT des GMT étaient insatisfaits de leur carrière. La satisfaction de carrière était statistiquement influencée par le nombre d'entreprises en charge (p=0,016), l'organisation du travail (p=0,010),le ressenti du métier (p=0,011),le salaire (p‹10-3) et l'information sur la réglementation en vigueur (p=0,047). Conclusion L'homogénéisation des grilles salariales et des échelons de carrière des MT des GMT basée sur une révision des textes législatifs est indiquée. L'amélioration de l'organisation et des conditions de travail peut permettre un épanouissement au travail et une amélioration des prestations. PMID:28819472

  6. An Overview of the Canadian Forces’ Second Generation Capability-Based Planning Analytical Process

    DTIC Science & Technology

    2010-09-01

    gestion et intgration des capacités Feuille de route des capacits stratégiques Produits clès Plan d’investissement Plan de capacités de défense...méthodes de recherche opérationnelle objectives et subjectives permet- tant la mise en œuvre du volet « planification, gestion et intégration des ...pacités, la gestion des capacités et l’intégration des capacités. Le processus comprend des intrants, des méthodes

  7. 3-Year Clinical Follow-Up of the RIBS IV Clinical Trial: A Prospective Randomized Study of Drug-Eluting Balloons Versus Everolimus-Eluting Stents in Patients With In-Stent Restenosis in Coronary Arteries Previously Treated With Drug-Eluting Stents.

    PubMed

    Alfonso, Fernando; Pérez-Vizcayno, María José; Cuesta, Javier; García Del Blanco, Bruno; García-Touchard, Arturo; López-Mínguez, José Ramón; Masotti, Mónica; Zueco, Javier; Cequier, Angel; Velázquez, Maite; Moreno, Raúl; Mainar, Vicente; Domínguez, Antonio; Moris, Cesar; Molina, Eduardo; Rivero, Fernando; Jiménez-Quevedo, Pilar; Gonzalo, Nieves; Fernández-Pérez, Cristina

    2018-05-28

    This study sought to compare the long-term safety and efficacy of drug-eluting balloons (DEB) and everolimus-eluting stents (EES) in patients with in-stent restenosis (ISR) of drug-eluting stents (DES). Treatment of patients with DES-ISR remains a challenge. The RIBS IV (Restenosis Intra-Stent of Drug-Eluting Stents: Drug-Eluting Balloons vs Everolimus-Eluting Stents) trial is a prospective multicenter randomized clinical trial comparing DEB and EES in patients with DES-ISR. The pre-specified comparison of the 3-year clinical outcomes obtained with these interventions is the main objective of the present study. A total of 309 patients with DES-ISR were randomized to DEB (n = 154) or EES (n = 155). At angiographic follow-up, the in-segment minimal lumen diameter was larger in the EES arm (2.03 ± 0.7 mm vs. 1.80 ± 0.6 mm; p < 0.01). Three-year clinical follow-up was obtained in all enrolled patients (100%). The combined clinical outcome measure of cardiac death, myocardial infarction and target lesion revascularization was significantly reduced in the EES arm (19 [12.3%] vs. 31 [20.1%]; p = 0.04; hazard ratio: 0.57 [95% confidence interval: 0.34 to 0.96]), driven by a lower need for target lesion revascularization (11 [7.1%] vs. 24 [15.6%]; p = 0.015; hazard ratio: 0.43 [95% confidence interval: 0.21 to 0.87]). The need for "late" (>1 year) target lesion revascularization (2.6% vs. 4%) and target vessel revascularization (4% vs. 6.6%) was similar in the 2 arms. Rates of cardiac death (3.9% vs. 3.2%), myocardial infarction (2.6% vs. 4.5%), and stent thrombosis (1.3% vs. 2.6%) at 3 years were also similar in both arms. The 3-year clinical follow-up of this randomized clinical trial demonstrates that in patients with DES-ISR, EES reduce the need for repeat interventions compared with DEB. (Restenosis Intra-Stent of Drug-Eluting Stents: Drug-Eluting Balloons vs Everolimus-Eluting Stents [RIBS IV]; NCT01239940). Published by Elsevier Inc.

  8. Paternité des articles et intérêts concurrents : une analyse des recommandations aux auteurs des journaux traitant de pratique pharmaceutique

    PubMed Central

    Courbon, Ève; Tanguay, Cynthia; Lebel, Denis; Bussières, Jean-François

    2014-01-01

    RÉSUMÉ Contexte : La présence d’auteurs honorifiques et fantômes ainsi que les intérêts concurrents représentent des difficultés bien documentées, liées à la publication d’articles scientifiques. Il existe des lignes directrices encadrant la rédaction et la publication de manuscrits scientifiques, notamment celles de l’International Committee of Medical Journal Editors (ICMJE). Objectifs : L’objectif principal de cette étude descriptive et transversale visait à recenser les instructions portant sur la paternité des articles et les intérêts concurrents provenant des recommandations aux auteurs des journaux traitant de pratique pharmaceutique. L’objectif secondaire visait à déterminer des mesures correctrices pour une paternité des articles plus transparente. Méthode : La recherche a débuté par l’identification des journaux traitant de pratique pharmaceutique. La consultation des instructions aux auteurs des journaux a permis ensuite de recenser les recommandations destinées à éviter les problèmes de paternité des articles et d’intérêts concurrents. Finalement, les membres de l’équipe de recherche se sont consultés afin de définir des mesures correctrices possibles à l’intention des chercheurs. Résultats : Des 232 journaux traitant de pharmacie, 33 ont été définis comme traitant de pratique pharmaceutique. Un total de 24 (73 %) journaux mentionnaient suivre la politique de l’ICMJE, 14 (42 %) demandaient aux auteurs de remplir un formulaire de déclaration d’intérêts concurrents au moment de la soumission de l’article, 17 (52 %) présentaient une définition de la qualité d’auteur et 5 (15 %) demandaient de détailler les contributions de chaque auteur. Une grille de 40 critères a été élaborée pour définir l’attribution du statut d’auteur. Conclusion : Moins de la moitié des journaux demandait aux auteurs de transmettre un formulaire de déclaration des intérêts concurrents au moment de la soumission d’un article et seulement la moitié des journaux avait donné une définition de la qualité d’auteur. La publication scientifique de travaux sur les pratiques pharmaceutiques n’est pas à l’abri des manques de transparence liés à la publication. L’utilisation d’une grille décrivant la contribution de chaque auteur et la publication en ligne des travaux peuvent contribuer à limiter ces risques. PMID:24970938

  9. Oceanic Remnants In The Caribbean Plate: Origin And Loss Of Related LIPs.

    NASA Astrophysics Data System (ADS)

    Giunta, G.

    2005-12-01

    The modern Caribbean Plate is an independent lithospheric entity, occupying more than 4 Mkm2 and consisting of the remnants of little deformed Cretaceous oceanic plateau of the Colombia and Venezuela Basins (almost 1 Mkm2) and the Palaeozoic-Mesozoic Chortis continental block (about 700,000 km2), both bounded by deformed marginal belts. The northern (Guatemala and Greater Antilles) and the southern (northern Venezuela) plate margins are marked by collisional zones, whereas the western (Central America Isthmus) and the eastern (Lesser Antilles) margins are represented by convergent boundaries and their magmatic arcs, all involving ophiolitic terranes. The evolutionary history of the Caribbean Plate since the Jurassic-Early Cretaceous encompasses plume, accretionary, and collisional tectonics, the evidence of which has been recorded in the oceanic remnants of lost LIPs, as revealed in: i) the MORB to OIB thickened crust of the oceanic plateau, including its un-deformed or little deformed main portion, and scattered deformed tectonic units; ii) ophiolitic tectonic units of MORB affinity and the rock blocks in ophiolitic melanges; iii) intra-oceanic, supra subduction magmatic sequences with IAT and CA affinities. The Mesozoic oceanic LIPs, from which the remnants of the Caribbean Plate have been derived, have been poorly preserved during various episodes of the intra-oceanic convergence, either those related to the original proto-Caribbean oceanic realm or those connected with two eo-Caribbean stages of subduction. The trapped oceanic plateau of the Colombia and Venezuela Basins is likely to be an unknown portion of a bigger crustal element of a LIP, similar to the Ontong-Java plateau. The Jurassic-Early Cretaceous proto-Caribbean oceanic domain consists of oceanic crust generated at multiple spreading centres; during the Cretaceous, part of this crust was thickened to form an oceanic plateau with MORB and OIB affinities. At the same time, both South and North American continental margins, inferred to be close to the oceanic realm, were affected by rifting and within-plate tholeiitic magmatism (WPT); this interpretation supports a near mid-America original location of the "proto-Caribbean" LIP. The MORB magmatic sections and rock blocks in the ophiolitic melanges are interpreted as exhumed tectonic sheets of the normal proto-Caribbean oceanic lithosphere, or part of a back-arc crust, both deformed in the eo-Caribbean stages. The SSZ complexes, considered as Cordilleran-type deformed ophiolites, were derived from a LIP that experienced two superimposed eo-Caribbean stages of intra-oceanic subduction. The older (Mid-Cretaceous) stage involved the eastward subduction of the un-thickened proto-Caribbean lithosphere, resulting in IAT and CA magmatism accompanied by HP-LT metamorphism and melange formation. The second, Late Cretaceous stage involved a westward dipping intra-oceanic subduction, which generated tonalitic arc magmatism. The eastward wedging of the Caribbean Plateau between the North and South American plates progressively trapped remnants of the Colombia and Venezuela Basins between the Atlantic and Pacific subduction zones and their new volcanic arcs (Aves-Lesser Antilles and Central American Isthmus). Unlike the proto-Caribbean, it appears that this LIP did not involve the main continental margins, even though the northern and southern Caribbean borders experienced different evolutionary paths. It was largely lost by superimposed accretionary and collisional events producing the marginal belts of the Caribbean Plate; its evolution has been dominated by a strongly oblique tectonic regime, constraining seafloor spreading, subduction, crustal exhumation, emplacement, and dismembering processes.

  10. Hyperextension in the Caledonian margin of Baltica and its bearing on the structural and metamorphic evolution of Scandinavian Caledonides (Invited)

    NASA Astrophysics Data System (ADS)

    Andersen, T. B.

    2013-12-01

    The Scandinavian segment (~2000 km) of the Caledonian-Appalachian orogen formed by a head-on collision of Baltica and Laurentia. The collision followed rapid (>10 cm/yr) convergence, subduction and closure of the Iapetus Ocean in the Ordovician to the Middle Silurian. The collision culminated in a Himalayan type continental collision at 430 Ma, after which the continental subduction/convergence continued for 20 Myr. The terminal stage was characterized by syn- and post-orogenic extension and exhumation, which produced a template used in opening of the present-day Norwegian Sea. The Scandian collision produced a 'layer-cake' tectono-stratigraphy, but correlation of individual nappe units along strike is not trivial. The vestiges of the Iapetus can, however, be traced along the entire Scandinavian Peninsula and constitute the Iapetus suture. Rocks of assumed Laurentian origin structurally overlie the suture. The outboard units underwent several orogenic events that pre-date the Scandian collision and which took place outboard of Baltica. These will not be discussed further here. The Caledonian passive margin of Baltica was very wide, consisting of non-volcanic hyperextended segments as well as passive volcanic margin domains. Basement-cover pairs, in places with mafic dyke-swarms constitute most of these units. The Baltican and assumed Baltican units below the suture have evidence of diachronous and relatively locally developed pre-Scandian deformation and metamorphic events. In S. Norway large basement-cover units are separated by a melange with numerous solitary mantle peridotites and a number of detrital serpentinites. The melange can be traced along strike across S. Norway. Locally, an island-type ';Celtic' fauna is preserved in detrital serpentinite. Some mantle rocks were structurally emplaced, exhumed, eroded and juxtaposed with continental clastics and crust before the Early Ordovician. The melange was recently interpreted to represent an oceanic to transitional crust basin with mantle exhumed by hyperextension during the Caledonian Wilson cycle ';kick-off'. Islands formed by serpentinite and clastic serpentinites suggest that hydrated mantle diapirs rose above sea level in the Early Ordovician. A number of solitary peridotites and detrital serpentinites are also typical elements in Seve nappe complex in north-central Sweden and Norway. The Pre-Scandian events affecting the passive Baltican margin show a range of ages and characteristics, but most important are the eclogites of Ordovician age. The oldest (~482 Ma) occur in the northern part of the Seve (Nordbotn). UHP eclogites in Jämtland formed at 446 Ma, and both these occurrences in the Seve are associated with mantle peridotites. In SW Norway, 470-460 Ma eclogites are preserved in continental nappes immediately below the suture near Stavanger. Finally, a lower grade HP-LT Ordovician event (~450 Ma) also dated by unconformable Middle Silurian (Wenlock) sediments has been identified. These pre-Scandian events demonstrate that the margin of Baltica underwent a sequence of geographic and time-separated events in the Ordovician before the Iapetus closed in the Middle Silurian. In this presentation it is suggested that the extension and hyperextension geometry inherited from the Caledonian Wilson-cycle ';kick-off' controlled the sequence of short-lived and local HP-LT events in the Scandinavian Caledonides.

  11. Issue des accouchements sur utérus cicatriciel dans un hôpital universitaire au Burkina

    PubMed Central

    Dembélé, Adama; Tarnagda, Zekiba; Ouédraogo, Jean Louis; Thiombiano, Oumarou; Bambara, Moussa

    2012-01-01

    Certains auteurs ont tendance à privilégier la césarienne comme méthode de prise en charge d'une parturiente porteuse d'un utérus cicatriciel. D'autres auteurs préconisent un accouchement par voie basse quand des paramètres cliniques précis sont observés. Le but de cette étude est d'analyser la prise en charge et l'issue des accouchements sur utérus cicatriciel au Centre Hospitalier Universitaire Souro Sanou de Bobo-Dioulasso et de la comparer aux différentes approches recommandées. Nous avons menés une étude transversale dans le Département de Gynécologie d'Obstétrique et de Médecine de la Reproduction du Centre Hospitalier Universitaire Sanou Souro de Bobo Dioulasso du 1er août 2006 au 1er août 2007 et a concerné 252 parturientes ayant un utérus cicatriciel parmi 4256 accouchements déroulés pendant la même période. Les accouchements sur utérus cicatriciels ont représenté 5,92 % de l'ensemble des accouchements dans notre département. La moyenne d'âge des patientes était de 26,2 ans et la parité moyenne de 4,3. Une césarienne d'emblée a été pratiquée chez 44% des parturientes ayant un utérus cicatriciel et 56 % parmi elles ont fait l'objet d'une épreuve utérine. Sur l'ensemble des épreuves utérines, 61% des parturientes ont accouché par voie basse. La mortalité maternelle était nulle et La mortalité périnatale était relativement importante. Les conditions d'acceptabilité de la voie basse ont été les mêmes chez toutes les patientes et un check liste a été proposé pour une meilleure prise en charge. L'épreuve utérine en salle d'accouchement doit être la règle à chaque fois que cela est possible chez une parturiente porteuse d'utérus cicatriciel. L’établissement d'un check liste pour accouchement par voie basse sur utérus cicatriciel facilite les prises de décision. PMID:23133695

  12. Optical–SZE scaling relations for DES optically selected clusters within the SPT-SZ Survey

    DOE PAGES

    Saro, A.; Bocquet, S.; Mohr, J.; ...

    2017-03-15

    We study the Sunyaev-Zel'dovich effect (SZE) signature in South Pole Telescope (SPT) data for an ensemble of 719 optically identified galaxy clusters selected from 124.6 degmore » $^2$ of the Dark Energy Survey (DES) science verification data, detecting a stacked SZE signal down to richness $$\\lambda\\sim20$$. The SZE signature is measured using matched-filtered maps of the 2500 deg$^2$ SPT-SZ survey at the positions of the DES clusters, and the degeneracy between SZE observable and matched-filter size is broken by adopting as priors SZE and optical mass-observable relations that are either calibrated using SPT selected clusters or through the Arnaud et al. (2010, A10) X-ray analysis. We measure the SPT signal to noise $$\\zeta$$-$$\\lambda$$, relation and two integrated Compton-$y$ $$Y_\\textrm{500}$$-$$\\lambda$$ relations for the DES-selected clusters and compare these to model expectations accounting for the SZE-optical center offset distribution. For clusters with $$\\lambda > 80$$, the two SPT calibrated scaling relations are consistent with the measurements, while for the A10-calibrated relation the measured SZE signal is smaller by a factor of $$0.61 \\pm 0.12$$ compared to the prediction. For clusters at $$20 < \\lambda < 80$$, the measured SZE signal is smaller by a factor of $$\\sim$$0.20-0.80 (between 2.3 and 10~$$\\sigma$$ significance) compared to the prediction, with the SPT calibrated scaling relations and larger $$\\lambda$$ clusters showing generally better agreement. We quantify the required corrections to achieve consistency, showing that there is a richness dependent bias that can be explained by some combination of contamination of the observables and biases in the estimated masses. We discuss possible physical effects, as contamination from line-of-sight projections or from point sources, larger offsets in the SZE-optical centering or larger scatter in the $$\\lambda$$-mass relation at lower richnesses.« less

  13. Optical–SZE scaling relations for DES optically selected clusters within the SPT-SZ Survey

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

    Saro, A.; Bocquet, S.; Mohr, J.

    We study the Sunyaev-Zel'dovich effect (SZE) signature in South Pole Telescope (SPT) data for an ensemble of 719 optically identified galaxy clusters selected from 124.6 degmore » $^2$ of the Dark Energy Survey (DES) science verification data, detecting a stacked SZE signal down to richness $$\\lambda\\sim20$$. The SZE signature is measured using matched-filtered maps of the 2500 deg$^2$ SPT-SZ survey at the positions of the DES clusters, and the degeneracy between SZE observable and matched-filter size is broken by adopting as priors SZE and optical mass-observable relations that are either calibrated using SPT selected clusters or through the Arnaud et al. (2010, A10) X-ray analysis. We measure the SPT signal to noise $$\\zeta$$-$$\\lambda$$, relation and two integrated Compton-$y$ $$Y_\\textrm{500}$$-$$\\lambda$$ relations for the DES-selected clusters and compare these to model expectations accounting for the SZE-optical center offset distribution. For clusters with $$\\lambda > 80$$, the two SPT calibrated scaling relations are consistent with the measurements, while for the A10-calibrated relation the measured SZE signal is smaller by a factor of $$0.61 \\pm 0.12$$ compared to the prediction. For clusters at $$20 < \\lambda < 80$$, the measured SZE signal is smaller by a factor of $$\\sim$$0.20-0.80 (between 2.3 and 10~$$\\sigma$$ significance) compared to the prediction, with the SPT calibrated scaling relations and larger $$\\lambda$$ clusters showing generally better agreement. We quantify the required corrections to achieve consistency, showing that there is a richness dependent bias that can be explained by some combination of contamination of the observables and biases in the estimated masses. We discuss possible physical effects, as contamination from line-of-sight projections or from point sources, larger offsets in the SZE-optical centering or larger scatter in the $$\\lambda$$-mass relation at lower richnesses.« less

  14. NATO Human Resources (Manpower) Management (Gestion des ressources humaines (effectifs) de l’OTAN)

    DTIC Science & Technology

    2012-02-01

    performances , la gestion des récompenses et du salaire, et la motivation du personnel. En conséquence, il faut que la gestion des ressources humaines...importance au fil du temps. Les ressources humaines, chargées à l’origine de l’embauche, du licenciement, de la paie et de la gestion des ...les effets des systèmes d’évaluation des performances ;

  15. Determination dans les Installations au Sol des Parametres Aerodynamiques de Stabilite des Aeronefs (Determination in Ground Facilities of Aerodynamic Stability Parameters of Aircraft),

    DTIC Science & Technology

    1979-06-01

    7 INTRODUCTION ...................................................................................... 12 CHAPITRE I : ELEMENTS DE DYNAMIQUE...daone Ie texts. 12 INTRODUCTION La ddtermination des ddrivdes adrodynamiques de stabilitd, en soufflerie et au tunnel de tir, aur des maquettes...ddtection des forces eat effectuds de fegon classiqus depuis plus de vingt ana par des barreaux d’acier dquipds de jauges de contrainte, gdndralament en

  16. 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

  17. Using the verona coding definitions of emotional sequences (VR-CoDES) and health provider responses (VR-CoDES-P) in the dental context.

    PubMed

    Wright, Alice; Humphris, Gerry; Wanyonyi, Kristina L; Freeman, Ruth

    2012-10-01

    To show if cues, concerns and provider responses (defined in VR-CoDES and VR-CoDES-P manuals) are present, can be reliably coded and require additional advice for adoption in a dental context. Thirteen patients in a dental practice setting were videoed with either their dentist or hygienist and dental nurse present in routine treatment sessions. All utterances were coded using the Verona systems: VR-CoDES and the VR-CoDES-P. Rates of cue, concerns and provider responses described and reliability tested. The VR-CoDES and VR-CoDES-P were successfully applied in the dental context. The intra-rater ICCs for the detection of cues and concerns and provider response were acceptable and above 0.75. A similar satisfactory result was found for the inter-rater reliability. The VR-CoDES and the VR-CoDES-P are applicable in the dental setting with minor supporting guidelines and show evidence of reliable coding. The VR-CoDES and the VR-CoDES-P may be helpful tools for analysing patient cues and concerns and the dental professionals' responses in the dental context. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  18. Etude de pratiques d'enseignement relatives a la modelisation en sciences et technologies avec des enseignants du secondaire

    NASA Astrophysics Data System (ADS)

    Aurousseau, Emmanuelle

    Les modeles sont des outils amplement utilises en sciences et technologies (S&T) afin de representer et d’expliquer un phenomene difficilement accessible, voire abstrait. La demarche de modelisation est presentee de maniere explicite dans le programme de formation de l’ecole quebecoise (PFEQ), notamment au 2eme cycle du secondaire (Quebec. Ministere de l'Education du Loisir et du Sport, 2007a). Elle fait ainsi partie des sept demarches auxquelles eleves et enseignants sont censes recourir. Cependant, de nombreuses recherches mettent en avant la difficulte des enseignants a structurer leurs pratiques d’enseignement autour des modeles et de la demarche de modelisation qui sont pourtant reconnus comme indispensables. En effet, les modeles favorisent la conciliation des champs concrets et abstraits entre lesquels le scientifique, meme en herbe, effectue des allers-retours afin de concilier le champ experimental de reference qu’il manipule et observe au champ theorique relie qu’il construit. L’objectif de cette recherche est donc de comprendre comment les modeles et la demarche de modelisation contribuent a faciliter l’articulation du concret et de l’abstrait dans l’enseignement des sciences et des technologies (S&T) au 2eme cycle du secondaire. Pour repondre a cette question, nous avons travaille avec les enseignants dans une perspective collaborative lors de groupes focalises et d’observation en classe. Ces dispositifs ont permis d’examiner les pratiques d’enseignement que quatre enseignants mettent en oeuvre en utilisant des modeles et des demarches de modelisation. L’analyse des pratiques d’enseignement et des ajustements que les enseignants envisagent dans leur pratique nous permet de degager des connaissances a la fois pour la recherche et pour la pratique des enseignants, au regard de l’utilisation des modeles et de la demarche de modelisation en S&T au secondaire.

  19. 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.

  20. PubMed

    Belaid, Loubna; Cloos, Patrick; Ridde, Valéry

    2017-04-20

    Cette étude vise à décrire la mobilisation des représentations ethnoculturelles par des agents et des gestionnaires de santé pour expliquer l'échec partiel d'une politique de santé maternelle et discuter des conséquences potentielles de ces représentations sur l'accès aux soins de santé des populations.MÉTHODES : Il s'agit d'une recherche qualitative de type socio-anthropologique mobilisant des entretiens approfondis, des discussions informelles, des observations non participantes menées dans les centres de santé et une analyse documentaire. Les entretiens ont été menés auprès de 16 agents de santé et de 10 gestionnaires. Les entretiens ont été enregistrés sous support numérique et transcrits. L'étude s'est déroulée dans le district sanitaire de Djibo au Burkina Faso.RÉSULTATS : L'identification ethnique, les coutumes relatives à l'accouchement (pudeur, discrétion, présence féminine), le statut social des femmes (le faible pouvoir décisionnel), le nomadisme et l'organisation sociale des populations et leurs résistances au changement sont érigés comme des obstacles « culturels » à la politique de santé. L'usage largement répandu de ces représentations par les agents et les gestionnaires de santé contribue à réprimander les populations et à masquer les facteurs structurels qui ont pourtant une influence plus importante sur l'utilisation des services de santé maternelle. Cette recherche met en lumière le danger de l'usage excessif des représentations ethnoculturelles teintées de culturalisme dans les pratiques et les politiques de santé publique en véhiculant des stéréotypes à l'égard de certains groupes de population. Pour comprendre le succès ou l'échec des politiques sanitaires, il demeure important de considérer la qualité du contact avec le système de santé, les facteurs structurels notamment les capacités des ménages à faire face aux dépenses des soins de santé et des distances entre les villages et les centres de santé. Ces éléments permettraient de mieux comprendre les disparités constatées à l'égard des indicateurs d'utilisation des services de santé.

  1. Outcomes of ≤6-month versus 12-month dual antiplatelet therapy after drug-eluting stent implantation

    PubMed Central

    Villablanca, Pedro A.; Massera, Daniele; Mathew, Verghese; Bangalore, Sripal; Christia, Panagiota; Perez, Irving; Wan, Ningxin; Schulz-Schüpke, Stefanie; Briceno, David F.; Bortnick, Anna E.; Garcia, Mario J.; Lucariello, Richard; Menegus, Mark; Pyo, Robert; Wiley, Jose; Ramakrishna, Harish

    2016-01-01

    Abstract Background: The benefit of ≤6-month compared with 12-month dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) with drug-eluting stent (DES) placement remains controversial. We performed a meta-analysis and meta-regression of ≤6-month versus 12-month DAPT in patients undergoing PCI with DES placement. Methods: We conducted electronic database searches of randomized controlled trials (RCTs) comparing DAPT durations after DES placement. For studies with longer follow-up, outcomes at 12 months were identified. Odds ratios and 95% confidence intervals were computed with the Mantel–Haenszel method. Fixed-effect models were used; if heterogeneity (I2) > 40 was identified, effects were obtained with random models. Results: Nine RCTs were included with total n = 19,224 patients. No significant differences were observed between ≤6-month compared with 12-month DAPT in all-cause mortality (OR 0.87; 95% confidence interval (CI): 0.69–1.11), cardiovascular (CV) mortality (OR 0.89; 95% CI: 0.66–1.21), non-CV mortality (OR 0.85; 95% 0.58–1.24), myocardial infarction (OR 1.10; 95% CI: 0.89–1.37), stroke (OR 0.97; 95% CI: 0.67–1.42), stent thrombosis (ST) (OR 1.37; 95% CI: 0.89–2.10), and target vessel revascularization (OR 0.95; 95% CI: 0.77–1.18). No significant difference in major bleeding (OR 0.72; 95% CI: 0.49–1.05) was observed, though the all-bleeding event rate was significantly lower in the ≤6-month DAPT group (OR 0.76; 95% CI: 0.59–0.96). In the meta-regression analysis, a significant association between bleeding events and non-CV mortality with 12-month DAPT was found, as well as between ST and mortality in addition to MI with ≤6-month DAPT. Conclusion: DAPT for ≤6 months is associated with similar mortality and ischemic outcomes but less bleeding events compared with 12-month DAPT after PCI with DES. PMID:28033306

  2. Sex differences in left main coronary artery stenting: Different characteristics but similar outcomes for women compared with men.

    PubMed

    Shin, Eun-Seok; Lee, Cheol Whan; Ahn, Jung-Min; Lee, Pil Hyung; Chang, Mineok; Kim, Min-Ju; Yoon, Sung-Han; Park, Duk-Woo; Kang, Soo-Jin; Lee, Seung-Whan; Kim, Young-Hak; Park, Seong-Wook; Park, Seung-Jung

    2018-02-15

    The clinical outcomes for women compared with men undergoing left main PCI were sparse. We compared the characteristics and long-term outcomes in women versus men after percutaneous coronary intervention (PCI) with drug-eluting stents (DES) for unprotected left main CAD. We identified 2328 patients (545 women; 1783 men) with unprotected left main CAD who received PCI with DES between January 2007 and December 2013 in the Interventional Cardiology Research In-cooperation Society-left MAIN revascularization (IRIS-MAIN) registry. The primary outcome was a composite of death from any cause, myocardial infarction, or stroke. The median follow-up time was 2.9years (interquartile range: 1.0-4.1years). Women were older, had a higher incidence of insulin-requiring diabetes mellitus and hypertension, and more commonly presented with acute coronary syndrome than men. Left main ostial lesion was more common in women, whereas left main bifurcation lesion with more extensive CAD was more common in men. The incidence of primary outcome was similar between the two groups (10.8% vs. 10.8%, respectively, log-rank p=0.587). The results were similar after adjustment for baseline variables and consistent across major subgroups. The need for target lesion revascularization was significantly higher in women than in men (8.8% vs. 5.7%, respectively, p<0.05) but the sex bias was not confirmed after adjusting for confounders. Women, as compared to men, had different clinical and lesion characteristics but similar long-term outcomes after PCI with DES for left main CAD. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. "Voici des fruits, des fleurs, des feuilles et des branches" et pourquoi pas des legumes? ("Here are Fruits, Flowers, Leaves, and Branches" and Why Not Vegetables?).

    ERIC Educational Resources Information Center

    van Zundert, Danielle

    1986-01-01

    Describes an experiment in teaching language to young children through nature study. Activities are outlined, including the linguistic, cognitive, and cultural objectives for each. Brief illustrated descriptions are also given. (MSE)

  4. US Army Morale, Welfare and Recreation (MWR) Programmes : Links to Readiness and Retention

    DTIC Science & Technology

    2011-01-01

    la Direction des opérations, Bureau du sous-chef d’état-major pour la ... gestion des emprises et garnisons de l’US Army, Washington, DC. Il enseigne au Département de philosophie du Northern Virginia Community College...américaine à l’intention des personnels militaires et des familles, et des variables mesurant l’état de préparation des forces et la fidélisation de

  5. Aircraft Disinsection: A Guide for Military and Civilian Air Carriers (Desinsectisation des aeronefs: Un guide a l’intention des responsables des transports aeriens civils et militaires)

    DTIC Science & Technology

    1996-04-01

    regulations. - Ceratitis capitata (Mediterranean fruit fly). Quarantine regulations generally reduce - Rhagoletis pomonella (Apple maggot). the chances of a...d’insectes nuisibles dans un pays, en 6vitant des risques pour la sant6 des 6quipages, pour la s~curit6 de 1’a~ronef et pour l’industrie. Ce rapport examine 1...diffrrents officiels responsables de la r~glementation des insectes nuisibles introduits, de l’inscription des pesticides et de leur utilisation en

  6. Evaluation of in vivo [corrected] biological activity of new agmatine analogs of growth hormone-releasing hormone (GH-RH)

    PubMed

    Bokser, L; Zarandi, M; Schally, A V

    1990-01-01

    The effects of agmatine analogs of growth hormone releasing hormone (GH-RH) were compared to GH-RH(1-29)-NH2 after intravenous (iv) and subcutaneous (sc) administration to pentobarbital-anesthetized male rats. After the iv injection, the analogs [desNH2-Tyr1,Ala15,Nle27] GH-RH(1-28)Agm (MZ-2-51); [desNH2-Tyr1,D-Lys12,Ala15,Nle27] GH-RH(1-28)Agm (MZ-2-57); [desNH2-Tyr1,Ala15,D-Lys21,Nle27] GH-RH(1-28)Agm (MZ-2-75) and [desNH2-Tyr1, D-Lys12,21, Ala15, Nle27] GH-RH(1-28)Agm (MZ-2-87) showed a potency equivalent to 4.4, 1.9, 1.07 and 1.03 times that of GH-RH (1-29)-NH2, respectively, at 5 min and 5.6, 1.8, 1.9 and 1.8 times higher, respectively, at 15 min. After sc administration, analogs MZ-2-51, MZ-2-57 and MZ-2-75 showed to be 34.3, 14.3 and 10.5 times more potent than the parent hormone at 15 min and 179.1, 88.9 and 45.0 times more active, respectively, at 30 min. In addition, MZ-2-51 had prolonged GH-releasing activity as compared to the standard. We also compared the activity of MZ-2-51 and MZ-2-57 with their homologous L-Arg and D-Arg analogs [desNH2-Tyr1,Ala15,Nle27] GH-RH(1-29)-NH2 (MZ-2-117), [des-NH2Tyr1,D-Lys12, Ala15, Nle27] GH-RH(1-29)NH2 (MZ-2-123) and [desNH2-Tyr1,D-Lys12,Ala15, Nle27,D-Arg29] GH-RH(1-29)NH2 (MZ-2-135) after intramuscular (im) injection. MZ-2-51 induced a somewhat greater GH release than MZ-2-117 at 15 min, both responses being larger than the controls (p less than 0.01) at 15 and 30 min. MZ-2-57, MZ-2-123 and MZ-2-135 given i.m. were able to stimulate GH release only at 15 minutes (p less than 0.05). Animals injected i.m. with MZ-2-51, but not with MZ-2-117, showed GH levels significantly higher than the control group (p less than 0.05) at 60 min. GH-RH(1-29)NH2 had low activity intramuscularly when tested at a dose of 2.5 micrograms. No toxic effects were observed after the iv administration of 1 mg/kg of Agm GH-RH analogs. These results indicate that our Agm analogs are active iv, sc and im and that the substitutions made in these compounds produce increased and prolonged GH releasing activity. These analogs, especially MZ-2-51, should be useful for clinical and veterinary purposes.

  7. 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.

  8. Approche à l’endroit des blessures traumatiques à la main en soins primaires

    PubMed Central

    Cheung, Kevin; Hatchell, Alexandra; Thoma, Achilleas

    2013-01-01

    Résumé Objectif Passer en revue la prise en charge initiale des blessures traumatiques communes à la main que voient les médecins de soins primaires. Sources des données Nous avons examiné les données cliniques probantes et les ouvrages spécialisés récents cernés par des recherches dans la base de données électronique MEDLINE. Nous avons utilisé l’opinion d’experts pour compléter les recommandations dans les domaines où les données scientifiques étaient rares. Message principal Les médecins de soins primaires sont couramment appelés à prendre en charge des patients victimes de blessures traumatiques à la main. Dans le contexte d’un cas clinique, nous examinons l’évaluation, le diagnostic et la prise en charge initiale des traumatismes communs à la main. La présentation et la prise en charge des blessures au lit de l’ongle, des amputations de l’extrémité du doigt, des doigts en maillet, des fractures à la main, des lacérations de tendons, des morsures et de la ténosynovite infectieuse seront aussi discutées. Les principes de la prise en charge des blessures traumatiques à la main comportent la réduction et l’immobilisation des fractures, la prescription d’imagerie radiographique post-réduction, l’obtention d’un recouvrement par les tissus mous, la prévention et le traitement des infections et l’assurance d’une prophylaxie antitétanique. Conclusion Il est essentiel d’assurer une évaluation et une prise en charge appropriées des blessures traumatiques à la main pour prévenir une morbidité considérable à long terme dans une population autrement en santé. La reconnaissance sans délai des blessures qui nécessitent une demande de consultation urgente ou rapide auprès d’un chirurgien spécialiste de la main est également critique.

  9. Relation entre les caractéristiques des table-bancs et les mesures anthropométriques des écoliers au Benin

    PubMed Central

    Falola, Stève Marjelin; Gouthon, Polycarpe; Falola, Jean-Marie; Fiogbe, Michel Armand; Nigan, Issiako Bio

    2014-01-01

    Introduction Le mobilier scolaire et la posture assise en classe sont souvent impliqués dans l'apparition des douleurs rachidiennes, influant de fait sur la qualité des tâches réalisées par les apprenants. Aucune étude n'a encore vérifié le degré d'adéquation entre les caractéristiques du mobilier et celles des écoliers au Bénin. L'objectif de cette étude transversale est donc de déterminer la relation entre les dimensions des table-bancs utilisées en classe et les mesures anthropométriques des écoliers au Bénin. Methods Elle a été réalisée avec un échantillon probabiliste de 678 écoliers, âgés de 4 à 17 ans. Les mesures anthropométriques des écoliers et les mensurations relatives aux longueurs, largeurs et hauteurs des table-bancs ont été mesurées, puis intégrées aux équations proposées dans la littérature. Les pourcentages des valeurs situées hors des limitesacceptables, dérivées de l'application des équations ont été calculés. Results La largeur et la hauteur des table-bancs utilisées par les écoliers étaient plus élevées (p < 0,05) que les valeurs de référence recommandées par les structures officielles de contrôle et de production des mobiliers scolaires au Bénin. Quel que soit le sexe, il y avait une inadéquation entre la largeur du banc et la longueur fesse-poplité, puis entre la hauteur de la table et la distance coude-bancdes écoliers. Conclusion Les résultats suggèrent de prendre en compte l’évolution des mesures anthropométriques des écoliers dans la confection des table-bancs, afin de promouvoir de bonnes postures assises en classe et de réduire le risque de troubles du rachis. PMID:25317232

  10. Guide de pratique clinique pour les lésions cérébrales traumatiques légères et les symptômes persistants

    PubMed Central

    Marshall, Shawn; Bayley, Mark; McCullagh, Scott; Velikonja, Diana; Berrigan, Lindsay

    2012-01-01

    Résumé Objectif Présenter les nouvelles lignes directrices sur la prise en charge des lésions cérébrales traumatiques légères (LCTL) et les symptômes persistants post-commotion (SPPC) afin de renseigner et d’orienter les médecins qui prennent en charge des patients qui se remettent d’une LCTL. Qualité des données On a effectué une recherche des guides de pratique clinique existants portant sur les LCTL et une synthèse critique des ouvrages scientifiques évaluant le traitement des SPPC. Étant donné la rareté des conseils sur la prise en charge des SPPC dans les travaux sur les lésions cérébrales traumatiques, une deuxième recherche documentaire a été faite pour recenser les guides de pratique clinique et les synthèses critiques concernant la prise en charge de ces symptômes communs dans la population en général. On a convoqué des professionnels de la santé provenant de différentes disciplines et régions du Canada et de l’étranger à une conférence consensuelle d’experts pour examiner les lignes directrices et les données probantes existantes et élaborer un guide complet pour la prise en charge des LCTL et des SPPC. Message principal À l’aide d’un processus Delphi modifié, on a produit 71 recommandations portant sur le diagnostic et la prise en charge des LCTL et des SPPC. De plus, on a inclus dans le guide de nombreuses ressources et des outils pour faciliter la mise en œuvre des recommandations. Conclusion Un guide de pratique clinique a été élaboré pour aider les professionnels de la santé à fournir des soins fondés sur les données probantes et les pratiques exemplaires à la population complexe de personnes qui ont des SPPC à la suite d’une LCTL.

  11. 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

  12. Influence du comportement des accompagnants sur le vécu des patients admis pour hémorragies digestives hautes au CHU campus de Lomé (Togo)

    PubMed Central

    Bagny, Aklesso; Dusabe, Angelique; Bouglouga, Oumboma; Lawson-ananisoh, Mawuli Late; Kaaga, Yeba Laconi; Djibril, Mohaman Awalou; Soedje, Kokou Mensah; Dassa, Simliwa Kolou; Redah, Datouda

    2014-01-01

    Introduction L'hémorragie digestive haute est une urgence, qui constitue souvent pour les patients un danger mortel suscitant inquiétude et agitation. Dans cet état, le patient dépend de ses accompagnants pour ses soins et pour honorer le traitement; mais souvent, il a été observé une discordance entre l'urgence et les comportements des accompagnants. Le but de cette étude était de décrire les facteurs socioéconomiques et psychologiques pouvant influencer les comportements des accompagnants des patients admis pour HDH, estimer l'indice de relation entre ces comportements et les facteurs associés d'une part et le vécu des patients admis pour HDH d'autre part. Méthodes Il s'agit d'une étude prospective menée de Septembre 2010 à Juin 2011 (soit 10 mois). Nous avions utilisé l'entretien semi-dirigé et l'observation directe pour collecter nos données, ces dernières avaient été traitées par les méthodes statistiques et d'analyse de contenu. Résultats Dans la présente étude, les comportements des accompagnants des patients admis pour HDH sont en majorité marqués par l'abandon (84%) et le manque de sollicitude (80,2%). Ces comportements sont souvent stimulés par les facteurs socioéconomiques tels que les difficultés économiques (83,2%), des conflits intrafamiliaux (85,1%) et des représentations (maladie incurable ou envoûtement) de la maladie par les accompagnants (73,3%) des cas. Quant aux patients, ils vivent ces comportements comme étant des menaces de mort ou des rejets (77,20%) et comme étant une dévalorisation ou une humiliation de la part de leurs accompagnants (70,30%). Les résultats confirment l'existence de lien significatif entre les comportements des accompagnants et les facteurs socio économiques, entre les comportements des accompagnants et des facteurs psychologiques, et entre le vécu des patients admis pour l'HDH et les comportements des accompagnants. Conclusion Des études ultérieures devraient aborder les points non touchés dans cette étude. Certes, elle a apporté un plus dans la compréhension du vécu des patients admis pour HDH et des comportements de leurs accompagnants. Cependant, elle est loin d'avoir épuisé les différents contours de la problématique de la présente étude. PMID:25848453

  13. Central acylated ghrelin improves memory function and hippocampal AMPK activation and partly reverses the impairment of energy and glucose metabolism in rats infused with β-amyloid.

    PubMed

    Kang, Suna; Moon, Na Rang; Kim, Da Sol; Kim, Sung Hoon; Park, Sunmin

    2015-09-01

    Ghrelin is a gastric hormone released during the fasting state that targets the hypothalamus where it induces hunger; however, emerging evidence suggests it may also affect memory function. We examined the effect of central acylated-ghrelin and DES-acetylated ghrelin (native ghrelin) on memory function and glucose metabolism in an experimentally induced Alzheimer's disease (AD) rat model. AD rats were divided into 3 groups and Non-AD rats were used as a normal-control group. Each rat in the AD groups had intracerebroventricular (ICV) infusion of β-amyloid (25-35; 16.8nmol/day) into the lateral ventricle for 3 days, and then the pumps were changed to infuse either acylated-ghrelin (0.2nmol/h; AD-G), DES-acylated ghrelin (0.2nmol/h; AD-DES-G), or saline (control; AD-C) for 3 weeks. The Non-AD group had ICV infusion of β-amyloid (35-25) which does not deposit in the hippocampus. During the next 3 weeks memory function, food intake, body weight gain, body fat composition, and glucose metabolism were measured. AD-C exhibited greater β-amyloid deposition compared to Non-AD-C, and AD-G suppressed the increased β-amyloid deposition and potentiated the phosphorylation AMPK. In addition, AD-G increased the phosphorylation GSK and decreased the phosphorylation of Tau in comparison to AD-C and AD-DES-G. Cognitive function, measured by passive avoidance and water maze tests, was much lower in AD-C than Non-AD-C whereas AD-G but not AD-DES-G prevented the decrease (p<0.021). Body weight gain was lower in AD-C group than Non-AD-C group without changing epididymal fat mass. AD-G reversed the decrease in body weight which was due to increased energy intake and decreased energy expenditure. The AD-G group exhibited a decrease in the second part of serum glucose levels during an oral glucose tolerance test (OGTT) compared to the AD-C and AD-DES-G group (p<0.009). However, area under the curve of insulin during the first part of OGTT was higher in AD-DES-G than other groups, whereas during the second part it was suppressed in AD-G as much as Non-AD. In conclusion, central acylated ghrelin in rats prevented the deterioration of memory function, and energy and glucose metabolisms were partially improved, possibly due to less β-amyloid accumulation. This research suggests that interventions such as intermittent fasting to facilitate sustained elevations of acyl-ghrelin should be investigated for cognitive and metabolic benefits, especially in person with early symptoms of memory impairment. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Herbal Supplement in a Buffer for Dry Eye Syndrome Treatment.

    PubMed

    Chen, Hung-Chang; Chen, Zhi-Yu; Wang, Tsung-Jen; Drew, Victor J; Tseng, Ching-Li; Fang, Hsu-Wei; Lin, Feng-Huei

    2017-08-03

    Dry eye syndrome (DES) is one of the most common types of ocular diseases. There is a major need to treat DES in a simple yet efficient way. Artificial tears (AT) are the most commonly used agents for treating DES, but are not very effective. Herbal extractions of ferulic acid (FA), an anti-oxidant agent, and kaempferol (KM), an anti-inflammatory reagent, were added to buffer solution (BS) to replace ATs for DES treatment. The cytotoxicity and anti-inflammatory effects were examined in vitro by co-culture with human corneal epithelial cells (HCECs) to obtain the optimal concentration of KM and FA for treating HCECs. Physical properties of BS, such as pH value, osmolality, and refractive index were also examined. Then, rabbits with DES were used for therapeutic evaluation. Tear production, corneal damage, and ocular irritation in rabbits' eyes were examined. The non-toxic concentrations of KM and FA for HCEC cultivation over 3 days were 1 µM and 100 µM, respectively. Live/dead stain results also show non-toxicity of KM and FA for treating HCECs. Lipopolysaccharide-stimulated HCECs in inflammatory conditions treated with 100 µM FA and 1 µM KM (FA100/KM1) showed lower IL-1B , IL-6 , IL-8 , and TNFα expression when examined by real-time PCR. The BS with FA100/KM1 had neutral pH, and a similar osmolality and refractive index to human tears. Topical delivery of BS + FA100/KM1 showed no irritation to rabbit eyes. The corneal thickness in the BS + FA100/KM1 treated group was comparable to normal eyes. Results of DES rabbits treated with BS + FA100/KM1 showed less corneal epithelial damage and higher tear volume than the normal group. In conclusion, we showed that the combination of FA (100 µM) and KM (1 µM) towards treating inflamed HCECs had an anti-inflammatory effect, and it is effective in treating DES rabbits when BS is added in combination with these two herbal supplements and used as a topical eye drop.

  15. Structure-function studies of BPP-BrachyNH2 and synthetic analogues thereof with Angiotensin I-Converting Enzyme.

    PubMed

    Arcanjo, Daniel D R; Vasconcelos, Andreanne G; Nascimento, Lucas A; Mafud, Ana Carolina; Plácido, Alexandra; Alves, Michel M M; Delerue-Matos, Cristina; Bemquerer, Marcelo P; Vale, Nuno; Gomes, Paula; Oliveira, Eduardo B; Lima, Francisco C A; Mascarenhas, Yvonne P; Carvalho, Fernando Aécio A; Simonsen, Ulf; Ramos, Ricardo M; Leite, José Roberto S A

    2017-10-20

    The vasoactive proline-rich oligopeptide termed BPP-BrachyNH 2 (H-WPPPKVSP-NH 2 ) induces in vitro inhibitory activity of angiotensin I-converting enzyme (ACE) in rat blood serum. In the present study, the removal of N-terminal tryptophan or C-terminal proline from BPP-BrachyNH 2 was investigated in order to predict which structural components are important or required for interaction with ACE. Furthermore, the toxicological profile was assessed by in silico prediction and in vitro MTT assay. Two BPP-BrachyNH 2 analogues (des-Trp 1 -BPP-BrachyNH 2 and des-Pro 8 -BPP-BrachyNH 2 ) were synthesized, and in vitro and in silico ACE inhibitory activity and toxicological profile were assessed. The des-Trp 1 -BPP-BrachyNH 2 and des-Pro 8 -BPP-BrachyNH 2 were respectively 3.2- and 29.5-fold less active than the BPP-BrachyNH 2 -induced ACE inhibitory activity. Molecular Dynamic and Molecular Mechanics Poisson-Boltzmann Surface Area simulations (MM-PBSA) demonstrated that the ACE/BBP-BrachyNH 2 complex showed lower binding and van der Wall energies than the ACE/des-Pro 8 -BPP-BrachyNH 2 complex, therefore having better stability. The removal of the N-terminal tryptophan increased the in silico predicted toxicological effects and cytotoxicity when compared with BPP-BrachyNH 2 or des-Pro 8 -BPP-BrachyNH 2 . Otherwise, des-Pro 8 -BPP-BrachyNH 2 was 190-fold less cytotoxic than BPP-BrachyNH 2 . Thus, the removal of C-terminal proline residue was able to markedly decrease both the BPP-BrachyNH 2 -induced ACE inhibitory and cytotoxic effects assessed by in vitro and in silico approaches. In conclusion, the aminoacid sequence of BPP-BrachyNH 2 is essential for its ACE inhibitory activity and associated with an acceptable toxicological profile. The perspective of the interactions of BPP-BrachyNH 2 with ACE found in the present study can be used for development of drugs with differential therapeutic profile than current ACE inhibitors. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  16. Soins primaires aux adultes ayant une déficience développementale

    PubMed Central

    Sullivan, William F.; Berg, Joseph M.; Bradley, Elspeth; Cheetham, Tom; Denton, Richard; Heng, John; Hennen, Brian; Joyce, David; Kelly, Maureen; Korossy, Marika; Lunsky, Yona; McMillan, Shirley

    2011-01-01

    Résumé Objectif Mettre à jour les lignes directrices canadiennes de 2006 sur les soins primaires aux adultes ayant une déficience développementale (DD) et présenter des recommandations pratiques fondées sur les connaissances actuelles pour traiter des problèmes de santé particuliers chez des adultes ayant une DD. Qualité des preuves Des professionnels de la santé expérimentés participant à un colloque et un groupe de travail subséquent ont discuté et convenu des révisions aux lignes directrices de 2006 en se fondant sur une recherche documentaire exhaustive, la rétroaction obtenue des utilisateurs du guide de pratique et les expériences cliniques personnelles. La plupart des preuves disponibles dans ce domaine viennent de l’opinion d’experts ou de déclarations consensuelles publiées (niveau III). Message principal Les adultes ayant une DD ont des problèmes de santé complexes, dont plusieurs diffèrent de ceux de la population en général. De bons soins primaires permettent d’identifier les problèmes de santé particuliers dont souffrent les adultes ayant une DD pour améliorer leur qualité de vie et leur accès aux soins de santé et prévenir la morbidité et le décès prématuré. Ces lignes directrices résument les problèmes de santé générale, physique, comportementale et mentale des adultes ayant une DD que devraient connaître les professionnels des soins primaires et présentent des recommandations pour le dépistage et la prise en charge en se basant sur les connaissances actuelles que les cliniciens peuvent mettre en pratique. En raison de l’interaction des facteurs biologiques, psychoaffectifs et sociaux qui contribuent à la santé et au bien-être des adultes ayant une DD, ces lignes directrices insistent sur la participation des aidants, l’adaptation des interventions, au besoin, et la consultation auprès de divers professionnels de la santé quand ils sont accessibles. Elles mettent aussi en évidence la nature éthique des soins. Les lignes directrices sont formulées dans le contexte d’un cadre éthique qui tient compte des questions comme le consentement éclairé et l’évaluation des bienfaits pour la santé par rapport aux risques de préjudice. Conclusion La mise en œuvre des lignes directrices proposées ici améliorerait la santé des adultes ayant une DD et minimiserait les disparités sur les plans de la santé et des soins de santé entre les adultes ayant une DD et la population en général.

  17. Methodes iteratives paralleles: Applications en neutronique et en mecanique des fluides

    NASA Astrophysics Data System (ADS)

    Qaddouri, Abdessamad

    Dans cette these, le calcul parallele est applique successivement a la neutronique et a la mecanique des fluides. Dans chacune de ces deux applications, des methodes iteratives sont utilisees pour resoudre le systeme d'equations algebriques resultant de la discretisation des equations du probleme physique. Dans le probleme de neutronique, le calcul des matrices des probabilites de collision (PC) ainsi qu'un schema iteratif multigroupe utilisant une methode inverse de puissance sont parallelises. Dans le probleme de mecanique des fluides, un code d'elements finis utilisant un algorithme iteratif du type GMRES preconditionne est parallelise. Cette these est presentee sous forme de six articles suivis d'une conclusion. Les cinq premiers articles traitent des applications en neutronique, articles qui representent l'evolution de notre travail dans ce domaine. Cette evolution passe par un calcul parallele des matrices des PC et un algorithme multigroupe parallele teste sur un probleme unidimensionnel (article 1), puis par deux algorithmes paralleles l'un mutiregion l'autre multigroupe, testes sur des problemes bidimensionnels (articles 2--3). Ces deux premieres etapes sont suivies par l'application de deux techniques d'acceleration, le rebalancement neutronique et la minimisation du residu aux deux algorithmes paralleles (article 4). Finalement, on a mis en oeuvre l'algorithme multigroupe et le calcul parallele des matrices des PC sur un code de production DRAGON ou les tests sont plus realistes et peuvent etre tridimensionnels (article 5). Le sixieme article (article 6), consacre a l'application a la mecanique des fluides, traite la parallelisation d'un code d'elements finis FES ou le partitionneur de graphe METIS et la librairie PSPARSLIB sont utilises.

  18. Membrane fluidization by alcohols inhibits DesK-DesR signalling in Bacillus subtilis.

    PubMed

    Vaňousová, Kateřina; Beranová, Jana; Fišer, Radovan; Jemioła-Rzemińska, Malgorzata; Matyska Lišková, Petra; Cybulski, Larisa; Strzałka, Kazimierz; Konopásek, Ivo

    2018-03-01

    After cold shock, the Bacillus subtilis desaturase Des introduces double bonds into the fatty acids of existing membrane phospholipids. The synthesis of Des is regulated exclusively by the two-component system DesK/DesR; DesK serves as a sensor of the state of the membrane and triggers Des synthesis after a decrease in membrane fluidity. The aim of our work is to investigate the biophysical changes in the membrane that are able to affect the DesK signalling state. Using linear alcohols (ethanol, propanol, butanol, hexanol, octanol) and benzyl alcohol, we were able to suppress Des synthesis after a temperature downshift. The changes in the biophysical properties of the membrane caused by alcohol addition were followed using membrane fluorescent probes and differential scanning calorimetry. We found that the membrane fluidization induced by alcohols was reflected in an increased hydration at the lipid-water interface. This is associated with a decrease in DesK activity. The addition of alcohol mimics a temperature increase, which can be measured isothermically by fluorescence anisotropy. The effect of alcohols on the membrane periphery is in line with the concept of the mechanism by which two hydrophilic motifs located at opposite ends of the transmembrane region of DesK, which work as a molecular caliper, sense temperature-dependent variations in membrane properties. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. Le patrimoine astronomique provençal

    NASA Astrophysics Data System (ADS)

    Rous, M.; Figon, P.; Guyot, S.

    2012-12-01

    L'OSU OAMP/Institut Pythéas porte les missions de conservation, inventaire et valorisation du patrimoine. Suite à la fusion de l'Observatoire de Marseille et du Laboratoire d'Astronomie Spatiale en 2000 pour créer le Laboratoire d'Astrophysique de Marseille, le déménagement des équipes sur le site de Château-Gombert en 2008 a soulevé le problème du devenir des collections des deux sites d'origine. Nous ferons le bilan des actions passées en matière de conservation et de valorisation de ce riche patrimoine : versement à l'inventaire général du Ministère de la Culture, classement de 22 instruments au titre des Monuments Historiques, inventaire et numérisation des archives anciennes, montage d'expositions et réalisation du catalogue Telescopium, 400 ans de lunettes et de télescopes. Nous présenterons les actions en cours: mesures de conservation préventive, inventaire des archives et des instruments. Nous parlerons enfin des projets: création d'un espace d'exposition permanente, participation à des expositions temporaires.

  20. Préface

    NASA Astrophysics Data System (ADS)

    Schober, Helmut; Fischer, Henry; Leclercq-Hugeux, Françoise

    2003-09-01

    L'École Thématique “Structure et Dynamique des Systèmes Désordonnés” [1] s'inscrit dans le cadre des écoles organisées sous l'impulsion de la Société Française de la Neutronique (SFN). Elle s'est deroulée en mai 2002 sur la Presqu'île de Giens (Var) en première partie des 11émes Journées de la Diffusion Neutronique. L'Édition de ces cours constitue ainsi le cinquième ouvrage introduisant les techniques neutroniques et leurs apports à differentes thématiques [2]. Le désordre est un facteur déterminant pour pratiquement toutes les propriétés des matériaux. Il est inhérent dans les matériaux amorphes ou liquides, mais il détermine également les propriétés mécaniques et électroniques d'autres composés d'importance technologique comme les matériaux métalliques, dont l'aspect “désordonné” est moins évident. Le désordre enfin joue un rôle essentiel dans tout ce que touche à la vie. En fait, il est difficile d'imaginer des systèmes, à part quelques exceptions rares comme l'hélium ou le silicium de haute pureté, où il n'y ait pas de désordre. En dehors de cet aspect pratique, la description scientifique du désordre atomique pose toujours des problèmes fondamentaux faute de concepts pertinents. Une des tâches importantes du scientifique ou de l'ingenieur est de préciser quel genre de désordre existe à une échelle d'espace et de temps donnée. Un materiau peut très bien être homogène à l'échelle atomique et présenter des défauts ou des hétrogéneité visibles à l'œil et inversement. De même, un système désordonné à un instant donné, peut apparaître ordonné si on moyenne dans le temps. Les techniques de diffusion des neutrons sont idéales pour aborder ces questions. Les neutrons sondent directement les noyaux et ont à la fois des longueurs d'ondes proches des distances inter atomiques et des énergies avoisinant celles des excitations élémentaires de la matière condensée. Ils permettent ainsi une observation directe et non-destructive des positions et des mouvements atomiques. La gamme des distances et des temps sondés par les neutrons autorisent aussi bien de suivre le mouvement des atomes à l'échelle inter atomique que l'évolution d'une structure soit mésoscopique soit macroscopique sur des temps de moins d'une picoseconde à plusieurs heures. La gamme des techniques de diffusion utilisées pour couvrir un tel champ d'application est naturellement très large : différents types de diffractomètres permettent des études de structure atomique trés pointue et résolue dans le temps. Les spectromètres nous donnent accès à la dynamique d'une dizaine de femto- à plusieurs nanosecondes. La diffusion aux petits angles, la reflectomètrie et finalement la tomographie nous permettent de regarder la structure et la dynamique d'objets plus grands. Il était illusoire de prétendre couvrir la totalité des systèmes désordonnés et l'ensemble des techniques de diffusion neutronique pertinentes au cours d'une école de 3 jours. Nous avons donc été amené à nous concentrer sur les liquides, les verres, les cristaux plastiques et les polymères. Ce choix s'est imposé par le souhait d'introduire les concepts de base, en acceptant de sacrifier certains domaines d'applications. Il va de soi que l'étude approfondie de systèmes mettant en jeu plusieurs échelles de distance (structure moléculaire, portée des corrélations entre les molécules) et de temps (relaxations caractéristiques des divers phenomènes dynamiques selon leur extension spatiale) implique une pluralité de techniques expérimentales, complémentaires des différentes techniques neutroniques disponibles. Un des objectifs de cette école etait donc de préciser les domaines de pertinence des différentes techniques neutroniques disponibles en en situant la complémentarité avec d'autres approches instrumentales (diffraction des rayons X, EXAFS, RMN, etc.). Enfin la confrontation avec les résultats obtenus par simulation et modélisation numérique est essentielle à la compréhension des processus élémentaires dans ces systèmes complexes. En première partie de cet ouvrage, on trouvera une description géntrale des systèmes désordonnés et une introduction aux techniques de diffusion de neutrons. Pour la partie concernant la structure, une revue des techniques de diffraction est suivie par des applications à des systèmes de complexité croissante (liquides métalliques simples, alliages liquides, semiconducteurs fondus, solutions aqueuses, verres d'oxydes). L'apport des méthodes de variation de longueur de diffusion (substitution isotopique pour les mesures aux neutrons, diffusion anomale des rayons X ou combinaison de ces deux techniques) permet la détermination des facteurs de structures partiels. Pour la dynamique, on a privilégié une approche introduisant progressivement le désordre en passant des solides aux liquides. Le concept de diffusion puis les particularités dynamiques des verres sont ensuite présentés et illustrés par des exemples concrets. Enfin la dernière partie est consacrée à la simulation numérique des propriétés dynamiques des verres et des liquides et à la modélisation de la structure par méthode de Monte Carlo inverse (RMC) à partir de l'ensemble des données expérimentales existant pour un système donné. La communauté française a joué un rôle important dans le développement des techniques neutroniques dédites à l'étude des systèmes désordonnés et y a acquis une competence reconnue. Nous avons essayé, dans cet ouvrage, de privilégier les aspects pédagogiques des cours, pour les rendre accessibles aux scientifiques francophones non spécialistes en diffusion des neutrons. Nous saluons ici l'effort de rédaction, en langue française, des différents intervenants et souhaitons que cet ouvrage puisse participer à la formation et au renouvellement de la communauté neutronique française. Helmut Schober et Henry Fischer (Editeurs scientifiques) Françoise Leclercq-Hugeux (Présidente de la SFN)

  1. Modeling complex treatment strategies: construction and validation of a discrete event simulation model for glaucoma.

    PubMed

    van Gestel, Aukje; Severens, Johan L; Webers, Carroll A B; Beckers, Henny J M; Jansonius, Nomdo M; Schouten, Jan S A G

    2010-01-01

    Discrete event simulation (DES) modeling has several advantages over simpler modeling techniques in health economics, such as increased flexibility and the ability to model complex systems. Nevertheless, these benefits may come at the cost of reduced transparency, which may compromise the model's face validity and credibility. We aimed to produce a transparent report on the construction and validation of a DES model using a recently developed model of ocular hypertension and glaucoma. Current evidence of associations between prognostic factors and disease progression in ocular hypertension and glaucoma was translated into DES model elements. The model was extended to simulate treatment decisions and effects. Utility and costs were linked to disease status and treatment, and clinical and health economic outcomes were defined. The model was validated at several levels. The soundness of design and the plausibility of input estimates were evaluated in interdisciplinary meetings (face validity). Individual patients were traced throughout the simulation under a multitude of model settings to debug the model, and the model was run with a variety of extreme scenarios to compare the outcomes with prior expectations (internal validity). Finally, several intermediate (clinical) outcomes of the model were compared with those observed in experimental or observational studies (external validity) and the feasibility of evaluating hypothetical treatment strategies was tested. The model performed well in all validity tests. Analyses of hypothetical treatment strategies took about 30 minutes per cohort and lead to plausible health-economic outcomes. There is added value of DES models in complex treatment strategies such as glaucoma. Achieving transparency in model structure and outcomes may require some effort in reporting and validating the model, but it is feasible.

  2. Cost effectiveness of drug eluting coronary artery stenting in a UK setting: cost-utility study.

    PubMed

    Bagust, A; Grayson, A D; Palmer, N D; Perry, R A; Walley, T

    2006-01-01

    To assess the cost effectiveness of drug eluting stents (DES) compared with conventional stents for treatment of symptomatic coronary artery disease in the UK. Cost-utility analysis of audit based patient subgroups by means of a simple economic model. Tertiary care. 12 month audit data for 2884 patients receiving percutaneous coronary intervention with stenting at the Cardiothoracic Centre Liverpool between January 2000 and December 2002. Risk of repeat revascularisation within 12 months of index procedure and reduction in risk from use of DES. Economic modelling was used to estimate the cost-utility ratio and threshold price premium. Four factors were identified for patients undergoing elective surgery (n = 1951) and two for non-elective surgery (n = 933) to predict risk of repeat revascularisation within 12 months. Most patients fell within the subgroup with lowest risk (57% of the elective surgery group with 5.6% risk and 91% of the non-elective surgery group with 9.9% risk). Modelled cost-utility ratios were acceptable for only one group of high risk patients undergoing non-elective surgery (only one patient in audit data). Restricting the number of DES for each patient improved results marginally: 4% of stents could then be drug eluting on economic grounds. The threshold price premium justifying 90% substitution of conventional stents was estimated to be 112 pound sterling (212 USD, 162 pound sterling) (sirolimus stents) or 89 pound sterling (167 USD, 130 pound sterling) (paclitaxel stents). At current UK prices, DES are not cost effective compared with conventional stents except for a small minority of patients. Although the technology is clearly effective, general substitution is not justified unless the price premium falls substantially.

  3. Can you score with balloons to enhance outcomes after drug coated balloon angioplasty? Insights from the Paris DCB Registry for in-stent restenosis.

    PubMed

    Merat, Benoît; Waliszewski, Matthias; Dillinger, Guillaume; Henry, Patrick; Sideris, Georgios

    2018-06-01

    The objective of this study was to assess the 12-month clinical outcomes in patients with drug-eluting stent in-stent restenosis (DES-ISR) who were either pre-dilated with non-compliant balloons (NCBA) and with additional scoring balloons (NCBA + SBA) prior to drug coated balloon (DCB) angioplasty. This monocentric, retrospective study included patients with DES-ISR who were routinely treated over a 2-year time span. Patients with stable angina and documented ischemia or selected forms of unstable angina due to a culprit DES-ISR lesion were analyzed. The primary endpoint was the clinically driven target-lesion revascularization (TLR) rate at 12 months. Secondary endpoints included post-interventional lumen gain and late lumen loss (LLL) at 6 months. The 12-month TLR rates in 124 patients who underwent either NCBA + SBA or NCBA only group were not different (17.3%, 9/52 vs 11.6%, 8/69, P = 0.371) and low as compared to other comparable studies. The use of SBA led to equally high post minimal lumen diameters (MLD) in both treatment arms (NCBA 2.21 ± 0.33 vs NCBA + SBA 2.18 ± 0.41, P = 0.868). We did not find a significant difference in late lumen loss (LLL) between both groups (0.50 ± 0.62 mm vs 0.40 ± 0.46 mm, P = 0.468). Scoring Balloon Angioplasty can safely and effectively prepare DES-ISR lesions to render them suitable for DCB angioplasty with acceptable TLR and MACE rates. © 2018, Wiley Periodicals, Inc.

  4. Modeling Clinical Outcomes in Prostate Cancer: Application and Validation of the Discrete Event Simulation Approach.

    PubMed

    Pan, Feng; Reifsnider, Odette; Zheng, Ying; Proskorovsky, Irina; Li, Tracy; He, Jianming; Sorensen, Sonja V

    2018-04-01

    Treatment landscape in prostate cancer has changed dramatically with the emergence of new medicines in the past few years. The traditional survival partition model (SPM) cannot accurately predict long-term clinical outcomes because it is limited by its ability to capture the key consequences associated with this changing treatment paradigm. The objective of this study was to introduce and validate a discrete-event simulation (DES) model for prostate cancer. A DES model was developed to simulate overall survival (OS) and other clinical outcomes based on patient characteristics, treatment received, and disease progression history. We tested and validated this model with clinical trial data from the abiraterone acetate phase III trial (COU-AA-302). The model was constructed with interim data (55% death) and validated with the final data (96% death). Predicted OS values were also compared with those from the SPM. The DES model's predicted time to chemotherapy and OS are highly consistent with the final observed data. The model accurately predicts the OS hazard ratio from the final data cut (predicted: 0.74; 95% confidence interval [CI] 0.64-0.85 and final actual: 0.74; 95% CI 0.6-0.88). The log-rank test to compare the observed and predicted OS curves indicated no statistically significant difference between observed and predicted curves. However, the predictions from the SPM based on interim data deviated significantly from the final data. Our study showed that a DES model with properly developed risk equations presents considerable improvements to the more traditional SPM in flexibility and predictive accuracy of long-term outcomes. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  5. Clinical study to assess the efficacy of Keshanjana and Netra Parisheka in the management of Shushkakshipaka (dry eye syndrome).

    PubMed

    Vardhan, Prabhakar; Dhiman, Kartar Singh

    2014-01-01

    Dry eye syndrome (DES) is a common ophthalmic problem predominantly affecting middle-aged and elderly people. It is a disease of deficient or deranged tears and ocular surface disorder producing symptoms of discomfort, visual disturbance, and tears film instability. Shushkakshipaka, an etymologically and clinically similar entity to DES, is defined in Ayurveda as the disease affecting all parts of the eye characterized by Paka (inflammation) due to Shuskatva (dryness) caused by altered coherence of Ashru (tears) with ocular surface or due to lack of Ashru. To compare the effect of Keshanjana and Netra Parisheka in Shushkakshipaka with artificial tear drops (carboxy methyl cellulose [CMC]). To search a safe, potent and cost-effective Ayurvedic treatment for DES, a randomized comparative clinical trial was conducted on 32 patients. Patients were divided in two groups 15 in group I and 17 in group II. Group I treated with artificial tear drop four times a day for topical use and group II treated with combination therapy of Keshanjana applied topically once a day and Netra Prisheka was done thrice a day. The effect of Ayurvedic management was found to be equivalent to the standard therapy, although the trial drugs provided more relief in foreign body sensation, burning sensation, dryness, pain, photophobia, itching, crusting, stuck eyelids, tear meniscus, conjunctival congestion, Schirmer I test, and tear film break-up time (TUBT). The standard therapy provided more relief than trial drugs in mucous discharges, transiently blurred vision, redness, and the presence of mucin debris in tear film. Keshanjana and Netra Parisheka can be used as a potent, safe and cost-effective treatment to ameliorate the symptoms of DES.

  6. Clinical study to assess the efficacy of Keshanjana and Netra Parisheka in the management of Shushkakshipaka (dry eye syndrome)

    PubMed Central

    Vardhan, Prabhakar; Dhiman, Kartar Singh

    2014-01-01

    Background: Dry eye syndrome (DES) is a common ophthalmic problem predominantly affecting middle-aged and elderly people. It is a disease of deficient or deranged tears and ocular surface disorder producing symptoms of discomfort, visual disturbance, and tears film instability. Shushkakshipaka, an etymologically and clinically similar entity to DES, is defined in Ayurveda as the disease affecting all parts of the eye characterized by Paka (inflammation) due to Shuskatva (dryness) caused by altered coherence of Ashru (tears) with ocular surface or due to lack of Ashru. Aim: To compare the effect of Keshanjana and Netra Parisheka in Shushkakshipaka with artificial tear drops (carboxy methyl cellulose [CMC]). Materials and Methods: To search a safe, potent and cost-effective Ayurvedic treatment for DES, a randomized comparative clinical trial was conducted on 32 patients. Patients were divided in two groups 15 in group I and 17 in group II. Group I treated with artificial tear drop four times a day for topical use and group II treated with combination therapy of Keshanjana applied topically once a day and Netra Prisheka was done thrice a day. Results: The effect of Ayurvedic management was found to be equivalent to the standard therapy, although the trial drugs provided more relief in foreign body sensation, burning sensation, dryness, pain, photophobia, itching, crusting, stuck eyelids, tear meniscus, conjunctival congestion, Schirmer I test, and tear film break-up time (TUBT). The standard therapy provided more relief than trial drugs in mucous discharges, transiently blurred vision, redness, and the presence of mucin debris in tear film. Conclusion: Keshanjana and Netra Parisheka can be used as a potent, safe and cost-effective treatment to ameliorate the symptoms of DES. PMID:26664237

  7. Electrophysiological effects of desflurane in children with Wolff-Parkinson-White syndrome: a randomized crossover study.

    PubMed

    Hino, H; Oda, Y; Yoshida, Y; Suzuki, T; Shimada, M; Nishikawa, K

    2018-02-01

    We hypothesized that, compared with propofol, desflurane prolongs the antegrade accessory pathway effective refractory period (APERP) in children undergoing radiofrequency catheter ablation for Wolff-Parkinson-White (WPW) syndrome. In this randomized crossover study, children aged 4.1-16.1 years undergoing radiofrequency catheter ablation for WPW syndrome were randomly divided into four groups according to the concentration of desflurane and anesthetics used in the first and the second electrophysiological studies (EPS). After induction of general anesthesia with propofol and tracheal intubation, they received one of the following regimens: 0.5 minimum alveolar concentration (MAC) desflurane (first EPS) and propofol (second EPS) (Des0.5-Prop group, n = 8); propofol (first EPS) and 0.5 MAC desflurane (second EPS) (Prop-Des0.5 group, n = 9); 1 MAC desflurane (first EPS) and propofol (second EPS) (Des1.0-Prop group, n = 10); propofol (first EPS) and 1 MAC desflurane (second EPS) (Prop-Des1.0 group, n = 9). Radiofrequency catheter ablation was performed upon completion of EPS. Sample size was determined to detect a difference in the APERP. Desflurane at 1.0 MAC significantly prolonged the APERP compared with propofol, but did not affect the sinoatrial conduction time, atrio-His interval or atrioventricular node effective refractory period. Supraventricular tachycardia was induced in all children receiving propofol, but not induced in 1 and 4 children receiving 0.5 MAC and 1.0 MAC desflurane, respectively. Desflurane enhances the refractoriness and may block the electrical conduction of the atrioventricular accessory pathway, and is therefore not suitable for use in children undergoing radiofrequency catheter ablation for WPW syndrome. © 2017 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  8. 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

  9. Etude analytique et numérique de la réponse en vibration à hautes fréquences d'éprouvettes de fatigue vibratoire des métaux. Application aux aciers

    NASA Astrophysics Data System (ADS)

    Ben Aich, A.; El Kihel, B.; Kifani, A.; Sahban, F.

    1994-07-01

    In the present paper, the so-called " ultrasonic fatigue " or fatigue at very high frequency has been studied in the materials elastic behaviour case while neglecting the thermal effects that influence the mechanical fields. The determination of mechanical fields and specimen resonance length has been done both analytically and numerically. The numerical method used for this calculation is the finite element method (FEM). Martensitic steel " Soleil A2 " and austenitic steel " ICL 472 BC " have been considered in order to compare the two methods (analytical and numerical). It is shown that a perfect convergence is obtained between the two solutions. Dans le présent travail, la fatigue vibratoire a été étudiée dans le cas du comportement élastique des matériaux en négligeant les effets thermiques pouvant influencer les champs mécaniques. La détermination de ces champs et de la longueur de résonance des éprouvettes de fatigue a été faite analytiquement et numériquement. Le calcul numérique effectué se base sur la méthode des éléments finis. Dans le but d'une comparaison des solutions analytiques et numériques, deux aciers ont été considérés : un acier martensitique (Soleil A2) et un acier austénitique de type 18-10 (ICL 472 BC). Une parfaite convergence est obtenue entre les deux solutions.

  10. Peste des Petits Ruminants Virus Tissue Tropism and Pathogenesis in Sheep and Goats following Experimental Infection

    PubMed Central

    Truong, Thang; Boshra, Hani; Embury-Hyatt, Carissa; Nfon, Charles; Gerdts, Volker; Tikoo, Suresh; Babiuk, Lorne A.; Kara, Pravesh; Chetty, Thireshni; Mather, Arshad; Wallace, David B.; Babiuk, Shawn

    2014-01-01

    Peste des petits ruminants (PPR) is a viral disease which primarily affects small ruminants, causing significant economic losses for the livestock industry in developing countries. It is endemic in Saharan and sub-Saharan Africa, the Middle East and the Indian sub-continent. The primary hosts for peste des petits ruminants virus (PPRV) are goats and sheep; however recent models studying the pathology, disease progression and viremia of PPRV have focused primarily on goat models. This study evaluates the tissue tropism and pathogenesis of PPR following experimental infection of sheep and goats using a quantitative time-course study. Upon infection with a virulent strain of PPRV, both sheep and goats developed clinical signs and lesions typical of PPR, although sheep displayed milder clinical disease compared to goats. Tissue tropism of PPRV was evaluated by real-time RT-PCR and immunohistochemistry. Lymph nodes, lymphoid tissue and digestive tract organs were the predominant sites of virus replication. The results presented in this study provide models for the comparative evaluation of PPRV pathogenesis and tissue tropism in both sheep and goats. These models are suitable for the establishment of experimental parameters necessary for the evaluation of vaccines, as well as further studies into PPRV-host interactions. PMID:24498032

  11. Culotte stenting for coronary bifurcation lesions with 2nd and 3rd generation everolimus-eluting stents: the CELTIC Bifurcation Study.

    PubMed

    Walsh, Simon J; Hanratty, Colm G; Watkins, Stuart; Oldroyd, Keith G; Mulvihill, Niall T; Hensey, Mark; Chase, Alex; Smith, Dave; Cruden, Nick; Spratt, James C; Mylotte, Darren; Johnson, Tom; Hill, Jonathan; Hussein, Hafiz M; Bogaerts, Kris; Morice, Marie-Claude; Foley, David P

    2018-05-24

    The aim of this study was to provide contemporary outcome data for patients with de novo coronary disease and Medina 1,1,1 lesions who were treated with a culotte two-stent technique, and to compare the performance of two modern-generation drug-eluting stent (DES) platforms, the 3-connector XIENCE and the 2-connector SYNERGY. Patients with Medina 1,1,1 bifurcation lesions who had disease that was amenable to culotte stenting were randomised 1:1 to treatment with XIENCE or SYNERGY DES. A total of 170 patients were included. Technical success and final kissing balloon inflation occurred in >96% of cases. Major adverse cardiovascular or cerebrovascular events (MACCE: a composite of death, myocardial infarction [MI], cerebrovascular accident [CVA] and target vessel revascularisation [TVR]) occurred in 5.9% of patients by nine months. The primary endpoint was a composite of death, MI, CVA, target vessel failure (TVF), stent thrombosis and binary angiographic restenosis. At nine months, the primary endpoint occurred in 19% of XIENCE patients and 16% of SYNERGY patients (p=0.003 for non-inferiority for platform performance). MACCE rates for culotte stenting using contemporary everolimus-eluting DES are low at nine months. The XIENCE and SYNERGY stents demonstrated comparable performance for the primary endpoint.

  12. Support de source de radioactivité à base de PEDT, amélioration des qualités métrologiques

    NASA Astrophysics Data System (ADS)

    Geffroy, B.; Rosilio, Ch.; de Sanoit, J.; Bouchard, J.; Hainos, D.

    1998-06-01

    Self-supported conducting membranes with a thickness in the range of 150 to 600 nm have been obtained with a composite of poly(3-4ethylenedioxythiophene) (PEDT) and PVC. The PEDT is prepared by oxydation of the EDT monomer with ferric tosylate. The best conductivity of the PEDT/PVC composite is around 20 S/cm. High quality metrology radioactive 60Co sources are prepared with these thin conducting membranes. The advantages of this radioactive source preparation are presented throuth comparative results. Des membranes conductrices, auto-supportées, d'une épaisseur comprise entre 150 et 600 nm ont été obtenues à partir d'un composite de poly(3-4 éthylènedioxythiophène) (PEDT) et de PVC. Le PEDT est synthétisé par oxydation chimique du monomère par le tosylate ferrique et la conductivité maximale du composite est de 20 S/cm. Ces membranes sont utilisées pour préparer des sources de 60Co de bonnes qualités métrologiques. Les avantages de cette méthode de préparation de sources radioactives sont présentés au travers de mesures comparatives.

  13. The NICE recommendation for drug-coated balloons and its global impact.

    PubMed

    Eccleshall, Simon; Waliszewski, M

    2015-06-01

    The clinical efficacy and safety of drug-coated balloon (DCB) angioplasty in patients with coronary in-stent restenosis (ISR) has been demonstrated. The objective of this article is to provide comparative cost efficacy data for DCB angioplasty in various countries based on the original methodology of the Medical Technologies Evaluation Programme (MTEP) at the National Institute for Health and Clinical Excellence (NICE) in 2010. Published and unpublished Health Technology Assessment (HTA) reports were evaluated for comparison in selected countries. Furthermore, a systematic review of economic evaluations of DCB angioplasty versus standard treatments (uncoated balloon angioplasty or drug-eluting stent implantations) was conducted. National cost efficacy data were evaluated using Markov state transition models which were adapted to fit each country's device and procedure related costs. The clinical input for adverse events was defined with two relevant trials for in-stent restenosis of bare metal stents (BMS-ISR) and of drug-eluting stents (DES-ISR). In the UK, Germany, Switzerland, South Africa, Japan and Brazil, DCB angioplasty is cost-effective when compared with drug-eluting stents to treat either BMS-ISR or DES-ISR. DCB angioplasty ought to be the preferred treatment option for patients with BMS-ISR and DES-ISR from the payers' point of view. © The Author(s), 2015.

  14. Peste des petits ruminants virus tissue tropism and pathogenesis in sheep and goats following experimental infection.

    PubMed

    Truong, Thang; Boshra, Hani; Embury-Hyatt, Carissa; Nfon, Charles; Gerdts, Volker; Tikoo, Suresh; Babiuk, Lorne A; Kara, Pravesh; Chetty, Thireshni; Mather, Arshad; Wallace, David B; Babiuk, Shawn

    2014-01-01

    Peste des petits ruminants (PPR) is a viral disease which primarily affects small ruminants, causing significant economic losses for the livestock industry in developing countries. It is endemic in Saharan and sub-Saharan Africa, the Middle East and the Indian sub-continent. The primary hosts for peste des petits ruminants virus (PPRV) are goats and sheep; however recent models studying the pathology, disease progression and viremia of PPRV have focused primarily on goat models. This study evaluates the tissue tropism and pathogenesis of PPR following experimental infection of sheep and goats using a quantitative time-course study. Upon infection with a virulent strain of PPRV, both sheep and goats developed clinical signs and lesions typical of PPR, although sheep displayed milder clinical disease compared to goats. Tissue tropism of PPRV was evaluated by real-time RT-PCR and immunohistochemistry. Lymph nodes, lymphoid tissue and digestive tract organs were the predominant sites of virus replication. The results presented in this study provide models for the comparative evaluation of PPRV pathogenesis and tissue tropism in both sheep and goats. These models are suitable for the establishment of experimental parameters necessary for the evaluation of vaccines, as well as further studies into PPRV-host interactions.

  15. Gestion des ressources hydriques adaptee aux changements climatiques pour la production optimale d'hydroelectricite. Etude de cas: Bassin versant de la riviere Manicouagan

    NASA Astrophysics Data System (ADS)

    Haguma, Didier

    Il est dorenavant etabli que les changements climatiques auront des repercussions sur les ressources en eau. La situation est preoccupante pour le secteur de production d'energie hydroelectrique, car l'eau constitue le moteur pour generer cette forme d'energie. Il sera important d'adapter les regles de gestion et/ou les installations des systemes hydriques, afin de minimiser les impacts negatifs et/ou pour capitaliser sur les retombees positives que les changements climatiques pourront apporter. Les travaux de la presente recherche s'interessent au developpement d'une methode de gestion des systemes hydriques qui tient compte des projections climatiques pour mieux anticiper les impacts de l'evolution du climat sur la production d'hydroelectricite et d'etablir des strategies d'adaptation aux changements climatiques. Le domaine d'etude est le bassin versant de la riviere Manicouagan situe dans la partie centrale du Quebec. Une nouvelle approche d'optimisation des ressources hydriques dans le contexte des changements climatiques est proposee. L'approche traite le probleme de la saisonnalite et de la non-stationnarite du climat d'une maniere explicite pour representer l'incertitude rattachee a un ensemble des projections climatiques. Cette approche permet d'integrer les projections climatiques dans le probleme d'optimisation des ressources en eau pour une gestion a long terme des systemes hydriques et de developper des strategies d'adaptation de ces systemes aux changements climatiques. Les resultats montrent que les impacts des changements climatiques sur le regime hydrologique du bassin de la riviere Manicouagan seraient le devancement et l'attenuation de la crue printaniere et l'augmentation du volume annuel d'apports. L'adaptation des regles de gestion du systeme hydrique engendrerait une hausse de la production hydroelectrique. Neanmoins, une perte de la performance des installations existantes du systeme hydrique serait observee a cause de l'augmentation des deversements non productibles dans le climat futur. Des strategies d'adaptation structurale ont ete analysees pour augmenter la capacite de production et la capacite d'ecoulement de certaines centrales hydroelectriques afin d'ameliorer la performance du systeme. Une analyse economique a permis de choisir les meilleures mesures d'adaptation et de determiner le moment opportun pour la mise en oeuvre de ces mesures. Les resultats de la recherche offrent aux gestionnaires des systemes hydriques un outil qui permet de mieux anticiper les consequences des changements climatiques sur la production hydroelectrique, incluant le rendement de centrales, les deversements non productibles et le moment le plus opportun pour inclure des modifications aux systemes hydriques. Mots-cles : systemes hydriques, adaptation aux changements climatiques, riviere Manicouagan

  16. Inhibition of DES-induced DNA adducts by diallyl sulfide: implications in liver cancer prevention.

    PubMed

    Green, Mario; Thomas, Ronald; Gued, Lisa; Sadrud-Din, Sakeenah

    2003-01-01

    Diethylstilbesterol (DES) is known to cause cancer in humans and animals. Diallyl sulfide (DAS), a component of garlic, has been shown to prevent various types of cancer, presumably via metabolic modulation. Previously, we have demonstrated that DAS prevents the oxidation and reduction of DES in vitro. We hypothesize that DAS will inhibit the metabolism of DES in vivo thus preventing the formation of DES-induced DNA adducts. To test this hypothesis, five groups of five male Sprague-Dawley rats were treated as follows: the control received 0.5 ml of corn oil daily for four days. The second group received 50 mg/kg DAS daily for four days. The third group received 50 mg/kg DAS daily for four days followed by 150 mg/kg DES on day five. The fourth group received 400 mg/kg DAS on day five followed by 150 mg/kg DES. The fifth group received 150 mg/kg DES on day five. All of the rats were sacrificed on day five, 4 h after DES treatment. DNA was isolated from the liver and analyzed by 32P-post-labeling for DNA adducts. The in vitro study was performed utilizing four reactions described as follows: the control reaction contained 200 microg DNA, microsomes (346 microg protein/ml), and 10 mM DES; no oxidation co-factor (cumen hydroperoxide) was added. The second reaction, a complete oxidation system, contained 200 microg DNA, microsomes (346 microg protein/ml), 30 mM cumen hydroperoxide, and 10 mM DES. The third reaction contained 200 microg DNA, microsomes (346 microg protein/ml), 30 mM cumen hydroperoxide, 50 mM DAS, and 10 mM DES. The fourth reaction contained 200 microg DNA, microsomes (346 microg protein/ml), 30 mM cumen hydroperoxide, 100 mM DAS, and 10 mM DES. All of the in vitro reactions were buffered with 100 mM KPO4 pH 7.4 and incubated for 30 min at 37 degrees C. DNA was extracted and analyzed by 32P-post-labeling. We found that DAS inhibited the formation of DES-induced DNA adducts in a dose-dependent fashion. We have shown that DES-induced DNA adducts were inhibited in rats that received DAS pre-treatment and co-treatment with DES. These results suggest that DAS directly inhibits the metabolism of DES thus preventing the formation of DNA adducts. In addition to directly inhibiting the metabolism of DES, DAS appears to alter the expression of the metabolic machinery such that DES-induced adducts are inhibited. The inhibition of DES-induced DNA adducts by DAS may prevent the initiation of estrogen-induced cancer.

  17. Mouse hypospadias: A critical examination and definition

    PubMed Central

    Sinclair, Adriane Watkins; Cao, Mei; Shen, Joel; Cooke, Paul; Risbridger, Gail; Baskin, Laurence; Cunha, Gerald R.

    2016-01-01

    Hypospadias is a common malformation whose etiology is based upon perturbation of normal penile development. The mouse has been previously used as a model of hypospadias, despite an unacceptably wide range of definitions for this malformation. The current paper presents objective criteria and a definition of mouse hypospadias. Accordingly, diethylstilbestrol (DES) induced penile malformations were examined at 60 days postnatal (P60) in mice treated with DES over the age range of 12 days embryonic to 20 days postnatal (E12 to P20). DES-induced hypospadias involves malformation of the urethral meatus, which is most severe in DES E12-P10, DES P0-P10 and DES P5-P15 groups and less so or absent in the other treatment groups. A frenulum-like ventral tether between the penis and the prepuce was seen in the most severely affected DES-treated mice. Internal penile morphology was also altered in the DES E12-P10, DES P0-P10 and DES P5-P15 groups (with little effect in the other DES treatment groups). Thus, adverse effects of DES are a function of the period of DES treatment and most severe in the P0 to P10 period. In “estrogen mutant mice” (NERKI, βERKO, αERKO and AROM+) hypospadias was only seen in AROM+ male mice having genetically-engineered elevation is serum estrogen. Significantly, mouse hypospadias was only seen distally at and near the urethral meatus where epithelial fusion events are known to take place and never in the penile midshaft, where urethral formation occurs via an entirely different morphogenetic process. PMID:27068029

  18. Caracterisation des proprietes dielectriques de materiaux composites a base de polyethylene terephtalate recycle =

    NASA Astrophysics Data System (ADS)

    Mebarki, Fouzia

    Cette etude vise a etudier la possibilite d'utiliser des materiaux composites a matrice thermoplastique pour des applications electriques comme les supports des systemes d'allumage dans les moteurs d'automobile. Nous nous interessons plus particulierement aux composites a base de polyethylene terephtalate (PET) recycle. Les isolants classiques comme le PET ne peuvent pas satisfaire toutes les exigences. L'introduction des renforts comme les fibres de verre et le mica peuvent ameliorer les caracteristiques mecaniques de ces materiaux. Toutefois, cette amelioration peut etre accompagnee d'une diminution des proprietes electriques surtout que ces materiaux doivent operer sous contraintes thermiques et electriques tres severes. Afin d'estimer la duree de vie de ces isolants, des essais de vieillissement accelere ont ete effectues a une frequence de 300Hz dans une plage de temperature allant de la temperature ambiante a 140°C. L'etude a haute temperature permettra de determiner la temperature de service des materiaux candidats. Des essais de la rupture dielectrique ont ete realises sur un grand nombre d'echantillon selon la norme ASTM D-149 relative aux mesures de rigidite dielectrique des isolants solides. Ces tests ont permis de deceler les echantillons problematiques et de verifier la qualite de ces isolants solides. Les differentes connaissances acquises lors de cette analyse ont servi a predire les performances des materiaux en service et vont permettre a la compagnie Groupe Lavergne d'apporter des ameliorations au niveau des formulations existantes et par la suite developper un materiau ayant les proprietes electriques et thermiques adequates pour ce type d'application. None None None None

  19. Kinematic evolution of the Maacama Fault Zone, Northern California Coast Ranges

    NASA Astrophysics Data System (ADS)

    Schroeder, Rick D.

    The Maacama Fault Zone (MFZ) is a major component of the Pacific-North American transform boundary in northern California, and its distribution of deformation and kinematic evolution defines that of a young continental transform boundary. The USGS Quaternary database (2010) currently defines the MFZ as a relatively narrow fault zone; however, a cluster analysis of microearthquakes beneath the MFZ defines a wider fault zone, composed of multiple seismogenically active faults. The surface projection of best-fit tabular zones through foci clusters correlates with previously interpreted faults that were assumed inactive. New investigations further delineate faults within the MFZ based on geomorphic features and shallow resistivity surveys, and these faults are interpreted to be part of several active pull-apart fault systems. The location of faults and changes in their geometry in relation to geomorphic features, indicate >8 km of cumulative dextral displacement across the eastern portion of the MFZ at Little Lake Valley, which includes other smaller offsets on fault strands in the valley. Some faults within the MFZ have geometries consistent with reactivated subduction-related reverse faults, and project near outcrops of pre-existing faults, filled with mechanically weak minerals. The mechanical behavior of fault zones is influenced by the spatial distribution and abundance of mechanically weak lithologies and mineralogies within the heterogeneous Franciscan melange that the MFZ displaces. This heterogeneity is characterized near Little Lake Valley (LLV) using remotely sensed data, field mapping, and wellbore data, and is composed of 2--5 km diameter disk-shaped coherent blocks that can be competent and resist deformation. Coherent blocks and the melange that surrounds them are the source for altered minerals that fill portions of fault zones. Mechanically weak minerals in pre-existing fault zones, identified by X-ray diffraction and electron microprobe analyses, are interpreted as a major reason for complex configurations of clusters of microearthquakes and zones of aseismic creep along the MFZ. Analysis of the kinematics of the MFZ and the distribution of its deformation is important because it improves the understanding of young stages of transform system evolution, which has implications that affect issues ranging from seismic hazard to petroleum and minerals exploration around the world.

  20. Dynamic ambulance reallocation for the reduction of ambulance response times using system status management.

    PubMed

    Lam, Sean Shao Wei; Zhang, Ji; Zhang, Zhong Cheng; Oh, Hong Choon; Overton, Jerry; Ng, Yih Yng; Ong, Marcus Eng Hock

    2015-02-01

    Dynamically reassigning ambulance deployment locations throughout a day to balance ambulance availability and demands can be effective in reducing response times. The objectives of this study were to model dynamic ambulance allocation plans in Singapore based on the system status management (SSM) strategy and to evaluate the dynamic deployment plans using a discrete event simulation (DES) model. The geographical information system-based analysis and mathematical programming were used to develop the dynamic ambulance deployment plans for SSM based on ambulance calls data from January 1, 2011, to June 30, 2011. A DES model that incorporated these plans was used to compare the performance of the dynamic SSM strategy against static reallocation policies under various demands and travel time uncertainties. When the deployment plans based on the SSM strategy were followed strictly, the DES model showed that the geographical information system-based plans resulted in approximately 13-second reduction in the median response times compared to the static reallocation policy, whereas the mathematical programming-based plans resulted in approximately a 44-second reduction. The response times and coverage performances were still better than the static policy when reallocations happened for only 60% of all the recommended moves. Dynamically reassigning ambulance deployment locations based on the SSM strategy can result in superior response times and coverage performance compared to static reallocation policies even when the dynamic plans were not followed strictly. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. [Not Available].

    PubMed

    Belmir, R; Fejjal, N; El Omari, M; El Mazouz, S; Gharib, N; Abassi, A; Belmahi, A

    2008-09-30

    Les accidents électriques par haute tension (AEHT) provoquent des brûlures profondes par effet Joule le long des axes vasculo-nerveux entre les points d'entrée et de sortie, qui sont le siège de lésions délabrantes. Les Auteurs rapportent une série de dix cas d'AEHT admis au service de chirurgie réparatrice et de brûlés de l'Hôpital Ibn Sina de Rabat à travers laquelle ils étudient les caractéristiques épidémiologiques, cliniques et thérapeutiques. Tous les patients étaient des adultes de sexe masculin dont l'âge moyen était de 31 ans. Dans 70% des cas, ces brûlures étaient secondaires à un contact avec les distributeurs d'électricité avec une surface brûlée inférieure à 20%. Le traitement des lésions électrothermiques a nécessité des interventions itératives avec amputation des segments de membres nécrosés dans 70% des cas, dont les suites étaient marquées par des séquelles fonctionnelles invalidantes. La prévention des AEHT, en particulier pour les accidents du travail au sein des professions exposées, reste fondamentale.

  2. Diethylstilbestrol (DES) and Cancer

    MedlinePlus

    ... Genetics Services Directory Cancer Prevention Overview Research Diethylstilbestrol (DES) and Cancer On This Page What is DES? ... outlined in the table below. Fertility Problems in DES Daughters ( 7 ) Fertility Complication Hazard Ratio Percent Cumulative ...

  3. Des recommandations probantes pour surveiller l’innocuité des antipsychotiques de deuxième génération chez les enfants et les adolescents

    PubMed Central

    Pringsheim, Tamara; Panagiotopoulos, Constadina; Davidson, Jana; Ho, Josephine

    2012-01-01

    HISTORIQUE : Au Canada, l’utilisation d’antipsychotiques, notamment les antipsychotiques de deuxième génération (ADG), a augmenté de façon considérable depuis cinq ans chez les enfants ayant des troubles de santé mentale. Ces médicaments ont le potentiel de causer de graves complications métaboliques et neurologiques lorsqu’on les utilise de manière chronique. OBJECTIF : Synthétiser les données probantes relatives aux effets secondaires métaboliques et neurologiques précis associés à l’usage d’ADG chez les enfants et fournir des recommandations probantes sur la surveillance de ces effets secondaires. MÉTHODOLOGIE : Les auteurs ont procédé à une analyse systématique des essais cliniques contrôlés des ADG auprès d’enfants. Ils ont fait des recommandations à l’égard de la surveillance de l’innocuité des ADG d’après un modèle de classification fondé sur le système GRADE (système de notation de l’évaluation et de l’élaboration des recommandations). Lorsque les données probantes n’étaient pas suffisantes, ils fondaient leurs recommandations sur le consensus et l’avis d’experts. Un groupe consensuel multidisciplinaire a analysé toutes les données probantes pertinentes et est parvenu à un consensus à l’égard des recommandations. RÉSULTATS : Les recommandations probantes portant sur la surveillance de l’innocuité des ADG figurent dans les présentes lignes directrices. Les auteurs indiquent la qualité des recommandations relatives à des examens physiques et tests de laboratoire précis à l’égard de chaque ADG à des moments déterminés. CONCLUSION : De multiples essais aléatoires et contrôlés ont permis d’évaluer l’efficacité de bon nombre des ADG utilisés pour traiter les troubles de santé mentale en pédiatrie. Toutefois, leurs avantages ne sont pas sans risques : on observe à la fois des effets secondaires métaboliques et neurologiques chez les enfants traités au moyen d’ADG. Le risque de prise de poids, d’augmentation de l’indice de masse corporelle et de taux lipidiques anormaux est plus élevé à l’utilisation d’olanzapine, suivie de la clozapine et de la quétiapine. Quant au risque d’effets secondaires neurologiques des traitements, il est plus élevé à l’utilisation de rispéridone, d’olanzapine et d’aripiprazole. Des interventions de surveillance pertinentes des effets secondaires amélioreront la qualité des soins des enfants traités à l’aide de ces médicaments. PMID:24082813

  4. Etude aerodynamique d'un jet turbulent impactant une paroi concave

    NASA Astrophysics Data System (ADS)

    LeBlanc, Benoit

    Etant donne la demande croissante de temperatures elevees dans des chambres de combustion de systemes de propulsions en aerospatiale (turbomoteurs, moteur a reaction, etc.), l'interet dans le refroidissement par jets impactant s'est vu croitre. Le refroidissement des aubes de turbine permet une augmentation de temperature de combustion, ce qui se traduit en une augmentation de l'efficacite de combustion et donc une meilleure economie de carburant. Le transfert de chaleur dans les au bages est influence par les aspects aerodynamiques du refroidissement a jet, particulierement dans le cas d'ecoulements turbulents. Un manque de comprehension de l'aerodynamique a l'interieur de ces espaces confinees peut mener a des changements de transfert thermique qui sont inattendus, ce qui augmente le risque de fluage. Il est donc d'interet pour l'industrie aerospatiale et l'academie de poursuivre la recherche dans l'aerodynamique des jets turbulents impactant les parois courbes. Les jets impactant les surfaces courbes ont deja fait l'objet de nombreuses etudes. Par contre des conditions oscillatoires observees en laboratoire se sont averees difficiles a reproduire en numerique, puisque les structures d'ecoulements impactants des parois concaves sont fortement dependantes de la turbulence et des effets instationnaires. Une etude experimentale fut realisee a l'institut PPRIME a l'Universite de Poitiers afin d'observer le phenomene d'oscillation dans le jet. Une serie d'essais ont verifie les conditions d'ecoulement laminaires et turbulentes, toutefois le cout des essais experimentaux a seulement permis d'avoir un apercu du phenomene global. Une deuxieme serie d'essais fut realisee numeriquement a l'Universite de Moncton avec l'outil OpenFOAM pour des conditions d'ecoulement laminaire et bidimensionnel. Cette etude a donc comme but de poursuivre l'enquete de l'aerodynamique oscillatoire des jets impactant des parois courbes, mais pour un regime d'ecoulement transitoire, turbulent, tridimensionnel. Les nombres de Reynolds utilises dans l'etude numerique, bases sur le diametre du jet lineaire observe, sont de Red = 3333 et 6667, consideres comme etant en transition vers la turbulence. Dans cette etude, un montage numerique est construit. Le maillage, le schema numerique, les conditions frontiere et la discretisation sont discutes et choisis. Les resultats sont ensuite valides avec des donnees turbulentes experimentales. En modelisation numerique de turbulence, les modeles de Moyennage Reynolds des Equations Naviers Stokes (RANS) presentent des difficultes avec des ecoulements instationnaires en regime transitionnel. La Simulation des Grandes Echelles (LES) presente une solution plus precise, mais au cout encore hors de portee pour cette etude. La methode employee pour cette etude est la Simulation des Tourbillons Detaches (DES), qui est un hybride des deux methodes (RANS et LES). Pour analyser la topologie de l'ecoulement, la decomposition des modes propres (POD) a ete egalement ete effectuee sur les resultats numeriques. L'etude a demontre d'abord le temps de calcul relativement eleve associe a des essais DES pour garder le nombre de Courant faible. Les resultats numeriques ont cependant reussi a reproduire correctement le basculement asynchrone observe dans les essais experimentaux. Le basculement observe semble etre cause par des effets transitionnels, ce qui expliquerait la difficulte des modeles RANS a correctement reproduire l'aerodynamique de l'ecoulement. L'ecoulement du jet, a son tour, est pour la plupart du temps tridimensionnel et turbulent sauf pour de courtes periodes de temps stable et independant de la troisieme dimension. L'etude topologique de l'ecoulement a egalement permit la reconaissances de structures principales sousjacentes qui etaient brouillees par la turbulence. Mots cles : jet impactant, paroi concave, turbulence, transitionnel, simulation des tourbillons detaches (DES), OpenFOAM.

  5. Relations de Dispersion et Diffusion des Glueballs et des Mesons dans la Theorie de Jauge U(1)(2+1) Compacte

    NASA Astrophysics Data System (ADS)

    Ahmed, Chaara El Mouez

    Nous avons etudie les relations de dispersion et la diffusion des glueballs et des mesons dans le modele U(1)_{2+1} compact. Ce modele a ete souvent utilise comme un simple modele de la chromodynamique quantique (QCD), parce qu'il possede le confinement ainsi que les etats de glueballs. Par contre, sa structure mathematique est beaucoup plus simple que la QCD. Notre methode consiste a diagonaliser l'Hamiltonien de ce modele dans une base appropriee de graphes et sur reseau impulsion, afin de generer les relations de dispersion des glueballs et des mesons. Pour la diffusion, nous avons utilise la methode dependante du temps pour calculer la matrice S et la section efficace de diffusion des glueballs et des mesons. Les divers resultats obtenus semblent etre en accord avec les travaux anterieurs de Hakim, Alessandrini et al., Irving et al., qui eux, utilisent plutot la theorie des perturbations en couplage fort, et travaillent sur un reseau espace-temps.

  6. [Isolation, identification and characterization of a diethylstilbestrol-degrading bacterial strain Serratia sp].

    PubMed

    Xu, Ran-Fang; Sun, Min-Xia; Liu, Juan; Wang, Hong; Li, Xin; Zhu, Xue-Zhu; Ling, Wan-Ting

    2014-08-01

    Utilizing the diethylstilbestrol (DES)-degrading bacteria to biodegrade DES is a most reliable technique for cleanup of DES pollutants from the environment. However, little information is available heretofore on the isolation of DES-degrading bacteria and their DES removal performance in the environment. A novel bacterium capable of degrading DES was isolated from the activated sludge of a wastewater treatment plant. According to its morphology, physiochemical characteristics, and 16S rDNA sequence analysis, this strain was identified as Serratia sp.. The strain was an aerobic bacterium, and it could degrade 68.3% of DES (50 mg x L(-1)) after culturing for 7 days at 30 degrees C, 150 r x min(-1) in shaking flasks. The optimal conditions for DES biodegradation by the obtained strain were 30 degrees C, 40-60 mg x L(-1) DES, pH 7.0, 5% of inoculation volume, 0 g x L(-1) of added NaCl, and 10 mL of liquid medium volume in 100 mL flask.

  7. Small lung cancers: improved detection by use of bone suppression imaging--comparison with dual-energy subtraction chest radiography.

    PubMed

    Li, Feng; Engelmann, Roger; Pesce, Lorenzo L; Doi, Kunio; Metz, Charles E; Macmahon, Heber

    2011-12-01

    To determine whether use of bone suppression (BS) imaging, used together with a standard radiograph, could improve radiologists' performance for detection of small lung cancers compared with use of standard chest radiographs alone and whether BS imaging would provide accuracy equivalent to that of dual-energy subtraction (DES) radiography. Institutional review board approval was obtained. The requirement for informed consent was waived. The study was HIPAA compliant. Standard and DES chest radiographs of 50 patients with 55 confirmed primary nodular cancers (mean diameter, 20 mm) as well as 30 patients without cancers were included in the observer study. A new BS imaging processing system that can suppress the conspicuity of bones was applied to the standard radiographs to create corresponding BS images. Ten observers, including six experienced radiologists and four radiology residents, indicated their confidence levels regarding the presence or absence of a lung cancer for each lung, first by using a standard image, then a BS image, and finally DES soft-tissue and bone images. Receiver operating characteristic (ROC) analysis was used to evaluate observer performance. The average area under the ROC curve (AUC) for all observers was significantly improved from 0.807 to 0.867 with BS imaging and to 0.916 with DES (both P < .001). The average AUC for the six experienced radiologists was significantly improved from 0.846 with standard images to 0.894 with BS images (P < .001) and from 0.894 to 0.945 with DES images (P = .001). Use of BS imaging together with a standard radiograph can improve radiologists' accuracy for detection of small lung cancers on chest radiographs. Further improvements can be achieved by use of DES radiography but with the requirement for special equipment and a potential small increase in radiation dose. © RSNA, 2011.

  8. Fast Plasma Instrument for MMS: Simulation Results

    NASA Technical Reports Server (NTRS)

    Figueroa-Vinas, Adolfo; Adrian, Mark L.; Lobell, James V.; Simpson, David G.; Barrie, Alex; Winkert, George E.; Yeh, Pen-Shu; Moore, Thomas E.

    2008-01-01

    Magnetospheric Multiscale (MMS) mission will study small-scale reconnection structures and their rapid motions from closely spaced platforms using instruments capable of high angular, energy, and time resolution measurements. The Dual Electron Spectrometer (DES) of the Fast Plasma Instrument (FPI) for MMS meets these demanding requirements by acquiring the electron velocity distribution functions (VDFs) for the full sky with high-resolution angular measurements every 30 ms. This will provide unprecedented access to electron scale dynamics within the reconnection diffusion region. The DES consists of eight half-top-hat energy analyzers. Each analyzer has a 6 deg. x 11.25 deg. Full-sky coverage is achieved by electrostatically stepping the FOV of each of the eight sensors through four discrete deflection look directions. Data compression and burst memory management will provide approximately 30 minutes of high time resolution data during each orbit of the four MMS spacecraft. Each spacecraft will intelligently downlink the data sequences that contain the greatest amount of temporal structure. Here we present the results of a simulation of the DES analyzer measurements, data compression and decompression, as well as ground-based analysis using as a seed re-processed Cluster/PEACE electron measurements. The Cluster/PEACE electron measurements have been reprocessed through virtual DES analyzers with their proper geometrical, energy, and timing scale factors and re-mapped via interpolation to the DES angular and energy phase-space sampling measurements. The results of the simulated DES measurements are analyzed and the full moments of the simulated VDFs are compared with those obtained from the Cluster/PEACE spectrometer using a standard quadrature moment, a newly implemented spectral spherical harmonic method, and a singular value decomposition method. Our preliminary moment calculations show a remarkable agreement within the uncertainties of the measurements, with the results obtained by the Cluster/PEACE electron spectrometers. The data analyzed was selected because it represented a potential reconnection event as currently published.

  9. Topical administration of Esculetin as a potential therapy for experimental dry eye syndrome.

    PubMed

    Jiang, D; Liu, X; Hu, J

    2017-12-01

    PurposeIn this study, we investigated the therapeutic effects of topical Esculetin for dry eye rabbits through the ocular tests, inflammatory factor levels and specific phosphorylated protein expressions of ERK1/2 singnal pathway.Patients and methodsThirty-two healthy adult male New Zealand white rabbits were chosen for the study. DES models were established after removing of the main lacrimal gland, Harderian gland and nictitating membrane in the left eyes and randomly divided into group DES control, group CsA, group Esculetin and group Esculetin combined with CsA (C&E), meanwhile the right eyes served as group Normal control. Schirmer's I tests, fluorescein scores, goblet cell densities, inflammatory cytokines IL-1α,IL-1β,TNF-αlevels were observed by slit-lamp microscope, conjunctival impression cytology and ELISA essay at week 0, 1, 2, 4, 8. Phosphorylated-ERK1/2 expressions were detected in Western blot analysis at week 8.ResultsAfter induction of DES, aqueous tear production and goblet cell density were decreased, FL score was much higher in group DES control throughout the study (P<0.05). Both topical Esculetin and Esculetin combing CsA increased the SIT values (10±1 mm, 14±3 mm, P<0.05) and goblet cell densities (77±12/HP, 92±12/HP, P<0.05), decreased FL scores (7.48±0.33, 5.09±0.24, P<0.05) at week 8. Alternations of IL-1α,IL-1β,TNF-αlevels had similar trend. In Western blot analysis, downregulations of p-ERK1/2 were observed in therapy groups when compared with group DES control and the most decreasing was found in group C&E (P<0.05).ConclusionTopical Esculetin improved DES symptoms, downregulated the inflammatory cytokine expressions, suppressed the ERK1/2 pathway and enhanced the therapeutic effect of CsA.

  10. Les bons conseils de la naissance à la maternelle

    PubMed Central

    Rourke, Leslie; Leduc, Denis; Constantin, Evelyn; Carsley, Sarah; Rourke, James; Li, Patricia

    2013-01-01

    Résumé Objectif Donner un aperçu de la version 2011 du Relevé postnatal Rourke (RPR), qui comporte aussi des nouveautés dans son site web et de nouvelles initiatives connexes et qui intègre les données des ouvrages scientifiques récents sur les soins de santé préventifs à l’intention des enfants de 0 à 5 ans. Qualité des données À l’instar des versions antérieures du RPR, la nouvelle édition présente des recommandations identifiées comme se fondant sur des preuves suffisantes, acceptables ou consensuelles, selon les classifications adoptées par le Groupe d’étude canadien sur les soins de santé préventifs en 2011. Message principal De nouveaux renseignements et des recommandations sont présentés concernant la surveillance de la croissance, la nutrition et la vaccination contre la varicelle, les pneumocoques, les méningocoques et le rotavirus. Il y a maintenant de bonnes données probantes en faveur de l’adaptation canadienne des courbes de croissance de l’Organisation mondiale de la Santé, du dépistage universel des problèmes d’audition chez le nouveau-né et du recours à des stratégies de réduction de la douleur liée à la vaccination. On a mis à jour les conseils anticipatoires concernant la sécurité durant le sommeil, la supervision de la santé des enfants en foyer d’accueil, le trouble du spectre de l’alcoolisation fœtale, les facteurs de risque nécessitant le dépistage du plomb et de l’anémie, les soins dentaires et la santé buccale. Parmi les nouvelles rubriques dans le site web du RPR, on peut mentionner une section présentant des ressources pour les parents, des modifications à l’intention de populations particulières, comme les personnes vivant au Nunavut, une version du RPR qui met en évidence en un coup d’œil les modifications à la version de 2009 et une expansion de la fonction d’exploration du RPR accompagnée des hyperliens connexes menant aux renseignements pertinents. On peut aussi avoir accès au RPR sous forme d’une page par visite. Le Collège des médecins de famille du Canada et la Société canadienne de pédiatrie ont donné leur aval au RPR de 2011. Les versions nationale et ontarienne sont disponibles en français et en anglais. Conclusion Le RPR de 2011 est un outil pratique, mis à jour, fondé sur des données probantes de transposition du savoir concernant les soins de santé préventifs aux enfants de la naissance à l’âge de 5 ans. Il propose des ressources exhaustives dans le web à l’intention des professionnels de la santé, des étudiants, des résidents et des parents.

  11. Controle optique de qubits lies a des centres isoelectroniques d'azote dans le GaAs

    NASA Astrophysics Data System (ADS)

    Ethier-Majcher, Gabriel

    Le traitement de l'information quantique est un domaine de recherche actuellement en pleine effervescence car il laisse entrevoir une revolution dans notre facon de traiter et d'echanger de l'information. D'une part, l'ordinateur quantique promet de resoudre des problemes comme la factorisation d'un polynome de facon beaucoup plus efficace qu'un ordinateur classique. D'autre part, les communications quantiques promettent l'echange d'information de facon fondamentalement inviolable. Afin de tirer pleinement profit de ces nouvelles technologies, il sera avantageux de construire des reseaux quantiques. Dans un tel reseau, des processeurs quantiques, les noeuds, seront connectes par des photons voyageant dans des fibres optiques. Les reseaux quantiques permettront de deployer les communications quantiques a grande echelle et de creer des super-ordinateurs quantiques. La realisation de reseaux quantiques necessitera des interfaces optiques pouvant echanger l'information de facon coherente entre un qubit (bit d'information quantique) et un photon. L'implementation de telles interfaces dans un systeme physique s'avere un important defi scientifique et technologique. Or, les systemes actuellement envisages a cette fin souffrent d'un faible couplage avec la lumiere ou encore de grandes inhomogeneites, constituant des obstacles a la realisation de reseaux a grande echelle. Dans cette these, le potentiel des centres isoelectroniques pour realiser des interfaces optiques est evalue. Deux types de qubits lies a des paires d'azote dans le GaAs sont consideres : les qubits excitoniques et les qubits de spin electronique, controlables par l'intermediaire d'excitons charges. Le controle optique complet des qubits excitoniques est demontre, ce qui constitue la premiere realisation du genre dans les centres isoelectroniques. L'observation d'excitons charges dans ce systeme, liant a la fois des trous lourds et des trous legers, laisse entrevoir de nouvelles possibilites afin de manipuler des spins electroniques. Les excitons et excitons charges lies aux paires d'azote sont etudies par la photoluminescence resolue spatialement. Le controle des qubits excitoniques est realisee a l'aide d'impulsions laser resonantes avec un etat excitonique et l'etat du qubit est lu par sa fluorescence en resonance. Une experience de rotations de Rabi est realisee pour demontrer un controle sur la population du qubit. Cette experience permet d'extraire un moment dipolaire moyen de 27 D pour l'exciton.

  12. Caracterisation des proprietes acoustiques des materiaux poreux a cellules ouvertes et a matrice rigide ou souple

    NASA Astrophysics Data System (ADS)

    Salissou, Yacoubou

    L'objectif global vise par les travaux de cette these est d'ameliorer la caracterisation des proprietes macroscopiques des materiaux poreux a structure rigide ou souple par des approches inverses et indirectes basees sur des mesures acoustiques faites en tube d'impedance. La precision des approches inverses et indirectes utilisees aujourd'hui est principalement limitee par la qualite des mesures acoustiques obtenues en tube d'impedance. En consequence, cette these se penche sur quatre problemes qui aideront a l'atteinte de l'objectif global precite. Le premier probleme porte sur une caracterisation precise de la porosite ouverte des materiaux poreux. Cette propriete en est une de passage permettant de lier la mesure des proprietes dynamiques acoustiques d'un materiau poreux aux proprietes effectives de sa phase fluide decrite par les modeles semi-phenomenologiques. Le deuxieme probleme traite de l'hypothese de symetrie des materiaux poreux selon leur epaisseur ou un index et un critere sont proposes pour quantifier l'asymetrie d'un materiau. Cette hypothese est souvent source d'imprecision des methodes de caracterisation inverses et indirectes en tube d'impedance. Le critere d'asymetrie propose permet ainsi de s'assurer de l'applicabilite et de la precision de ces methodes pour un materiau donne. Le troisieme probleme vise a mieux comprendre le probleme de transmission sonore en tube d'impedance en presentant pour la premiere fois un developpement exact du probleme par decomposition d'ondes. Ce developpement permet d'etablir clairement les limites des nombreuses methodes existantes basees sur des tubes de transmission a 2, 3 ou 4 microphones. La meilleure comprehension de ce probleme de transmission est importante puisque c'est par ce type de mesures que des methodes permettent d'extraire successivement la matrice de transfert d'un materiau poreux et ses proprietes dynamiques intrinseques comme son impedance caracteristique et son nombre d'onde complexe. Enfin, le quatrieme probleme porte sur le developpement d'une nouvelle methode de transmission exacte a 3 microphones applicable a des materiaux ou systemes symetriques ou non. Dans le cas symetrique, on montre que cette approche permet une nette amelioration de la caracterisation des proprietes dynamiques intrinseques d'un materiau. Mots cles. materiaux poreux, tube d'impedance, transmission sonore, absorption sonore, impedance acoustique, symetrie, porosite, matrice de transfert.

  13. Current State of Bioabsorbable Polymer-Coated Drug-Eluting Stents

    PubMed Central

    Akinapelli, Abhilash; Chen, Jack P.; Roy, Kristine; Donnelly, Joseph; Dawkins, Keith; Huibregtse, Barbara; Hou, Dongming

    2017-01-01

    Drug-eluting stents (DES) have been shown to significantly reduce clinical and angiograph-ic restenosis compared to bare metal stents (BMS). The polymer coatings on DES elute antiproliferative drugs to inhibit intimal proliferation and prevent restenosis after stent implantation. Permanent poly-mers which do not degrade in vivo may increase the likelihood of stent-related delayed arterial healing or polymer hypersensitivity. In turn, these limitations may contribute to an increased risk of late clinical events. Intuitively, a polymer which degrades after completion of drug release, leaving an inert metal scaffold in place, may improve arterial healing by removing a chronic source of inflammation, neoath-erosclerosis, and/or late thrombosis. In this way, a biodegradable polymer may reduce late ischemic events. Additionally, improved healing after stent implantation could reduce the requirement for long-term dual antiplatelet therapy and the associated risk of bleeding and cost. This review will focus on bioabsorbable polymer-coated DES currently being evaluated in clinical trials.

  14. Ataque de nervios: relationship to anxiety sensitivity and dissociation predisposition.

    PubMed

    Hinton, Devon E; Chong, Roberto; Pollack, Mark H; Barlow, David H; McNally, Richard J

    2008-01-01

    We investigated the relative importance of "fear of arousal symptoms" (i.e., anxiety sensitivity) and "dissociation tendency" in generating ataque de nervios. Puerto Rican patients attending an outpatient psychiatric clinic were assessed for ataque de nervios frequency in the previous month, and they completed the Anxiety Sensitivity Index (ASI) and the Dissociation Experiences Scale (DES). ASI scores were especially high in the ataque-positive group (M=41.6, SD=12.8) as compared with the ataque-negative group (M=27.2, SD=11.7), t(2, 68)=4.6, P<.001. Among the whole sample (N=70), in a logistic regression analysis, the ASI significantly predicted (odds ratio=2.6) the presence of ataque de nervios, but the DES did not. In a linear regression analysis, ataque severity was significantly predicted by both the ASI (beta=.46) and the DES (beta=.29). The theoretical and clinical implications of the strong relationship of the ASI to ataque severity are discussed.

  15. The origin of absorptive features in the two-dimensional electronic spectra of rhodopsin.

    PubMed

    Farag, Marwa H; Jansen, Thomas L C; Knoester, Jasper

    2018-05-09

    In rhodopsin, the absorption of a photon causes the isomerization of the 11-cis isomer of the retinal chromophore to its all-trans isomer. This isomerization is known to occur through a conical intersection (CI) and the internal conversion through the CI is known to be vibrationally coherent. Recently measured two-dimensional electronic spectra (2DES) showed dramatic absorptive spectral features at early waiting times associated with the transition through the CI. The common two-state two-mode model Hamiltonian was unable to elucidate the origin of these features. To rationalize the source of these features, we employ a three-state three-mode model Hamiltonian where the hydrogen out-of plane (HOOP) mode and a higher-lying electronic state are included. The 2DES of the retinal chromophore in rhodopsin are calculated and compared with the experiment. Our analysis shows that the source of the observed features in the measured 2DES is the excited state absorption to a higher-lying electronic state and not the HOOP mode.

  16. A green deep eutectic solvent dispersive liquid-liquid micro-extraction (DES-DLLME) for the UHPLC-PDA determination of oxyprenylated phenylpropanoids in olive, soy, peanuts, corn, and sunflower oil.

    PubMed

    Ferrone, Vincenzo; Genovese, Salvatore; Carlucci, Maura; Tiecco, Matteo; Germani, Raimondo; Preziuso, Francesca; Epifano, Francesco; Carlucci, Giuseppe; Taddeo, Vito Alessandro

    2018-04-15

    A green dispersive liquid-liquid microextraction (DLLME) using deep eutectic solvent (DES) as the extracting solvent has been developed and applied for the simultaneous quantification of ferulic acid, umbelliferone, boropinic acid, 7-isopentenyloxycoumarin, 4'-geranyloxyferulic acid (GOFA), and auraptene in some vegetable oils using ultra high performance liquid chromatography (UHPLC) with photodiode array detection (PDA). All parameters in the extraction step, including selection and loading of both extracting and dispersing solvents, amount of both extractant and disperser solvent were investigated and optimized. PhAA/TMG DES achieved higher recovery and enrichment factor compared to other DESs. The validated method showed good linearity with correlation coefficients, r 2 >0.9990 for all the analytes. Furthermore, this is the first time that eco-friendly solvents are used for the extraction of oxyprenylated phenylpropanoids and the corresponding extract analyzed with ultra high performance liquid chromatography with photodiode array detection. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Biodegradable-polymer drug-eluting stents vs. bare metal stents vs. durable-polymer drug-eluting stents: a systematic review and Bayesian approach network meta-analysis.

    PubMed

    Kang, Si-Hyuck; Park, Kyung Woo; Kang, Do-Yoon; Lim, Woo-Hyun; Park, Kyung Taek; Han, Jung-Kyu; Kang, Hyun-Jae; Koo, Bon-Kwon; Oh, Byung-Hee; Park, Young-Bae; Kandzari, David E; Cohen, David J; Hwang, Seung-Sik; Kim, Hyo-Soo

    2014-05-01

    The aim of this study was to compare the safety and efficacy of biodegradable-polymer (BP) drug-eluting stents (DES), bare metal stents (BMS), and durable-polymer DES in patients undergoing coronary revascularization, we performed a systematic review and network meta-analysis using a Bayesian framework. Study stents included BMS, paclitaxel-eluting (PES), sirolimus-eluting (SES), endeavor zotarolimus-eluting (ZES-E), cobalt-chromium everolimus-eluting (CoCr-EES), platinium-chromium everolimus-eluting (PtCr-EES), resolute zotarolimus-eluting (ZES-R), and BP biolimus-eluting stents (BP-BES). After a systematic electronic search, 113 trials with 90 584 patients were selected. The principal endpoint was definite or probable stent thrombosis (ST) defined according to the Academic Research Consortium within 1 year. Biodegradable polymer-biolimus-eluting stents [OR, 0.56; 95% credible interval (CrI), 0.33-0.90], SES (OR, 0.53; 95% CrI, 0.38-0.73), CoCr-EES (OR, 0.34; 95% CrI, 0.23-0.52), and PtCr-EES (OR, 0.31; 95% CrI, 0.10-0.90) were all superior to BMS in terms of definite or probable ST within 1 year. Cobalt-chromium everolimus-eluting stents demonstrated the lowest risk of ST of all stents at all times after stent implantation. Biodegradable polymer-biolimus-eluting stents was associated with a higher risk of definite or probable ST than CoCr-EES (OR, 1.72; 95% CrI, 1.04-2.98). All DES reduced the need for repeat revascularization, and all but PES reduced the risk of myocardial infarction compared with BMS. All DESs but PES and ZES-E were superior to BMS in terms of ST within 1 year. Cobalt-chromium everolimus-eluting stents was safer than any DES even including BP-BES. Our results suggest that not only the biodegradability of polymer, but the optimal combination of stent alloy, design, strut thickness, polymer, and drug all combined determine the safety of DES.

  18. Impact of Chloroquine on Viral Load in Breast Milk

    PubMed Central

    Semrau, Katherine; Kuhn, Louise; Kasonde, Prisca; Sinkala, Moses; Kankasa, Chipepo; Shutes, Erin; Vwalika, Cheswa; Ghosh, Mrinal; Aldrovandi, Grace; Thea, Donald M.

    2006-01-01

    Summary The anti-malarial agent chloroquine has activity against HIV. We compared the effect of chloroquine (n = 18) to an anti-malarial agent without known anti-HIV-activity, sulfadoxine-pyrimethamine (n = 12), on breast milk HIV RNA levels among HIV-infected breastfeeding women in Zambia. After adjusting for CD4 count and plasma viral load, chloroquine was associated with a trend towards lower levels of HIV RNA in breast milk compared with sulfadoxine-pyrimethamine (P 0.05). Higher breastmilk viral load was also observed among women receiving presumptive treatment = for symptomatic malaria compared with asymptomatic controls and among controls reporting fever in the prior week. Further research is needed to determine the potential role of chloroquine in prevention of HIV transmission through breastfeeding. Impacte de la chloroquine sur la charge virale dans le lait maternelle La chloroquine, agent antimalarique, a une activité contre le VIH. Nous avons comparé l’effet de la chloroquine à celui d’un autre agent antimalarique, la sulfadoxine-pyrimethamine, dont l’activité sur le VIH n’est pas connue, en mesurant les taux d’ARN de VIH dans le lait maternel de femmes allaitantes infectées par le VIH en Zambie. Après ajustement pour les taux de CD4 et la charge virale dans le plasma, la chloroquine comparée à la sulfadoxine pyrimethamine était associée à une tendance vers des teneurs plus bas en ARN de VIH dans le lait maternel (P = 0,05). Des charges virales plus élevées dans le lait maternel étaient aussi observées chez des femmes recevant un traitement présomptif pour des symptômes de malaria par rapport aux contrôles asymptomatiques et par rapport à des contrôles rapportant de la fièvre durant la première semaine. Des études supplémentaires sont nécessaires pour déterminer le rôle potentiel de la chloroquine dans la prévention de la transmission du VIH par l’allaitement maternel. mots clésVIH, malaria, allaitement maternel, chloroquine, sulfadoxine-pyrimethamine, charge virale du lait maternel, fièvre Impacto de la cloroquina en la carga viral de la leche materna El antimalárico cloroquina tiene actividad frente al VIH. Comparamos el efecto de la cloroquina (n = 18) frente a un antimalárico sin actividad anti-VIH conocida, la sulfadoxina-pirimetamina (n = 12), en los niveles de ARN en la leche materna de mujeres infectadas con VIH, en Zambia. Después de ajustar para recuento de CD4 y la carga viral en plasma, se asoció a la cloroquina con una tendencia hacia menores niveles de ARN del VIH en leche materna, comparado con la sulfadoxina pirimetamina (P = 0.05). También se observó una mayor carga viral en la leche materna de mujeres recibiendo tratamiento presuntivo para malaria sintomática, que en los controles asintomáticos y controles que habáan reportado fiebre la semana anterior. Es necesario realizar más estudios para determinar el papel potencial de la cloroquina en la prevención de la trasmisión de VIH a través de la lactancia materna. palabras claveVIH, malaria, lactancia materna, cloroquina, sulfadoxina pirimetamina, transmisión vertical, leche materna, carga viral, fiebre PMID:16772000

  19. Developpement d'un modele analytique pour l'analyse en elasticite lineaire de champs de deformation et contrainte au sein d'un polycristal. comparaison avec la methode des elements finis =

    NASA Astrophysics Data System (ADS)

    Bretin, Remy

    L'endommagement par fatigue des materiaux est un probleme courant dans de nombreux domaines, dont celui de l'aeronautique. Afin de prevenir la rupture par fatigue des materiaux il est necessaire de determiner leur duree de vie en fatigue. Malheureusement, dues aux nombreuses heterogeneites presentes, la duree de vie en fatigue peut fortement varier entre deux pieces identiques faites dans le meme materiau ayant subi les memes traitements. Il est donc necessaire de considerer ces heterogeneites dans nos modeles afin d'avoir une meilleure estimation de la duree de vie des materiaux. Comme premiere etape vers une meilleure consideration des heterogeneites dans nos modeles, une etude en elasticite lineaire de l'influence des orientations cristallographiques sur les champs de deformations et de contraintes dans un polycristal a ete realisee a l'aide de la methode des elements finis. Des correlations ont pu etre etablies a partir des resultats obtenus, et un modele analytique en elasticite lineaire prenant en compte les distributions d'orientations cristallographiques et les effets de voisinage a pu etre developpe. Ce modele repose sur les bases des modeles d'homogeneisation classique, comme le schema auto-coherent, et reprend aussi les principes de voisinage des automates cellulaires. En prenant pour reference les resultats des analyses elements finis, le modele analytique ici developpe a montre avoir une precision deux fois plus grande que le modele auto-coherent, quel que soit le materiau etudie.

  20. Etudes optiques de nouveaux materiaux laser: Des orthosilicates dopes a l'ytterbium: Le yttrium (lutetium,scandium) pentoxide de silicium

    NASA Astrophysics Data System (ADS)

    Denoyer, Aurelie

    La decouverte et l'elaboration de nouveaux materiaux laser solides suscitent beaucoup d'interet parmi la communaute scientifique. En particulier les lasers dans la gamme de frequence du micron debouchent sur beaucoup d'applications, en telecommunication, en medecine, dans le domaine militaire, pour la, decoupe des metaux (lasers de puissance), en optique non lineaire (doublage de frequence, bistabilite optique). Le plus couramment utilise actuellement est le Nd:YAG dans cette famille de laser, mais des remplacants plus performants sont toujours recherches. Les lasers a base d'Yb3+ possedent beaucoup d'avantages compares aux lasers Nd3+ du fait de leur structure electronique simple et de leur deterioration moins rapide. Parmi les matrices cristallines pouvant accueillir l'ytterbium, les orthosilicates Yb:Y 2SiO5, Yb:Lu2SiO5 et Yb:Sc2SiO 5 se positionnent tres bien, du fait de leur bonne conductivite thermique et du fort eclatement de leur champ cristallin necessaire a l'elaboration de lasers quasi-3 niveaux. De plus l'etude fine et systematique des proprietes microscopiques de nouveaux materiaux s'avere toujours tres interessante du point de vue de la recherche fondamentale, c'est ainsi que de nouveaux modeles sont concus (par exemple pour le champ cristallin) ou que de nouvelles proprietes inhabituelles sont decouvertes, menant a de nouvelles applications. Ainsi d'autres materiaux dopes a l'ytterbium sont connus pour leurs proprietes de couplage electron-phonon, de couplage magnetique, d'emission cooperative ou encore de bistabilite optique, mais ces proprietes n'ont encore jamais ete mises en evidence dans Yb:Y 2SiO5, Yb:Lu2SiO5 et Yb:Sc2SiO 5. Ainsi, cette these a pour but l'etude des proprietes optiques et des interactions microscopiques dans Yb:Y2SiO 5, Yb:Lu2SiO5 et Yb:Sc2SiO5. Nous utilisons principalement les techniques d'absorption IR et de spectroscopie Raman pour determiner les excitations du champ cristallin et les modes de vibration dans le materiau. Des mesures optiques sous champ magnetique ont egalement ete effectuees dans le but de caracteriser le comportement de ces excitations lorsqu'elles sont soumises a l'effet Zeeman. La resonance paramagnetique electronique a permis de completer cette etude de l'eclatement Zeeman suivant toutes les orientations du cristal. Enfin la fluorescence par excitation selective et la fluorescence induite par Raman FT, completent la description des niveaux d'energie et revelent l'existence d'emission cooperative de deux ions Yb3+ et de transferts d'energie. Les resultats de cette these apportent une contribution originale dans le domaine des nouveaux materiaux lasers par l'etude et la comprehension des interactions fines et des proprietes microscopiques d'un materiau en particulier. Ils debouchent a la fois sur des applications possibles dans le domaine de l'optique et des lasers, et sur la comprehension d'aspects fondamentaux. Cette these a prouve l'interet de ces matrices pour leur utilisation comme lasers solides: un fort eclatement du champ cristallin favorable a l'elaboration de laser quasi-3 niveaux, et de larges bandes d'absorption (dues a un fort couplage electron-phonon et a des raies satellites causees par une interaction d'echange entre deux ions Yb3+) qui permettent la generation d'impulsions laser ultra-courtes, l'accordabilite du laser, etc. De plus la miniaturisation des lasers est possible pour l'optique integree grace a des couches minces synthetisees par epitaxie en phase liquide dont nous avons demontre la tres bonne qualite structurale et l'ajustement possible de certains parametres. Nous avons reconstruit le tenseur g du niveau fondamental (qui donne des informations precieuses sur les fonctions d'onde), ceci dans le but d'aider les theoriciens a concevoir un modele de champ cristallin valide. Plusieurs mecanismes de transferts d'energie ont ete mis en evidence: un mecanisme de relaxation d'un site vers l'autre, un mecanisme d'emission cooperative, et un mecanisme d'excitation de l'Yb3+ par le Tm3+ (impurete presente dans le materiau). Ces transferts sont plutot nefastes pour la fabrication d'un laser mais sont interessants pour l'optique non lineaire (doublage de frequence, memoires optiques). Enfin, plusieurs elements (le couplage magnetique de paire, le couplage electron-phonon et l'emission cooperative) nous ont permis de conclure sur le caractere covalent de la matrice. Nous avons d'ailleurs demontre ici le role de la covalence dans l'emission cooperative, transition habituellement attribuee aux interactions multipolaires electriques.

  1. Caracterisation environnementale des emissions atmospheriques d'une source fixe et creation d'un outil de gestion dynamique =

    NASA Astrophysics Data System (ADS)

    Fournier, Marie-Claude

    Une caracterisation des emissions atmospheriques provenant des sources fixes en operation, alimentees au gaz et a l'huile legere, a ete conduite aux installations visees des sites no.1 et no.2. La caracterisation et les calculs theoriques des emissions atmospheriques aux installations des sites no.1 et no.2 presentent des resultats qui sont en dessous des valeurs reglementaires pour des conditions d'operation normales en periode hivernale et par consequent, a de plus fortes demandes energetiques. Ainsi, pour une demande energetique plus basse, le taux de contaminants dans les emissions atmospheriques pourrait egalement etre en dessous des reglementations municipales et provinciales en vigueur. Dans la perspective d'une nouvelle reglementation provinciale, dont les termes sont discutes depuis 2005, il serait souhaitable que le proprietaire des infrastructures visees participe aux echanges avec le Ministere du Developpement Durable, de l'Environnement et des Parcs (MDDEP) du Quebec. En effet, meme si le principe de droit acquis permettrait d'eviter d'etre assujetti a la nouvelle reglementation, l'application de ce type de principe ne s'inscrit pas dans ceux d'un developpement durable. L'âge avance des installations etudiees implique la planification d'un entretien rigoureux afin d'assurer les conditions optimales de combustion en fonction du type de combustible. Des tests de combustion sur une base reguliere sont donc recommandes. Afin de supporter le processus de suivi et d'evaluation de la performance environnementale des sources fixes, un outil d'aide a la gestion de l'information environnementale a ete developpe. Dans ce contexte, la poursuite du developpement d'un outil d'aide a la gestion de l'information environnementale faciliterait non seulement le travail des personnes affectees aux inventaires annuels mais egalement le processus de communication entre les differents acteurs concernes tant intra- qu'inter-etablissement. Cet outil serait egalement un bon moyen pour sensibiliser le personnel a leur consommation energetique ainsi qu'a leur role dans la lutte contre les emissions polluantes et les gaz a effets de serre. En outre, ce type d'outil a pour principale fonction de generer des rapports dynamiques pouvant s'adapter a des besoins precis. Le decoupage coherent de l'information associe a un developpement par modules offre la perspective d'application de l'outil pour d'autres types d'activites. Dans ce cas, il s'agit de definir la part commune avec les modules existants et planifier les activites de developpement specifiques selon la meme demarche que celle presentee dans le present document.

  2. Optimisation des trajectoires verticales par la methode de la recherche de l'harmonie =

    NASA Astrophysics Data System (ADS)

    Ruby, Margaux

    Face au rechauffement climatique, les besoins de trouver des solutions pour reduire les emissions de CO2 sont urgentes. L'optimisation des trajectoires est un des moyens pour reduire la consommation de carburant lors d'un vol. Afin de determiner la trajectoire optimale de l'avion, differents algorithmes ont ete developpes. Le but de ces algorithmes est de reduire au maximum le cout total d'un vol d'un avion qui est directement lie a la consommation de carburant et au temps de vol. Un autre parametre, nomme l'indice de cout est considere dans la definition du cout de vol. La consommation de carburant est fournie via des donnees de performances pour chaque phase de vol. Dans le cas de ce memoire, les phases d'un vol complet, soit, une phase de montee, une phase de croisiere et une phase de descente, sont etudies. Des " marches de montee " etaient definies comme des montees de 2 000ft lors de la phase de croisiere sont egalement etudiees. L'algorithme developpe lors de ce memoire est un metaheuristique, nomme la recherche de l'harmonie, qui, concilie deux types de recherches : la recherche locale et la recherche basee sur une population. Cet algorithme se base sur l'observation des musiciens lors d'un concert, ou plus exactement sur la capacite de la musique a trouver sa meilleure harmonie, soit, en termes d'optimisation, le plus bas cout. Differentes donnees d'entrees comme le poids de l'avion, la destination, la vitesse de l'avion initiale et le nombre d'iterations doivent etre, entre autre, fournies a l'algorithme pour qu'il soit capable de determiner la solution optimale qui est definie comme : [Vitesse de montee, Altitude, Vitesse de croisiere, Vitesse de descente]. L'algorithme a ete developpe a l'aide du logiciel MATLAB et teste pour plusieurs destinations et plusieurs poids pour un seul type d'avion. Pour la validation, les resultats obtenus par cet algorithme ont ete compares dans un premier temps aux resultats obtenus suite a une recherche exhaustive qui a utilisee toutes les combinaisons possibles. Cette recherche exhaustive nous a fourni l'optimal global; ainsi, la solution de notre algorithme doit se rapprocher le plus possible de la recherche exhaustive afin de prouver qu'il donne des resultats proche de l'optimal global. Une seconde comparaison a ete effectuee entre les resultats fournis par l'algorithme et ceux du Flight Management System (FMS) qui est un systeme d'avionique situe dans le cockpit de l'avion fournissant la route a suivre afin d'optimiser la trajectoire. Le but est de prouver que l'algorithme de la recherche de l'harmonie donne de meilleurs resultats que l'algorithme implemente dans le FMS.

  3. Les soins aux enfants et aux adolescents des familles des militaires canadiens : les considérations particulières

    PubMed Central

    Rowan-Legg, Anne

    2017-01-01

    Résumé Les familles des militaires font face à de nombreux facteurs de stress, tels que les réinstallations fréquentes, les longues pério des de séparation familiale, l’isolement géographique du réseau de soutien de la famille élargie et le déploiement en zones très dangereuses. Les enfants et les adolescents des familles des militaires vivent les mêmes trajectoires développementales et motivationnelles que leurs homologues civils, mais ils sont également aux prises avec des pressions et des facteurs de stress liés à leur développement qui sont inhabituels et qui leur sont imposés par les exigences de la vie militaire. Les effets de la vie militaire sur les familles et les enfants commencent à être admis et mieux caractérisés. Il est essentiel de comprendre les préoccupations propres aux enfants et aux adolescents des familles des militaires et de mobiliser les ressources nécessaires pour les soutenir afin de répondre à leurs besoins en matière de santé.

  4. Mouse hypospadias: A critical examination and definition.

    PubMed

    Sinclair, Adriane Watkins; Cao, Mei; Shen, Joel; Cooke, Paul; Risbridger, Gail; Baskin, Laurence; Cunha, Gerald R

    2016-12-01

    Hypospadias is a common malformation whose etiology is based upon perturbation of normal penile development. The mouse has been previously used as a model of hypospadias, despite an unacceptably wide range of definitions for this malformation. The current paper presents objective criteria and a definition of mouse hypospadias. Accordingly, diethylstilbestrol (DES) induced penile malformations were examined at 60 days postnatal (P60) in mice treated with DES over the age range of 12 days embryonic to 20 days postnatal (E12-P20). DES-induced hypospadias involves malformation of the urethral meatus, which is most severe in DES E12-P10, DES P0-P10 and DES P5-P15 groups, and less so or absent in the other treatment groups. A frenulum-like ventral tether between the penis and the prepuce was seen in the most severely affected DES-treated mice. Internal penile morphology was also altered in the DES E12-P10, DES P0-P10 and DES P5-P15 groups (with little effect in the other DES treatment groups). Thus, adverse effects of DES are a function of the period of DES treatment and most severe in the P0-P10 period. In "estrogen mutant mice" (NERKI, βERKO, αERKO and AROM+) hypospadias was only seen in AROM+ male mice having genetically-engineered elevation is serum estrogen. Significantly, mouse hypospadias was only seen distally at and near the urethral meatus where epithelial fusion events are known to take place and never in the penile midshaft, where urethral formation occurs via an entirely different morphogenetic process. Copyright © 2016 International Society of Differentiation. Published by Elsevier B.V. All rights reserved.

  5. Lignes directrices sur la prise en charge en soins primaires des céphalées chez l’adulte

    PubMed Central

    Becker, Werner J.; Findlay, Ted; Moga, Carmen; Scott, N. Ann; Harstall, Christa; Taenzer, Paul

    2015-01-01

    Résumé Objectif Accroître l’utilisation d’approches éclairées par des données probantes pour diagnostiquer, investiguer et traiter en soins primaires les céphalées des patients. Qualité des données Une recherche documentaire exhaustive a été effectuée pour trouver des lignes directrices et des révisions systématiques publiées entre janvier 2000 et mai 2011. La grille d’évaluation de la qualité des recommandations pour la pratique clinique AGREE a servi à l’analyse critique des lignes directrices. Les 6 guides de pratique clinique de la plus grande qualité ont servi de base dans le processus d’adaptation. Message principal Un groupe d’élaboration multidisciplinaire de professionnels des soins primaires ont formulé 91 recommandations précises à l’aide d’un processus consensuel. Les recommandations portent sur le diagnostic, l’investigation et la prise en charge de la migraine, de la céphalée de tension, de la céphalée due à une surmédication et de la céphalée vasculaire de Horton. Conclusion Un guide de pratique clinique adapté au contexte des soins de santé au Canada a été produit en suivant un processus d’adaptation de lignes directrices dans le but d’aider les professionnels de toutes les disciplines des soins primaires à dispenser des soins éclairés par des données probantes aux patients souffrant de céphalées.

  6. Les Cicatrices Retractiles Post-Brulures Du Membre Inferieur Chez L’Enfant

    PubMed Central

    Sankale, A.A.; Manyacka Ma Nyemb, P.; Coulibaly, N.F.; Ndiaye, A.; Ndoye, M.

    2010-01-01

    Summary Il s'agit d'une étude faisant ressortir les aspects épidémiologiques, cliniques et thérapeutiques des séquelles de brûlures du membre inférieur chez l'enfant, à propos de 42 cas colligés au service de chirurgie infantile de l'Hôpital Aristide Le Dantec (Sénégal). L'âge moyen retrouvé est de 5 ans et 3 mois, et le sex-ratio garçons/filles de 1,8/1. La brûlure thermique est causée par une flamme dans 33% des cas, par un liquide chaud dans 21% des cas, et par des braises dans 21% des cas. Les cicatrices rétractiles intéressent le genou et le creux poplité dans 47% des cas et le pied dans 45% des cas. Elles sont bilatérales dans 21% des cas, et concernent une autre localisation associée dans 21% des cas. Quant aux brides, 21% ont bénéficié d'une chirurgie, avec un délai moyen de 3 ans et 2 mois après la brûlure. Cette procédure chirurgicale consiste en une plastie en Z dans 91% des cas, à laquelle est associée une greffe de peau dans 54% des cas. Une rééducation fonctionnelle est pratiquée chez 54% des opérés. Parallèlement aux données de la littérature, nos résultats montrent que l'optimisation de la prise en charge passe par une meilleure prévention des accidents domestiques et une bonne codification thérapeutique. PMID:21991202

  7. Radar response to crop residue cover and tillage application on postharvest agricultural surfaces

    NASA Astrophysics Data System (ADS)

    McNairn, Heather

    Les informations sur les pratiques de conservation des sols comme le labourage et la gestion des residus de culture sont requises afin d'estimer avec exactitude les risques d'erosion des sols. Quoique les micro-ondes soient sensibles aux conditions d'humidite et aux proprietes geometriques des surfaces, il n'en demeure pas moins que l'on connait encore peu sur la sensibilite des micro-ondes polarisees lineaires ou des parametres polarimetriques du ROS en fonction des caracteristiques des residus. A partir de donnees prises a l'aide d'un diffusometre monte sur un camion en 1996 et lors d'une mission SIR-C menee en 1994, cette recherche a demontre que les micro-ondes sont sensibles a la fois a la quantite et au type de couverture de residus, de meme qu'a la teneur en eau des residus. La reponse des polarisations croisees lineaires et de plusieurs parametres polarimetriques, incluant la hauteur pedestre, a permis d'observer qu'une diffusion volumique importante avait lieu en presence de vegetation senescente qui se tenait debout et pour les champs non laboures. La diffusion de surface dominait cependant pour les champs avec de faibles quantites de residus et des residus plus fins. La recherche a toutefois demontre que des conditions de surface complexes etaient crees par differentes combinaisons de residus et de pratiques de labourage. Par consequent, il faudra attendre que des donnees multi-polarisees ou polarimetriques soient acquises par les capteurs prevus a bord du satellite canadien RADARSAT-2 et du satellite ENVISAT de l'Agence spatiale europeenne avant de pouvoir completement caracteriser les champs apres la recolte.

  8. The desA and desB genes from Clostridium scindens ATCC 35704 encode steroid-17,20-desmolase.

    PubMed

    Devendran, Saravanan; Mythen, Sean M; Ridlon, Jason M

    2018-06-01

    Clostridium scindens is a gut microbe capable of removing the side-chain of cortisol, forming 11β-hydro-xyandrostenedione. A cortisol-inducible operon ( desABCD ) was previously identified in C. scindens ATCC 35704 by RNA-Seq. The desC gene was shown to encode a cortisol 20α-hydroxysteroid dehydrogenase (20α-HSDH). The desD encodes a protein annotated as a member of the major facilitator family, predicted to function as a cortisol transporter. The desA and desB genes are annotated as N-terminal and C-terminal transketolases, respectively. We hypothesized that the DesAB forms a complex and has steroid-17,20-desmolase activity. We cloned the desA and desB genes from C. scindens ATCC 35704 in pETDuet for overexpression in Escherichia coli The purified recombinant DesAB was determined to be a 142 ± 5.4 kDa heterotetramer. We developed an enzyme-linked continuous spectrophotometric assay to quantify steroid-17,20-desmolase. This was achieved by coupling DesAB-dependent formation of 11β-hydroxyandrostenedione with the NADPH-dependent reduction of the steroid 17-keto group by a recombinant 17β-HSDH from the filamentous fungus, Cochliobolus lunatus The pH optimum for the coupled assay was 7.0 and kinetic constants using cortisol as substrate were K m of 4.96 ± 0.57 µM and k cat of 0.87 ± 0.076 min -1 Substrate-specificity studies revealed that rDesAB recognized substrates regardless of 11β-hydroxylation, but had an absolute requirement for 17,21-dihydroxy 20-ketosteroids. Copyright © 2018 Devendran et al.

  9. Adsorption de gaz sur les materiaux microporeux modelisation, thermodynamique et applications

    NASA Astrophysics Data System (ADS)

    Richard, Marc-Andre

    2009-12-01

    Nos travaux sur l'adsorption de gaz dans les materiaux microporeux s'inscrivent dans le cadre des recherches visant a augmenter l'efficacite du stockage de l'hydrogene a bord des vehicules. Notre objectif etait d'etudier la possibilite d'utiliser l'adsorption afin d'ameliorer l'efficacite de la liquefaction de l'hydrogene des systemes a petite echelle. Nous avons egalement evalue les performances d'un systeme de stockage cryogenique de l'hydrogene base sur la physisorption. Comme nous avons affaire a des plages de temperatures particulierement etendues et a de hautes pressions dans la region supercritique du gaz, nous avons du commencer par travailler sur la modelisation et la thermodynamique de l'adsorption. La representation de la quantite de gaz adsorbee en fonction de la temperature et de la pression par un modele semi-empirique est un outil utile pour determiner la masse de gaz adsorbee dans un systeme mais egalement pour calculer les effets thermiques lies a l'adsorption. Nous avons adapte le modele Dubinin-Astakhov (D-A) pour modeliser des isothermes d'adsorption d'hydrogene, d'azote et de methane sur du charbon actif a haute pression et sur une grande plage de temperatures supercritiques en considerant un volume d'adsorption invariant. Avec cinq parametres de regression (incluant le volume d'adsorption Va), le modele que nous avons developpe permet de tres bien representer des isothermes experimentales d'adsorption d'hydrogene (de 30 a 293 K, jusqu'a 6 MPa), d'azote (de 93 a 298 K, jusqu'a 6 MPa) et de methane (de 243 a 333 K, jusqu'a 9 MPa) sur le charbon actif. Nous avons calcule l'energie interne de la phase adsorbee a partir du modele en nous servant de la thermodynamique des solutions sans negliger le volume d'adsorption. Par la suite, nous avons presente les equations de conservation de la niasse et de l'energie pour un systeme d'adsorption et valide notre demarche en comparant des simulations et des tests d'adsorption et de desorption. En plus de l'energie interne, nous avons evalue l'entropie, l'energie differentielle d'adsorption et la chaleur isosterique d'adsorption. Nous avons etudie la performance d'un systeme de stockage d'hydrogene par adsorption pour les vehicules. La capacite de stockage d'hydrogene et les performances thermiques d'un reservoir de 150 L contenant du charbon actif Maxsorb MSC-30(TM) (surface specifique ˜ 3000 m2/g) ont ete etudiees sur une plage de temperatures de 60 a 298 K et a des pressions allant jusqu'a 35 MPa. Le systeme a ete considere de facon globale, sans nous attarder a un design particulier. Il est possible de stocker 5 kg d'hydrogene a des pressions de 7.8, 15.2 et 29 MPa pour des temperatures respectivement de 80, 114 et 172 K, lorsqu'on recupere l'hydrogene residuel a 2.5 bars en le chauffant. La simulation des phenomenes thermiques nous a permis d'analyser le refroidissement necessaire lors du remplissage, le chauffage lors de la decharge et le temps de dormance. Nous avons developpe un cycle de liquefaction de l'hydrogene base sur l'adsorption avec compression mecanique (ACM) et avons evalue sa faisabilite. L'objectif etait d'augmenter sensiblement l'efficacite des systemes de liquefaction de l'hydrogene a petite echelle (moins d'une tonne/jour) et ce, sans en augmenter le cout en capital. Nous avons adapte le cycle de refrigeration par ACM afin qu'il puisse par la suite etre ajoute a un cycle de liquefaction de l'hydrogene. Nous avons ensuite simule des cycles idealises de refrigeration par ACM. Meme dans ces conditions ideales, la refrigeration specifique est faible. De plus, l'efficacite theorique maximale de ces cycles de refrigeration est d'environ 20 a 30% de l'ideal. Nous avons realise experimentalement un cycle de refrigeration par ACM avec le couple azote/charbon actif. (Abstract shortened by UMI.)

  10. Exemples d’utilisation des techniques d’optimisation en calcul de structures de reacteurs

    DTIC Science & Technology

    2003-03-01

    34~ optimisation g~om~trique (architecture fig~e) A la difference du secteur automobile et des avionneurs, la plupart des composants des r~acteurs n...utilise des lois de comportement mat~riaux non lin~aires ainsi que des hypotheses de grands d~placements. L𔄀tude d’optimisation consiste ý minimiser...un disque simple et d~cid6 de s~lectionner trois param~tes qui influent sur la rupture : 1𔄀paisseur de la toile du disque ElI, la hauteur L3 et la

  11. [Outstanding problems of normal and pathological morphology of the diffuse endocrine system].

    PubMed

    Iaglov, V V; Iaglova, N V

    2011-01-01

    The diffuse endocrine system (DES)--a mosaic-cellular endoepithelial gland--is the biggest part of the human endocrine system. Scientists used to consider cells of DES as neuroectodermal. According to modem data cells of DES are different cytogenetic types because they develop from the different embryonic blastophyllum. So that any hormone-active tumors originated from DES of the digestive, respiratory and urogenital system shouldn't be considered as neuroendocrinal tumors. The basic problems of DES morphology and pathology are the creation of scientifically substantiated histogenetic classification of DES tumors.

  12. Technical Status Review Appraisal of the Suitability of Turbulence Models in Flow Calculations (Revue Technique - L’Evaluation de l’Applicabilite des Modeles de Turbulence dans de Calcul des Ecoulements)

    DTIC Science & Technology

    1991-07-01

    wall compared with a smooth wall. layer is due to the molecular diffusivity and to the increase in heat flux is less than the in- the transport by...models in use an Reyon-stmss- is now much , and cosiderable acityw recenly equit (R!) mdek also know ma lela 1 di1w1sed towass tesa; ad dewioplag low...flow relation is used to take into account the dependence of variables are hypothesized for the different zones. the molecular viscosity coefficient

  13. 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.

  14. L’offre des services de vaccination en milieu urbain, au Cameroun: étude de cas du District de Santé de Djoungolo

    PubMed Central

    Ngomba, Armelle Viviane; Kollo, Basile; Bita, André Fouda; Djouma, Fabrice Nembot; Edengue, Jean Marie; Elongue, Marie Josée; Adiogo, Dieudonné

    2016-01-01

    Introduction Les métropoles camerounaises concentrent un nombre croissant d'enfants cibles, non atteints par les services de vaccination de routine. Méthodes Une étude transversale descriptive, basée sur échantillonnage exhaustif des formations sanitaires légales offrant en routine des services de vaccination a été réalisée dans le district de santé de Djoungolo, (ville de Yaoundé). L'évaluation de l'offre des services de vaccination a été calquée sur l'approche « Atteindre Chaque District ». Résultats Des 70 formations sanitaires ayant participé à l'étude, 3 (4,3%) disposaient d'un micro plan actualisé pour la vaccination de routine. Des 63 (89,4%) formations sanitaires possédant un réfrigérateur fonctionnel, 12 (19,0%) vaccinaient au quotidien en stratégie fixe. Cinquante-sept (81,0%) formations sanitaires ne conduisaient pas des sessions de vaccination en stratégies avancées. La participation des membres de la communauté aux activités de vaccination de routine étaient effective dans 1 aire de santé sur les 12 que compte le district. Une courbe de suivi des couvertures vaccinales correctement renseignée étaient disponible dans 6 (8,5%) formations sanitaires. Conclusion L'approche « Atteindre Chaque District » telle que mise en œuvre dans le district de santé de Djoungolo limite l'atteinte d'un maximum d'enfants cibles. L'effectivité d'une micro planification réaliste, la régularité des sessions de vaccination en stratégie fixes et avancées, le suivi des données orienté vers l'action, la redynamisation communautaire en faveur de la vaccination sont des voies d'amélioration des prestations des services de vaccination, dans ce district. PMID:28292168

  15. Cancer du sein au Maroc: profil phénotypique des tumeurs

    PubMed Central

    Khalil, Ahmadaye Ibrahim; Bendahhou, Karima; Mestaghanmi, Houriya; Saile, Rachid; Benider, Abdellatif

    2016-01-01

    Le cancer du sein est le plus fréquent chez la femme et figure parmi les principales causes de mortalité liées au cancer. La curabilité de ce type tumoral est en augmentation, grâce aux programmes de dépistage et aux progrès thérapeutiques, qui ont certes augmenté la survie des patients. Mais des défis restent à relever en rapport avec l’instabilité phénotypique des cellules cancéreuses. L’objectif de ce travail est d’étudier le profil phénotypique du cancer du sein chez les patients pris en charge au Centre Mohammed VI pour le traitement des Cancers, durant les années 2013-2014. Il s’agit d’une étude transversale sur deux années, incluant les cas du cancer du sein pris en charge au Centre. Le recueil des données était fait à partir des dossiers des patients et analysés par le logiciel Epi Info. 1277 patients ont été pris en charge au sein de notre centre. 99,5% des cas de sexe féminin, l’âge moyen était 50,20 ± 11,34 ans. Le type histologique le plus fréquent était le carcinome canalaire infiltrant (80,7% des cas). Le stade diagnostic était précoce (56,9%). Le phénotype moléculaire le plus fréquent était le luminal A (41,4% des cas). Le luminal B, le HER2 et les triples négatifs étaient dans respectivement 10,4%, 6,3%, 11,2% des cas. L’étude du phénotype tumoral des patients atteints du cancer du sein permet l’orientation du clinicien dans le choix du traitement, et des décideurs dans la planification de programmes de lutte contre cette pathologie. PMID:28292037

  16. Le recours aux modeles dans l'enseignement de la biologie au secondaire : Conceptions d'enseignantes et d'enseignants et modes d'utilisation

    NASA Astrophysics Data System (ADS)

    Varlet, Madeleine

    Le recours aux modeles et a la modelisation est mentionne dans la documentation scientifique comme un moyen de favoriser la mise en oeuvre de pratiques d'enseignement-apprentissage constructivistes pour pallier les difficultes d'apprentissage en sciences. L'etude prealable du rapport des enseignantes et des enseignants aux modeles et a la modelisation est alors pertinente pour comprendre leurs pratiques d'enseignement et identifier des elements dont la prise en compte dans les formations initiale et disciplinaire peut contribuer au developpement d'un enseignement constructiviste des sciences. Plusieurs recherches ont porte sur ces conceptions sans faire de distinction selon les matieres enseignees, telles la physique, la chimie ou la biologie, alors que les modeles ne sont pas forcement utilises ou compris de la meme maniere dans ces differentes disciplines. Notre recherche s'est interessee aux conceptions d'enseignantes et d'enseignants de biologie au secondaire au sujet des modeles scientifiques, de quelques formes de representations de ces modeles ainsi que de leurs modes d'utilisation en classe. Les resultats, que nous avons obtenus au moyen d'une serie d'entrevues semi-dirigees, indiquent que globalement leurs conceptions au sujet des modeles sont compatibles avec celle scientifiquement admise, mais varient quant aux formes de representations des modeles. L'examen de ces conceptions temoigne d'une connaissance limitee des modeles et variable selon la matiere enseignee. Le niveau d'etudes, la formation prealable, l'experience en enseignement et un possible cloisonnement des matieres pourraient expliquer les differentes conceptions identifiees. En outre, des difficultes temporelles, conceptuelles et techniques peuvent freiner leurs tentatives de modelisation avec les eleves. Toutefois, nos resultats accreditent l'hypothese que les conceptions des enseignantes et des enseignants eux-memes au sujet des modeles, de leurs formes de representation et de leur approche constructiviste en enseignement representent les plus grands obstacles a la construction des modeles en classe. Mots-cles : Modeles et modelisation, biologie, conceptions, modes d'utilisation, constructivisme, enseignement, secondaire.

  17. Facteurs de risque cardiovasculaires au cours du lupus systémique

    PubMed Central

    Harzallah, Amel; Hajji, Mariem; Kaaroud, Hayet; Hamida, Fethi Ben; Abdallah, Taieb Ben

    2015-01-01

    Cette étude a pour objectif d’évaluer la fréquence des facteurs de risque cardiovasculaires au cours du lupus et de préciser leur prévalence. Etude rétrospective portant sur 250 patients ayant un lupus, diagnostiqué selon les critères de l'ACR, hospitalisés entre 1970 et 2013. Les données cliniques et para cliniques ont été recueillies à partir des observations médicales. Il s'agit de 228 femmes et 22 hommes d’âge moyen au diagnostic du lupus de 30, 32 ans (extrêmes: 16-69). La durée moyenne du suivi des patients était de 64 mois (extrêmes: 7 jours- 382mois). Quatre vingt dix patients (36%) étaient hypertendus, 74% avaient une hypercholestérolémie et 22% étaient diabétiques. Pour les autres facteurs de risque cardiovasculaire traditionnels, un âge > 50 ans a été retrouvé dans 40% des cas, le sexe masculin dans 8% des cas, l'obésité dans 76% des cas et le tabagisme dans 11% des cas. Les facteurs de risque surajoutés sont représentés par la présence des anticorps antiphospholipides (47% des cas), la néphropathie lupique (49% des cas), l'insuffisance rénale (42% des cas), la corticothérapie au long cours (74% des cas) et la chronicité de la maladie dans 35% des cas. Les complications cardiovasculaires retrouvées dans notre série étaient: les accidents vasculaires cérébraux (2%) et l'insuffisance coronarienne (5,6%). Devant l'importance du risque cardiovasculaire au cours du lupus, une surveillance rapprochée des facteurs de risque cardio-vasculaires semble primordiale chez les lupiques. PMID:27022427

  18. Évaluation des caractéristiques mécaniques du polissoir en polyuréthanne utilisé comme porte abrasifs durant le processus du polissage du verre optique

    NASA Astrophysics Data System (ADS)

    Aliouane, T.; Bouzid, D.; Belkhir, N.; Bouzid, S.; Herold, V.

    2005-05-01

    La fabrication des composants en verre optique nécessite des moyens de grande précision dans les procédés de finition vue l'importance accordée à leur qualité.
Durant le processus de polissage des verres optiques, le polissoir est un élément clé et a un impact direct sur les performances des composants optiques, non seulement il est utilisé comme support de grains abrasifs mais il doit posséder la fonction de transmission de la pression aux grains. La connaissance de ses propriétés, essentiellement mécanique, est impérative afin d'obtenir un état de surface optimal des composants optiques destinés à remplir des fonctions très précises dans des appareils optiques très performants.
Dans cette étude, nous avons constaté que les propriétés des polissoirs en polyuréthanne tel que la dureté, le module d'élasticité et la densité varient au cours du polissage. Ce changement a des effets sur l'état de surface de verre optique, causé par le changement microstructural de la surface du polissoir (distribution et dimensions des pores) et par conséquent sur la quantité des abrasifs (en oxyde de cérium) insérée dans les pores, ce qui influe sur la quantité de verre enlevée et sur l'état de surface du composant.
Sur la base des résultats obtenus, il a été prouvé que le polissoir subit des modifications très importantes ce qui influe considérablement sur son efficacité de polissage.

  19. VizieR Online Data Catalog: Australian Dark Energy Survey (OzDES) quasar catalog (Tie+, 2017)

    NASA Astrophysics Data System (ADS)

    Tie, S. S.; Martini, P.; Mudd, D.; Ostrovski, F.; Reed, S. L.; Lidman, C.; Kochanek, C.; Davis, T. M.; Sharp, R.; Uddin, S.; King, A.; Wester, W.; Tucker, B. E.; Tucker, D. L.; Buckley-Geer, E.; Carollo, D.; Childress, M.; Glazebrook, K.; Hinton, S. R.; Lewis, G.; Macaulay, E.; O'Neill, C. R.; Abbott, T. M. C.; Abdalla, F. B.; Annis, J.; Benoit-Levy, A.; Bertin, E.; Brooks, D.; Carnero Rosell, A.; Carrasco Kind, M.; Carretero, J.; Cunha, C. E.; da Costa, L. N.; Depoy, D. L.; Desai, S.; Doel, P.; Eifler, T. F.; Evrard, A. E.; Finley, D. A.; Flaugher, B.; Fosalba, P.; Frieman, J.; Garcia-Bellido, J.; Gaztanaga, E.; Gerdes, D. W.; Goldstein, D. A.; Gruen, D.; Gruendl, R. A.; Gutierrez, G.; Honscheid, K.; James, D. J.; Kuehn, K.; Kuropatkin, N.; Lima, M.; Maia, M. A. G.; Marshall, J. L.; Menanteau, F.; Miller, C. J.; Miquel, R.; Nichol, R. C.; Nord, B.; Ogando, R.; Plazas, A. A.; Romer, A. K.; Sanchez, E.; Santiago, B.; Scarpine, V.; Schubnell, M.; Sevilla-Noarbe, I.; Smith, R. C.; Soares-Santos, M.; Sobreira, F.; Suchyta, E.; Swanson, M. E. C.; Tarle, G.; Thomas, D.; Walker, A. R.; DES Collaboration

    2017-07-01

    The Australian Dark Energy Survey (OzDES; Yuan et al. 2015MNRAS.452.3047Y) is a spectroscopic survey of the DES supernova fields using the AAOmega spectrograph (Smith et al. 2004SPIE.5492..410S) on the Anglo-Australian Telescope (AAT). The field of view of the AAT multi-object fiber-positioning system (Lewis et al. 2002MNRAS.333..279L) is well matched to DECam, making the AAT a well-suited spectroscopic follow-up instrument for DES. OzDES commenced observations at the same time as DES in 2013B and aims to measure redshifts for thousands of host galaxies of Type Ia supernovae and black hole masses for hundreds of AGNs and quasars (King et al. 2015MNRAS.453.1701K) using reverberation mapping (Blandford & McKee 1982ApJ...255..419B; Peterson 1993PASP..105..247P). The observing targets and results of OzDES observations are compiled into a spectroscopic catalog known as the Global Redshift Catalog (GRC). The GRC is updated after every OzDES observing season. In this work, we used the 2016 February version of the OzDES GRC. Here we present the OzDES Quasar Catalog of 1263 OzDES sources with Mi<-22 mag and i<22 mag that are spectroscopically confirmed quasars. (1 data file).

  20. Les Brulures Electriques par Haut Voltage - A Propos de 10 Cas

    PubMed Central

    Belmir, R.; Fejjal, N.; El Omari, M.; El Mazouz, S.; Gharib, N.; Abassi, A.; Belmahi, A.

    2008-01-01

    Summary Les accidents électriques par haute tension (AEHT) provoquent des brûlures profondes par effet Joule le long des axes vasculo-nerveux entre les points d'entrée et de sortie, qui sont le siège de lésions délabrantes. Les Auteurs rapportent une série de dix cas d'AEHT admis au service de chirurgie réparatrice et de brûlés de l'Hôpital Ibn Sina de Rabat à travers laquelle ils étudient les caractéristiques épidémiologiques, cliniques et thérapeutiques. Tous les patients étaient des adultes de sexe masculin dont l'âge moyen était de 31 ans. Dans 70% des cas, ces brûlures étaient secondaires à un contact avec les distributeurs d'électricité avec une surface brûlée inférieure à 20%. Le traitement des lésions électrothermiques a nécessité des interventions itératives avec amputation des segments de membres nécrosés dans 70% des cas, dont les suites étaient marquées par des séquelles fonctionnelles invalidantes. La prévention des AEHT, en particulier pour les accidents du travail au sein des professions exposées, reste fondamentale. PMID:21991124

  1. COMPARATIVE STUDIES OF THE EFFECT OF POLYCYCLIC AROMATIC HYDROCARBON GEOMETRY ON THE HYDROLYSIS OF DIOL EPOXIDES

    EPA Science Inventory

    Comparative studies of the effect of polycyclic aromatic hydrocarbon geometry on the hydrolysis of diol epoxides

    The interaction of the diol epoxides (DEs) of both planar and non-planar PAHs with water have been examined using quantum mechanical and molecular dynamics. Th...

  2. Detection de la fin de la compaction des anodes par le son

    NASA Astrophysics Data System (ADS)

    Sanogo, Bazoumana

    L'objectif de ce projet etait de developper un outil de controle en temps reel du temps de compaction en se servant du son genere par le vibrocompacteur pendant le formage des anodes crues. Ainsi, une application a ete developpee pour l'analyse des sons enregistres. Des essais ont ete realises avec differents microphones pour une meilleure qualite des mesures et un a ete choisi pour la suite du projet. De meme, differents tests ont ete realises sur des anodes de laboratoire ainsi que des anodes a l'echelle industrielle afin de mettre en place une methode pour la detection du temps optimal necessaire au formage des anodes. Les travaux au laboratoire de carbone a l'Universite du Quebec a Chicoutimi (UQAC) ont consiste a l'enregistrement de son des anodes fabriquees sur place avec differentes configurations; et a la caracterisation de certaines anodes de l'usine. Les anodes fabriquees au laboratoire sont reparties en deux groupes. Le premier regroupe les anodes pour la validation de notre methode. Ce sont des anodes produites avec des temps de compaction differents. Le laboratoire de carbone a l'UQAC est unique et il est possible de produire des anodes avec les memes proprietes que celles des anodes industrielles. Par consequent, la validation initialement prevue a l'usine a ete effectuee avec les anodes de laboratoire. Le deuxieme groupe a servi a etudier les effets des matieres premieres sur le temps de compaction. Le type de coke et le type de brai ont constitue les differentes variations dans ce deuxieme groupe. Quant aux tests et mesures a l'usine, ils ont ete realises en trois campagnes de mesure. La premiere campagne en juin 2014 a servi a standardiser et a trouver le meilleur positionnement des appareils pour les mesures, a regler le logiciel et a faire les premieres mesures. Une deuxieme campagne en mai 2015 a fait l'objet d'enregistrement de son en classant les anodes selon differents temps de compaction. La troisieme et derniere campagne en decembre 2015 a ete le lieu de tests finaux a l'usine en fabriquant des anodes avec differents criteres (variation du temps de compaction, taux de brai, arret manuel du compacteur, variation de la pression des ballons du haut du compacteur). Ces anodes ont ete ensuite analysees au laboratoire a l'UQAC. En parallele a ces travaux precites, l'amelioration de l'application d'analyse du son a ete faite avec le choix des parametres d'analyse et leur standardisation. Les resultats des premiers tests au laboratoire et ceux de la campagne de juin 2014 ont montre que la formation des anodes se fait suivant trois etapes : rearrangement des particules et du brai, compaction et consolidation et enfin la finition. Ces travaux ont montre en outre que le temps de compaction joue un role tres important dans la definition des proprietes finales des anodes. Ainsi, en plus du type de brai, du taux de brai et du type de coke, il faut tenir compte du temps de sur-compaction et de sous-compaction. En effet, ceci a ete demontre a travers les deux validations qui ont ete realisees. Les resultats de la caracterisation des echantillons (venant des anodes de la campagne de decembre 2015) ont montre qu'une anode compactee a un temps optimal acquiert une bonne resistance a la compression et sa resistivite electrique baisse. En outre, on note que le temps de compaction dans notre cas a baisse legerement avec l'augmentation de la pression des ballons de haut du vibrocompacteur. Ce qui a eu pour effet d'augmenter la densite crue de l'anode. Toutefois, il faut s'abstenir de generaliser ce constat car le nombre d'anodes testees est faible dans notre cas. Par ailleurs, cette etude montre que le temps necessaire pour le formage d'une anode croit avec l'augmentation du taux de brai et baisse legerement avec l'augmentation de la pression des ballons. (Abstract shortened by ProQuest.).

  3. Centrales au gaz et Energies renouvelables: comparer des pommes avec des pommes

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

    Bolinger, Mark; Wiser, Ryan; Golove, William

    2003-10-20

    The fundamental conclusion that we draw from this analysis is that one should not to base itself blindly on forecasts prices of natural gas when one compare contracts at price fixes with producers of renewable energy with contracts at variable prices with promoters power stations with gas. Indeed, forecasts of the prices of gas do not succeed not to enter the associated costs with the covering of the risk, that they are connected to the negative pressure against the cover, with the CAPM, with costs of transaction or with unspecified combination of three. Thus, insofar as price stability to lengthmore » term is developed, better way of comparing the two choices would be to have recourse to the data on the prices in the long term natural gas, and not with forecasts of the prices. During three last years at least, the use of these prices in the long term would have besides license to correct a methodological error who, obviously, seem to have supported unduly, and of relatively important way, power stations with natural gas compared to their competitors of renewable energies.« less

  4. The Dark Energy Survey Image Processing Pipeline

    NASA Astrophysics Data System (ADS)

    Morganson, E.; Gruendl, R. A.; Menanteau, F.; Carrasco Kind, M.; Chen, Y.-C.; Daues, G.; Drlica-Wagner, A.; Friedel, D. N.; Gower, M.; Johnson, M. W. G.; Johnson, M. D.; Kessler, R.; Paz-Chinchón, F.; Petravick, D.; Pond, C.; Yanny, B.; Allam, S.; Armstrong, R.; Barkhouse, W.; Bechtol, K.; Benoit-Lévy, A.; Bernstein, G. M.; Bertin, E.; Buckley-Geer, E.; Covarrubias, R.; Desai, S.; Diehl, H. T.; Goldstein, D. A.; Gruen, D.; Li, T. S.; Lin, H.; Marriner, J.; Mohr, J. J.; Neilsen, E.; Ngeow, C.-C.; Paech, K.; Rykoff, E. S.; Sako, M.; Sevilla-Noarbe, I.; Sheldon, E.; Sobreira, F.; Tucker, D. L.; Wester, W.; DES Collaboration

    2018-07-01

    The Dark Energy Survey (DES) is a five-year optical imaging campaign with the goal of understanding the origin of cosmic acceleration. DES performs a ∼5000 deg2 survey of the southern sky in five optical bands (g, r, i, z, Y) to a depth of ∼24th magnitude. Contemporaneously, DES performs a deep, time-domain survey in four optical bands (g, r, i, z) over ∼27 deg2. DES exposures are processed nightly with an evolving data reduction pipeline and evaluated for image quality to determine if they need to be retaken. Difference imaging and transient source detection are also performed in the time domain component nightly. On a bi-annual basis, DES exposures are reprocessed with a refined pipeline and coadded to maximize imaging depth. Here we describe the DES image processing pipeline in support of DES science, as a reference for users of archival DES data, and as a guide for future astronomical surveys.

  5. Les infections à Pseudomonas aeruginosa au service des maladies infectieuses du CHU YO, Burkina Faso: à propos deux cas

    PubMed Central

    Mamoudou, Savadogo; Lassina, Dao; Fla, Koueta

    2015-01-01

    Nous rapportons deux cas d'infection à Pseudomonas aeruginosa: un cas de méningite et un cas d'infection urinaire. Les auteurs rappellent qu’à côté des étiologies classiques des méningites et des infections urinaires, des germes résistants comme Pseudomonas aeruginosa peuvent être responsables d'infections à localisation méningées et urinaires et dont il faut connaître pour une bonne prise en charge. Le traitement de ces infections requiert un antibiogramme au regard de la grande capacité de résistance de Pseudomonas aeruginosa en milieu hospitalier. La limitation des gestes invasifs et l'application rigoureuse des mesures de prévention des infections en milieu hospitalier contribueront à lutter efficacement contre ces infections en milieu de soins. PMID:26491521

  6. Influence des melanges complexes organiques sur le sort des dioxines et furanes: Implications dans le developpement de facteurs de caracterisation en analyse du cycle de vie

    NASA Astrophysics Data System (ADS)

    Taing, Eric

    The environmental fate of dioxins and furans, or polychlorodibenzo-p-dioxins and -furans (PCDD/Fs), leaching from wood poles treated with pentachlorophenol (PCP) oil is modified by the presence of oil. Interactions between co-contaminants, which also exist for other pollutants within the mixtures, were shown in the specific context of risk analysis, but have never been taken into account for the generic context of life cycle assessment (LCA). This decision-making tool relies on characterization factors (CF) to estimate the potential impacts of an emitted amount of a pollutant in different impact categories such as aquatic ecotoxicity and human toxicity. For these two impact categories, CFs are calculated from a cause-effect chain that models the environmental fate, exposure and effects of the pollutant (represented by a matrix of fate FF, exposure XF and effect EF, respectively), meaning that a modification of PCDD/Fs fate induces a change in PCDD/Fs CFs. The research question is therefore as follows: In life cycle impact assessment (LCIA), to what extent would the potential impacts of PCDD/Fs on aquatic ecotoxicity and human toxicity change when taking into account the influence of a complex organic mixture on PCDD/Fs fate?. Thus, the main objective is to develop CFs of PCDD/Fs when their fate is influenced by PCP oil and compare them with the CFs of PCDD/Fs without oil for the aquatic ecotoxicity and human toxicity impact categories. A mathematic approach is established to determine the new environmental distribution of PCDD/Fs in the presence of oil and a new FF' matrix is calculated from this new distribution to obtain new CFs' integrating oil influence. FF' and CF' are then compared to FF and CF of PCDD/Fs without the oil. Finally, potential (eco)toxic impacts of the PCDD/F Canadian emissions are calculated with the new CFs' of PCDD/Fs in presence of oil. By only focusing on the results for an emission into air, freshwater and natural soil on a continental scale, the overall elimination fractions of 2,3,7,8-TCDD changed significantly. For the three emissions, organic fractions increased the overall elimination fraction of 2,3,7,8-TCDD into the continental air compartment, induced by a higher volatility of organic fractions than 2,3,7,8-TCDD: for an emission into continental air, organic fractions increased the overall elimination fraction of 2,3,7,8-TCDD in the continental air from 29% to 49% at most. For an emission into continental freshwater, 2,3,7,8-TCDD fate was mainly influenced by two groups of organic fractions: the lightest ones that volatilize into continental air (overall elimination fraction of 2,3,7,8-TCDD increasing from 2% to 35%) and the heaviest ones that are removed by sedimentation (DTCDD,fwC,fwC from 87% up to 96%). Therefore, an approach has been proposed to represent the carrier behaviour of the oil for PCDD/Fs. PCDD/F potential impacts in aquatic ecotoxicity and human toxicity change in a range up to two orders of magnitude depending on the emitting compartment (except for the seawater and ocean compartments). As 2,3,7,8-TCDD is one of the most toxic pollutant, this changing is significant in LCA. To assess the validity of the model's result, it is recommended to carry out laboratory experiments on the PCDD/F volatilization with oil. In addition, it could be interesting to integrate the influence of PCP on PCDD/Fs fate and, more broadly, the influence of all cocontaminants on PCDD/Fs exposure and effects. Moreover having a unique CFeco and CF tox via a weighting of the 17 CF'eco and the 17 CF' tox, respectively, is necessary for a use in LCA. Unfortunately the variability of the composition makes the weighting difficult, so it is suggested to calculate the mean CF'eco and CF'tox. Finally this research could be carried out on other pollutants whose fate is known to be modified by a complex organic mixture in an effort to ensure that impact characterization better reflects reality. (Abstract shortened by UMI.).

  7. Developpements numeriques recents realises en aeroelasticite chez Dassault Aviation pour la conception des avions de combat modernes et des avions d’affaires

    DTIC Science & Technology

    2003-03-01

    combat modernes et des avions d’affaires E. Garrigues, Th. Percheron DASSAULT AVIATION DGT/DTA/IAP F-922 14, Saint-Cloud Cedex France 1. Introduction ...de vol, des acedidrations rigides et des rdponses de la structure ( jauges et acedidrations). Struturl Premdicton Grdjustments n~~~ligh Testsn~n Fig4ure

  8. A direct comparison of efficacy between desloratadine and rupatadine in seasonal allergic rhinoconjunctivitis: a randomized, double-blind, placebo-controlled study.

    PubMed

    Lukat, Kf; Rivas, P; Roger, A; Kowalski, Ml; Botzen, U; Wessel, F; Sanquer, F; Agache, I; Izquierdo, I

    2013-01-01

    H1-antihistamines are recommended as the first-line symptomatic treatment of allergic rhinitis. The objective of this study was to evaluate the effects of rupatadine (RUP) versus desloratadine (DES) in subjects with seasonal allergic rhinitis (SAR). To assess the efficacy and safety of RUP in SAR in comparison with placebo (PL) and DES. A randomized, double-blind, multicenter, international, and PL-controlled study was carried out. The main selection criteria included SAR patients over 12 years old with a positive prick test to a relevant seasonal allergen for the geographic area. Symptomatic patients at screening with a nasal symptom sum score of ≥6 points (nasal discharge, nasal obstruction, sneezing, and nasal pruritus), a non-nasal score of ≥3 points (ocular pruritus, ocular redness, and tearing eyes), and a rhinorrhea score of ≥2 points with laboratory test results and electrocardiography within acceptable limits were included in the study. Change from baseline in the total symptom-score (T7SS) over the 4-week treatment period (reflective evaluation) was considered the primary efficacy variable. Secondary efficacy measures included total nasal symptom score (T4NSS) and conjunctival symptom score (T3NNSS), both of which are reflective and instantaneous evaluations. Furthermore questions related to quality of life (eg, sleep disturbances or impairment of daily activities) have also been evaluated. Safety was assessed according to adverse events reported, as well as laboratory and electrocardiography controls. A total of 379 patients were randomized, of which 356 were included and allocated to PL (n = 122), RUP (n = 117), or DES (n = 117). Mean change of T7SS over the 4-week treatment period was significantly reduced in the RUP (-46.1%, P = 0.03) and DES (-48.9%, P = 0.01) groups, compared with PL. Similarly, RUP and DES were comparable and significantly superior to PL for all secondary endpoints, including nasal and conjunctival symptoms and patients' and investigator's overall clinical opinions. Symptom score evaluation (both reflective and instantaneous evaluations) throughout the treatment period showed a progressive and maintained significant improvement with both treatments at day 7 (P = 0.01), day 14 (P = 0.007), and day 21 (P = 0.01) in comparison with PL. Adverse events were scarce and were similar in both treatment groups. Electrocardiography (QTc) and lab test results did not show any relevant findings. RUP is a very good choice for SAR due to its contribution to the improvement of nasal (including obstruction) and non-nasal symptoms to a similar degree as DES.

  9. 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.

  10. Conception d'un outil d'aide a la decision de technologies de fabrication additive en milieu aeronautique

    NASA Astrophysics Data System (ADS)

    Buvat, Gael

    La fabrication additive offre une opportunite d'amelioration des methodes de productions de pieces. Cependant, les technologies de fabrication additive sont diverses, les fournisseurs de services sont multiples et peu de personnel est forme pour operer sur ces technologies. L'objectif de cette etude est d'emettre une suggestion de concepts d'outils d'aide a la decision de technologies, de materiaux et de post-traitements de fabrication additive en milieu aeronautique. Trois sous-objectifs sont employes. Premierement, la definition des criteres de decision de technologies, de materiaux et de post-traitements de fabrication additive. Ensuite, l'elaboration d'un cahier des charges de l'outil d'aide a la decision en accord avec les besoins industriels du secteur aeronautique. Et enfin, la suggestion de trois concepts d'outils d'aide a la decision et leur evaluation par comparaison au cahier des charges etabli. Les criteres captures aupres de 11 industriels concernent des criteres de couts, de qualite, de conception et de delai d'obtention. Ensuite, nous avons elabore un cahier des charges permettant de reunir les besoins des industriels du secteur aeronautique selon trois axes qui constituent la colonne vertebrale des outils d'aide a la decision : une suggestion d'interface utilisateur, une suggestion de bases de donnees et un moteur de selection des technologies, des materiaux et des post-traitements de fabrication additive. La convivialite de l'interface utilisateur, l'evaluation de la qualite souhaitee par l'utilisateur et la prise en compte des etudes de cas realisees par le moteur de selection sont exemples de besoins que nous avons identifie au sein de cette etude. Nous avons ensuite transcrit ces besoins en specifications techniques pour permettre une evaluation du niveau de satisfaction des industriels au travers d'un pointage des trois concepts suggeres. Ces trois concepts d'outils d'aide a la decision ont ete realises respectivement grâce a Microsoft ExcelRTM, Microsoft AccessRTM ainsi qu'une plateforme en ligne associee a l'outil d'apprentissage statistique RapidMinerRTM. Ce dernier outil en ligne a retenu l'attention des ingenieurs qui l'ont evalue principalement du fait de la prise en compte des etudes de cas dans la suggestion preferentielle de technologies, de materiaux et de post-traitements.

  11. Pratique de l’électroconvulsivothérapie dans un hôpital universitaire Tunisien

    PubMed Central

    Mechri, Anwar; Zaafrane, Hana; Khalifa, Monia Hadj; Toumi, Samir; Zaafrane, Férid; Gaha, Lotfi

    2018-01-01

    Les objectifs de cette étude étaient de décrire les modalités pratiques de l’électroconvulsivothérapie (ECT) à l’hôpital universitaire de Monastir (Tunisie). Il s'agit d'une étude rétrospective portant sur tous les patients traités par ECT à l’hôpital universitaire de Monastir entre 2002 et 2013. Le nombre des patients était de 80 patients (60 hommes et 20 femmes, d’âge moyen de 42,1±15,7 ans), représentant 1,4% de l’ensemble des patients hospitalisés en psychiatrie durant la période d’étude. Le nombre total des séances d’ECT était de 784. Le diagnostic principal était le trouble dépressif majeur isolé ou récurrent chez 50% des patients. La majorité des patients (78,8%) avait reçu une seule cure d’ECT avec un nombre moyen de séances de 8,1 ± 4,9. Le produit anesthésique le plus utilisé était le propofol (97,4%). L’énergie délivrée était comprise entre 40 et 80 joules dans 71% des cas et elle était positivement corrélée à l’âge des patients. La durée moyenne de la crise motrice était de 22,3 ± 7,2 secondes et elle était négativement corrélée à l’âge des patients. Le taux de réponse le plus élevé a été constaté au niveau des scores de dépression (64,3%). Des effets indésirables immédiats ont été mentionnés chez 51,2% des patients. Enfin, 20% des patients poursuivaient des séances d’ECT d’entretien avec un rythme uni ou bimensuel. La pratique de l’ECT à l’hôpital universitaire de Monastir reste peu développée en termes de nombre des patients et des séances d’ECT. Des efforts doivent être déployés pour promouvoir l’utilisation de cette méthode. PMID:29632628

  12. L’apport de l’échographie dans l’exploration des métrorragies post-ménopausiques

    PubMed Central

    Boudaya, Fethia; Jenayah, Amel Achour; Saoudi, Sarah; Gharsa, Anissa; Gharbi, Eya; Sfar, Ezzeddine; Chelli, Dalenda

    2016-01-01

    Les métrorragies post-ménopausiques représentant un motif fréquent de consultation en gynécologie. Notre étude avait pour but d’évaluer l’apport de l’échographie pelvienne dans l’exploration des lésions endo-cavitaires devant ce symptôme et de comparer les résultats retrouvés à ceux de l’hystéroscopie et de l’histologie. Il s’agissait d’une étude rétrospective analytique à propos de 33 observations de patientes prises en charge pour des métrorragies post-ménopausiques au service de gynécologie obstétrique «A» du centre de maternité et de néonatologie de Tunis durant l’année 2012. Toutes les patientes avaient bénéficié d’une échographie pelvienne et d’une hystéroscopie diagnostique. Nous avons analysé et confronté les données de l’échographie pelvienne, de l’hystéroscopie et de l’examen histologique. L’âge moyen de nos patientes était de 57,78 ans et l'âge moyen de la ménopause était de 48,36 ans. La confrontation des données échographiques et histologiques, a montré que l’échographie a présenté une sensibilité de 80,6%, une spécificité de 79,38%, une valeur prédictive positive (VPP) de l’ordre de 67,03% et une valeur prédictive négative (VPN) de 91,54%. Quant à l’hystéroscopie, ces valeurs étaient respectivement de 84,44%, 82,72%, 69,93% et 92,65%. Le degré de performance de chaque moyen d’exploration a été variable selon la lésion en cause des métrorragies et d’une façon générale l’hystéroscopie a été plus fiable dans l’exploration des métrorragies que l’échographie: indice de Youden 0,67 contre 0,59. Nos résultats rejoignent les données de la littérature qui attribue à l’hystéroscopie une plus grande fiabilité par rapport à l’échographie pelvienne dans le diagnostic des lésions endo-cavitaires à l’origine des métrorragies post-ménopausiques. PMID:27795772

  13. Unifying Model-Based and Reactive Programming within a Model-Based Executive

    NASA Technical Reports Server (NTRS)

    Williams, Brian C.; Gupta, Vineet; Norvig, Peter (Technical Monitor)

    1999-01-01

    Real-time, model-based, deduction has recently emerged as a vital component in AI's tool box for developing highly autonomous reactive systems. Yet one of the current hurdles towards developing model-based reactive systems is the number of methods simultaneously employed, and their corresponding melange of programming and modeling languages. This paper offers an important step towards unification. We introduce RMPL, a rich modeling language that combines probabilistic, constraint-based modeling with reactive programming constructs, while offering a simple semantics in terms of hidden state Markov processes. We introduce probabilistic, hierarchical constraint automata (PHCA), which allow Markov processes to be expressed in a compact representation that preserves the modularity of RMPL programs. Finally, a model-based executive, called Reactive Burton is described that exploits this compact encoding to perform efficIent simulation, belief state update and control sequence generation.

  14. Biogenic technology for recultivation of lands contaminated due to rocket propellant spillage

    NASA Astrophysics Data System (ADS)

    Kovshov, S. V.; Garkushev, A. U.; Sazykin, A. M.

    2015-04-01

    This article describes the problem of soil properties deterioration due to rocket propellant spillage. Melange and samin are considered to be the main pollutants. Provision is made for assessment of the existing mechanisms for monitoring of quality and recultivation of lands disturbed by rocket propellant spills. Some major disadvantages of currently used standard recultivation technologies are listed. An alternative is the use of more environmentally safe and cost effective methods aimed at disturbed lands biological restoration. An example of such a technology is covering the affected area with a biogenic mixture consisting of biohumus and sodium carboxymethyl cellulose followed by seeding it with specially selected herbal mixtures. It was found out that the most rational parameters of such protective layer is its thickness of 3 cm, and 99:1 ratio of its constituent components.

  15. Dependent personality features in a complex case of borderline personality disorder.

    PubMed

    Nirestean, Tudor; Lukacs, Emese; Nirestean, Aurel; Gabos Grecu, Iosif

    2016-11-01

    Borderline personality disorder is a complex disease model as it encompasses a diversity of pathological personality traits and psychopathological symptoms. It is not surprising, therefore, that it is often manifested by personality disorders across all three clusters and accompanied by other mental (Axis I) disorders. This melange makes both psychological treatment and pharmacotherapy especially challenging, and this paper describes the case of a particularly complex case of a 33-year-old Romanian patient, who has a history of severe deprivation in childhood, mood and substance use disorder in association with borderline pathology. In the course of treatment from many sources and interventions, it has become clear that dependence is a key component of the pathology and has been rewarded with a degree of success in management. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  16. Geologic interpretation of space shuttle radar images of Indonesia

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

    Sabing, F.F.

    1983-11-01

    The National Aeronautics and Space Administration (NASA) space shuttle mission in November 1981 acquired images of parts of the earth with a synthetic aperture radar system at a wavelength of 23.5 cm (9.3 in.) and spatial resolution of 38 m (125 ft). This report describes the geologic interpretation of 1:250,000-scale images of Irian Jaya and eastern Kalimantan, Indonesia, where the all-weather capability of radar penetrates the persistent cloud cover. The inclined look direction of radar enhances subtle topographic features that may be the expression of geologic structures. On the Indonesian images, the following terrain categories are recognizable for geologic mapping:more » carbonate, clastic, volcanic, alluvial and coastal, melange, and metamorphic, as well as undifferentiated bedrock. Regional and local geologic structures are well expressed on the images.« less

  17. 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.

  18. Vents stellaires chauds et nébuleuses éjectées des étoiles chaudes: nécessaire inclusion des phénomènes radiatifs dans les simulations hydrodynamiques

    NASA Astrophysics Data System (ADS)

    Grosdidier, Y.; Garcia-Segura, G.; Acker, A.; Moffat, A. F. J.

    Nous décrivons, à l'instar de la formation et de l'évolution des nébuleuses planétaires, comment l'histoire des vents stellaires issus d'une même étoile chaude (massive ou non) détermine la morphologie des nébuleuses éjectées. Ensuite, nous présentons sommairement la structure et la dynamique des vents accélérés radiativement au sein des étoiles massives (O, Wolf-Rayet) et des étoiles centrales de nébuleuses planétaires de type [WC]. Enfin, nous tâchong d'illustrer en quoi la prise en compte des phénomènes radiatifs est nécessaire pour effectuer toute simulation hydrodynamique sensée reproduire les observations dans les deux contextes, i.e. les vents stellaires chauds eux-mêmes, la persistance de surdensités en leur sein, et les nébuleuses éjectées qui en résultent.

  19. La prévention des blessures chez les enfants et les adolescents : une démarche de santé publique

    PubMed Central

    Yanchar, Natalie L; Warda, Lynne J; Fuselli, Pamela

    2012-01-01

    RÉSUMÉ La majorité des blessures dont sont victimes les enfants et les adolescents sont évitables. Le présent document de principes contient des renseignements généraux, des conseils et une déclaration d’engagement à l’égard de la prévention des blessures au Canada. Il sert de base sur laquelle construire en s’attardant d’abord aux définitions, à l’étendue et aux priorités en matière de prévention des blessures. Il contient également une description du fardeau et du profil des blessures non intentionnelles, de même que les principes d’interventions de prévention efficaces. La version intégrale renferme une liste de ressources en vue d’obtenir des données et de l’information probante (www.cps.ca). Enfin, le présent document de principes peut être utilisé pour la défense généralisée de la prévention des blessures.

  20. Impact de la preparation des anodes crues et des conditions de cuisson sur la fissuration dans des anodes denses

    NASA Astrophysics Data System (ADS)

    Amrani, Salah

    La fabrication de l'aluminium est realisee dans une cellule d'electrolyse, et cette operation utilise des anodes en carbone. L'evaluation de la qualite de ces anodes reste indispensable avant leur utilisation. La presence des fissures dans les anodes provoque une perturbation du procede l'electrolyse et une diminution de sa performance. Ce projet a ete entrepris pour determiner l'impact des differents parametres de procedes de fabrication des anodes sur la fissuration des anodes denses. Ces parametres incluent ceux de la fabrication des anodes crues, des proprietes des matieres premieres et de la cuisson. Une recherche bibliographique a ete effectuee sur tous les aspects de la fissuration des anodes en carbone pour compiler les travaux anterieurs. Une methodologie detaillee a ete mise au point pour faciliter le deroulement des travaux et atteindre les objectifs vises. La majorite de ce document est reservee pour la discussion des resultats obtenus au laboratoire de l'UQAC et au niveau industriel. Concernant les etudes realisees a l'UQAC, une partie des travaux experimentaux est reservee a la recherche des differents mecanismes de fissuration dans les anodes denses utilisees dans l'industrie d'aluminium. L'approche etait d'abord basee sur la caracterisation qualitative du mecanisme de la fissuration en surface et en profondeur. Puis, une caracterisation quantitative a ete realisee pour la determination de la distribution de la largeur de la fissure sur toute sa longueur, ainsi que le pourcentage de sa surface par rapport a la surface totale de l'echantillon. Cette etude a ete realisee par le biais de la technique d'analyse d'image utilisee pour caracteriser la fissuration d'un echantillon d'anode cuite. L'analyse surfacique et en profondeur de cet echantillon a permis de voir clairement la formation des fissures sur une grande partie de la surface analysee. L'autre partie des travaux est basee sur la caracterisation des defauts dans des echantillons d'anodes crues fabriquees industriellement. Cette technique a consiste a determiner le profil des differentes proprietes physiques. En effet, la methode basee sur la mesure de la distribution de la resistivite electrique sur la totalite de l'echantillon est la technique qui a ete utilisee pour localiser la fissuration et les macro-pores. La microscopie optique et l'analyse d'image ont, quant a elles, permis de caracteriser les zones fissurees tout en determinant la structure des echantillons analyses a l'echelle microscopique. D'autres tests ont ete menes, et ils ont consiste a etudier des echantillons cylindriques d'anodes de 50 mm de diametre et de 130 mm de longueur. Ces derniers ont ete cuits dans un four a UQAC a differents taux de chauffage dans le but de pouvoir determiner l'influence des parametres de cuisson sur la formation de la fissuration dans ce genre de carottes. La caracterisation des echantillons d'anodes cuites a ete faite a l'aide de la microscopie electronique a balayage et de l'ultrason. La derniere partie des travaux realises a l'UQAC contient une etude sur la caracterisation des anodes fabriquees au laboratoire sous differentes conditions d'operation. L'evolution de la qualite de ces anodes a ete faite par l'utilisation de plusieurs techniques. L'evolution de la temperature de refroidissement des anodes crues de laboratoire a ete mesuree; et un modele mathematique a ete developpe et valide avec les donnees experimentales. Cela a pour objectif d'estimer la vitesse de refroidissement ainsi que le stress thermique. Toutes les anodes fabriquees ont ete caracterisees avant la cuisson par la determination de certaines proprietes physiques (resistivite electrique, densite apparente, densite optique et pourcentage de defauts). La tomographie et la distribution de la resistivite electrique, qui sont des techniques non destructives, ont ete employees pour evaluer les defauts internes des anodes. Pendant la cuisson des anodes de laboratoire, l'evolution de la resistivite electrique a ete suivie et l'etape de devolatilisation a ete identifiee. Certaines anodes ont ete cuites a differents taux de chauffage (bas, moyen, eleve et un autre combine) dans l'objectif de trouver les meilleures conditions de cuisson en vue de minimiser la fissuration. D'autres anodes ont ete cuites a differents niveaux de cuisson, cela dans le but d'identifier a quelle etape de l'operation de cuisson la fissuration commence a se developper. Apres la cuisson, les anodes ont ete recuperees pour, a nouveau, faire leur caracterisation par les memes techniques utilisees precedemment. L'objectif principal de cette partie etait de reveler l'impact de differents parametres sur le probleme de fissuration, qui sont repartis sur toute la chaine de production des anodes. Le pourcentage de megots, la quantite de brai et la distribution des particules sont des facteurs importants a considerer pour etudier l'effet de la matiere premiere sur le probleme de la fissuration. Concernant l'effet des parametres du procede de fabrication sur le meme probleme, le temps de vibration, la pression de compaction et le procede de refroidissement ont ete a la base de cette etude. Finalement, l'influence de la phase de cuisson sur l'apparition de la fissuration a ete prise en consideration par l'intermediaire du taux de chauffage et du niveau de cuisson. Les travaux realises au niveau industriel ont ete faits lors d'une campagne de mesure dans le but d'evaluer la qualite des anodes de carbone en general et l'investigation du probleme de fissuration en particulier. Ensuite, il s'agissait de reveler les effets de differents parametres sur le probleme de la fissuration. Vingt-quatre anodes cuites ont ete utilisees. Elles ont ete fabriquees avec differentes matieres premieres (brai, coke, megots) et sous diverses conditions (pression, temps de vibration). Le parametre de la densite de fissuration a ete calcule en se basant sur l'inspection visuelle de la fissuration des carottes. Cela permet de classifier les differentes fissurations en plusieurs categories en se basant sur certains criteres tels que le type de fissures (horizontale, verticale et inclinee), leurs localisations longitudinales (bas, milieu et haut de l'anode) et transversales (gauche, centrale et droite). Les effets de la matiere premiere, les parametres de fabrication des anodes crues ainsi que les conditions de cuisson sur la fissuration ont ete etudies. La fissuration des anodes denses en carbones cause un serieux probleme pour l'industrie d'aluminium primaire. La realisation de ce projet a permis la revelation de differents mecanismes de fissuration, la classification de fissuration par plusieurs criteres (position, types localisation) et l'evaluation de l'impact de differents parametres sur la fissuration. Les etudes effectuees dans le domaine de cuisson ont donne la possibilite d'ameliorer l'operation et reduire la fissuration des anodes. Le travail consiste aussi a identifier des techniques capables d'evaluer la qualite d'anodes (l'ultrason, la tomographie et la distribution de la resistivite electrique). La fissuration des anodes en carbone est consideree comme un probleme complexe, car son apparition depend de plusieurs parametres repartis sur toute la chaine de production. Dans ce projet, plusieurs nouvelles etudes ont ete realisees, et elles permettent de donner de l'originalite aux travaux de recherches faits dans le domaine de la fissuration des anodes de carbone pour l'industrie de l'aluminium primaire. Les etudes realisees dans ce projet permettent d'ajouter d'un cote, une valeur scientifique pour mieux comprendre le probleme de fissuration des anodes et d'un autre cote, d'essayer de proposer des methodes qui peuvent reduire ce probleme a l'echelle industrielle.

  1. Simulation-Based Acquisition of the Future Air-Land Combat System (acquisition par la simulation des systemes futurs de combat aeroterresire)

    DTIC Science & Technology

    2003-11-01

    de défense sur des matériels, des hommes et des doctrines préexistants, mais part au contraire d’une analyse des menaces et du... hommes et les doctrines. Comme on le verra ultérieurement, cette nouvelle démarche d’ingénierie du système de défense, qui se veut proactive et non...résolvent sous des contraintes de zéro mort ou tout au moins de pertes minimales, dont l ’« acceptabilité » est essentiellement facteur de

  2. 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

  3. Neonatal diethylstilbestrol exposure alters the metabolic profile of uterine epithelial cells

    PubMed Central

    Yin, Yan; Lin, Congxing; Veith, G. Michael; Chen, Hong; Dhandha, Maulik; Ma, Liang

    2012-01-01

    SUMMARY Developmental exposure to diethylstilbestrol (DES) causes reproductive tract malformations, affects fertility and increases the risk of clear cell carcinoma of the vagina and cervix in humans. Previous studies on a well-established mouse DES model demonstrated that it recapitulates many features of the human syndrome, yet the underlying molecular mechanism is far from clear. Using the neonatal DES mouse model, the present study uses global transcript profiling to systematically explore early gene expression changes in individual epithelial and mesenchymal compartments of the neonatal uterus. Over 900 genes show differential expression upon DES treatment in either one or both tissue layers. Interestingly, multiple components of peroxisome proliferator-activated receptor-γ (PPARγ)-mediated adipogenesis and lipid metabolism, including PPARγ itself, are targets of DES in the neonatal uterus. Transmission electron microscopy and Oil-Red O staining further demonstrate a dramatic increase in lipid deposition in uterine epithelial cells upon DES exposure. Neonatal DES exposure also perturbs glucose homeostasis in the uterine epithelium. Some of these neonatal DES-induced metabolic changes appear to last into adulthood, suggesting a permanent effect of DES on energy metabolism in uterine epithelial cells. This study extends the list of biological processes that can be regulated by estrogen or DES, and provides a novel perspective for endocrine disruptor-induced reproductive abnormalities. PMID:22679223

  4. Effects of postnatal administration of diethylstilbestrol on puberty and thyroid function in male rats.

    PubMed

    Shin, Jae-Ho; Kim, Tae Sung; Kang, Il Hyun; Kang, Tae Seok; Moon, Hyun Ju; Han, Soon-Young

    2009-10-01

    To examine the effects of diethylstilbestrol (DES) on male pubertal development and thyroid function, juvenile male Sprague-Dawley rats were given DES daily by oral intubation at doses of 10, 20 and 40 microg/kg/day from postnatal day 33 for 20 days. Prepuce separation was significantly delayed at the dose of 20 microg/kg/day and above in the DES-treated rats. DES treatment induced a significant reduction in the weights of testes, epididymides, the ventral prostate, seminal vesicles plus coagulating glands and fluid, levator ani bulbocavernosus muscles, Cowper's glands and the glans penis. The weights of the liver and adrenals increased in the DES-treated animals. DES caused a dose-dependent reduction in germ cells; in particular the spermatids were mainly affected. The serum levels of testosterone and luteinizing hormone were significantly reduced in the DES-treated groups, but that of estradiol decreased. No differences were observed in the serum thyroxine levels of the control and DES-treated groups. In microscopic observation of the DES-treated animals, degeneration of germ cells and tubular atrophy in the testis were noted, but there were no microscopic changes in the thyroid. These results indicate that DES affected the pubertal development of juvenile male rats and that its mode of action may be related to alterations in hormone levels.

  5. 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.

  6. Etude thermo-hydraulique de l'ecoulement du moderateur dans le reacteur CANDU-6

    NASA Astrophysics Data System (ADS)

    Mehdi Zadeh, Foad

    Etant donne la taille (6,0 m x 7,6 m) ainsi que le domaine multiplement connexe qui caracterisent la cuve des reacteurs CANDU-6 (380 canaux dans la cuve), la physique qui gouverne le comportement du fluide moderateur est encore mal connue de nos jours. L'echantillonnage de donnees dans un reacteur en fonction necessite d'apporter des changements a la configuration de la cuve du reacteur afin d'y inserer des sondes. De plus, la presence d'une zone intense de radiations empeche l'utilisation des capteurs courants d'echantillonnage. En consequence, l'ecoulement du moderateur doit necessairement etre etudie a l'aide d'un modele experimental ou d'un modele numerique. Pour ce qui est du modele experimental, la fabrication et la mise en fonction de telles installations coutent tres cher. De plus, les parametres de la mise a l'echelle du systeme pour fabriquer un modele experimental a l'echelle reduite sont en contradiction. En consequence, la modelisation numerique reste une alternative importante. Actuellement, l'industrie nucleaire utilise une approche numerique, dite de milieu poreux, qui approxime le domaine par un milieu continu ou le reseau des tubes est remplace par des resistances hydrauliques distribuees. Ce modele est capable de decrire les phenomenes macroscopiques de l'ecoulement, mais ne tient pas compte des effets locaux ayant un impact sur l'ecoulement global, tel que les distributions de temperatures et de vitesses a proximite des tubes ainsi que des instabilites hydrodynamiques. Dans le contexte de la surete nucleaire, on s'interesse aux effets locaux autour des tubes de calandre. En effet, des simulations faites par cette approche predisent que l'ecoulement peut prendre plusieurs configurations hydrodynamiques dont, pour certaines, l'ecoulement montre un comportement asymetrique au sein de la cuve. Ceci peut provoquer une ebullition du moderateur sur la paroi des canaux. Dans de telles conditions, le coefficient de reactivite peut varier de maniere importante, se traduisant par l'accroissement de la puissance du reacteur. Ceci peut avoir des consequences majeures pour la surete nucleaire. Une modelisation CFD (Computational Fluid Dynamics) detaillee tenant compte des effets locaux s'avere donc necessaire. Le but de ce travail de recherche est de modeliser le comportement complexe de l'ecoulement du moderateur au sein de la cuve d'un reacteur nucleaire CANDU-6, notamment a proximite des tubes de calandre. Ces simulations servent a identifier les configurations possibles de l'ecoulement dans la calandre. Cette etude consiste ainsi a formuler des bases theoriques a l'origine des instabilites macroscopiques du moderateur, c.-a-d. des mouvements asymetriques qui peuvent provoquer l'ebullition du moderateur. Le defi du projet est de determiner l'impact de ces configurations de l'ecoulement sur la reactivite du reacteur CANDU-6.

  7. Lignes directrices canadiennes sur l’utilisation sécuritaire et efficace des opioïdes pour la douleur chronique non cancéreuse

    PubMed Central

    Kahan, Meldon; Mailis-Gagnon, Angela; Wilson, Lynn; Srivastava, Anita

    2011-01-01

    Résumé Objectif Présenter aux médecins de famille un résumé clinique pratique des lignes directrices canadiennes sur l’utilisation sécuritaire et efficace des opioïdes pour la douleur chronique non cancéreuse, produites par le National Opioid Use Guideline Group. Qualité des données Pour produire les lignes directrices, les chercheurs ont effectué une synthèse critique de la littérature médicale sur l’efficacité et l’innocuité des opioïdes pour la douleur chronique non cancéreuse et ont rédigé une série de recommandations. Un panel de 49 cliniciens experts de toutes les régions du Canada ont passé en revue l’ébauche et ont atteint un consensus sur 24 recommandations. Message principal Il est recommandé de faire un dépistage du risque de dépendance avant de prescrire des opioïdes. On recommande des opioïdes faibles (codéine et tramadol) pour une douleur de légère à modérée qui n’a pas répondu aux traitements de première intention. On peut essayer l’oxycodone, l’hydromorphone et la morphine chez les patients qui n’ont pas eu de soulagement avec des opioïdes plus faibles. Une faible dose initiale et une lente hausse du titrage sont recommandées, ainsi qu’une étroite surveillance du patient qu’on a d’abord renseigné. Les médecins doivent surveiller l’apparition de complications comme l’apnée du sommeil. La dose optimale est celle qui améliore le fonctionnement ou atténue les cotes d’évaluation de la douleur d’au moins 30 %. Pour la grande majorité des patients, la dose optimale sera bien en deçà de l’équivalent de 200 mg de morphine par jour. On recommande le sevrage progressif pour les patients qui n’ont pas répondu à un essai d’opioïdes adéquat. Conclusion Les opioïdes jouent un rôle important dans la prise en charge de la douleur chronique non cancéreuse, mais il faut en prescrire avec prudence pour limiter les dommages potentiels. Les nouvelles lignes directrices canadiennes offrent des conseils dont les médecins avaient grand besoin pour les aider à en arriver à un juste équilibre entre le contrôle optimal de la douleur et la sécurité.

  8. Approches pour la reduction de l'impact de defaut dans le transport d'energie du parc eolien offshore via VSC-HVDC =

    NASA Astrophysics Data System (ADS)

    Benadja, Mounir

    Dans ce travail est presente un systeme de generation d'energie d'un parc eolien offshore et un systeme de transport utilisant les stations VSC-HVDC connectees au reseau principal AC onshore. Trois configurations ont ete etudiees, modelisees et validees par simulation. Dans chacune des configurations, des contributions ameliorant les cotes techniques et economiques sont decrites ci-dessous : La premiere contribution concerne un nouvel algorithme MPPT (Maximum Power Point Tracking) utilise pour l'extraction de la puissance maximale disponible dans les eoliennes des parcs offshores. Cette technique d'extraction du MPPT ameliore le rendement energetique de la chaine de conversion des energies renouvelables notamment l'energie eolienne a petite et a grande echelles (parc eolien offshore) qui constitue un probleme pour les constructeurs qui se trouvent confrontes a developper des dispositifs MPPT simples, moins couteux, robustes, fiables et capable d'obtenir un rendement energetique maximal. La deuxieme contribution concerne la reduction de la taille, du cout et de l'impact des defauts electriques (AC et DC) dans le systeme construit pour transporter l'energie d'un parc eolien offshore (OWF) vers le reseau principal AC onshore via deux stations 3L-NPC VSCHVDC. La solution developpee utilise des observateurs non-lineaires bases sur le filtre de Kalman etendu (EKF). Ce filtre permet d'estimer la vitesse de rotation et la position du rotor de chacune des generatrices du parc eolien offshore et de la tension du bus DC de l'onduleur DC-AC offshore et des deux stations 3L-NPC-VSC-HVDC (offshore et onshore). De plus, ce developpement du filtre de Kalman etendu a permis de reduire l'impact des defauts AC et DC. Deux commandes ont ete utilisees, l'une (commande indirect dans le plan abc) avec EKF integre destinee pour controler le convertisseur DC-AC offshore et l'autre (commande d-q) avec EKF integre pour controler les convertisseurs des deux stations AC-DC et DC-AC tout en tenant compte des entrees de chacune des stations. L'integration des observateurs non-lineaires (EKF) dans le controle des convertisseurs permet de resoudre le probleme des incertitudes de mesure, des incertitudes dans la modelisation, en cas du dysfonctionnement ou de panne des capteurs de mesure ainsi que le probleme de l'impact des defauts (AC et DC) sur la qualite d'energie dans les systemes de transmission. Ces estimations contribuent a rendre le cout global du systeme moins cher et sa taille moins encombrante ainsi que la reduction de l'impact des defauts (AC et DC) sur le systeme. La troisieme contribution concerne la reduction de la taille, du cout et de l'impact des defauts electriques (AC et DC) dans le systeme construit pour transporter l'energie d'un parc eolien offshore (OWF) vers le reseau principal AC onshore via deux stations VSC-HVDC. La solution developpee utilise des observateurs non-lineaires bases sur le filtre de Kalman etendu (EKF). Ce filtre permet d'estimer la vitesse de rotation et la position du rotor de chacune des generatrices du parc eolien et de la tension du bus DC de l'onduleur DC-AC offshore. La contribution porte surtout sur le developpement des deux commandes des deux stations. La premiere, la commande non-lineaire modifiee pour controler le premier convertisseur de la station VSC-HVDC offshore assurant le transfert de la puissance generee par le parc eolien vers la station VSC-HVDC onshore. La deuxieme commande non-lineaire modifiee avec integration de la regulation de la tension du bus DC et de la commande a modele de reference adaptative (MRAC) pour la compensation des surintensites et surtensions durant les defauts AC et DC. On peut constater que lors d'un defaut AC au PCC (Point of Common Coupling) du cote reseau onshore, la profondeur de l'impact du defaut AC sur l'amplitude des courants du reseau principal AC onshore qui etait reduit a 60% par les travaux de recherche (Erlich, Feltes et Shewarega, 2014), comparativement a la nouvelle commande proposee MRAC qui reduit la profondeur de l'impact a 35%. Lors de l'apparition des defauts AC et DC, une reduction de l'impact des defauts sur l'amplitude des courants de reseau AC terrestre et du temps de reponse a ete observee et la stabilite du systeme a ete renforcee par l'utilisation de la commande adaptative basee sur le modele de reference MRAC. La quatrieme contribution concerne une nouvelle commande basee sur le mode de glissement (SM) appliquee pour la station VSC-HVDC qui relie le parc eolien offshore (OWF) au reseau principal AC. Ce parc est compose de dix eoliennes basees sur des generatrices synchrones a aimant permanent (VSWT/PMSGs) connectees en parallele et chacune est controlee par son propre convertisseur DC-DC. Une comparaison des performances entre la commande SM et de la commande non-lineaire avec des controleurs PI pour les deux conditions (presence et absence de defaut DC) a ete analysee et montre la superiorite de la commande par SM. Un prototype du systeme etudie a echelle reduite a ete realise et teste au laboratoire GREPCI en utilisant la carte dSPACE-DS1104 pour la validation experimentale. L'analyse et la simulation des systemes etudies sont developpees sous l'environnement Matlab/Simulink/Simpowersystem. Les resultats obtenus a partir des configurations developpees sont valides par simulation et par experimentation. Les performances sont tres satisfaisantes du point de vue reponse dynamique, reponse en regime permanent, stabilite du systeme et qualite de l'energie.

  9. Note des Éditeurs scientifiques

    NASA Astrophysics Data System (ADS)

    Averbuch, P.

    Cette série d'articles est une revue de résultats expérimentaux sur différents "fluides" moléculaires, dans lesquels la cohésion est due à des forces de Van der Waals et à des liaisons hydrogène, l'eau étant un de ces fluides. Ces résultats sont présentés de façon à justifier expérimentalement un modèle original, non extensif, des propriétés de ces fluides, et l'ensemble se présente sous la forme de trois articles décrivant le modèle, suivis chacun par un article le comparant aux résultats expérimentaux publiés par de nombreux auteurs. Le caractère non extensif des propriétés physiques des fluides est choquant, contraire à beaucoup d'idées établies, il semble n'avoir en sa faveur qu'un argument, la comparaison avec un nombre de résultats expérimentaux assez grand pour que l'effet du hasard soit difficilement soupçonnable. En particulier, les écarts entre des résultats de mesures faits par des auteurs différents dans des conditions différentes sont expliqués, le sérieux et la compétence des différents expérimentateurs ne sont plus mis en doute : mais l'interprétation de ces résultats avec un modèle extensif non adapté est seule mise en cause. Les modèles extensifs étant utilisés systématiquement, au delà des expériences de physiciens, dans les calculs d'ingénieurs, et dans la modélisation d'appareils qui fonctionnent et de phénomènes naturels observés par tout le monde, il fallait expliquer pourquoi on pouvait renoncer à l'extensivité. Les raisons du succès pratique des modèles extensifs sont données, d'abord dans le cas des nématiques, puis dans celui des liquides ordinaires, et c'est ce qui rend l'ensemble cohérent, tant avec les mesures physiques fines qu'avec les observations quotidiennes. Il n'en reste pas moins que si l'interprétation donnée dans cette série d'articles est généralisable, une justification théorique du modèle utilisé devient nécessaire. Pour ce qui est des propriétés d'équilibre, une séparation de l'énergie libre en énergie libre de volume et en énergie libre de surface devrait donner les mêmes résultats ; par contre les choses deviennent troublantes dès que l'on passe aux coefficients de transport, c'est-à-dire à l'aspect macroscopique de la dynamique moléculaire. Il y a là un écart notable avec les conceptions courantes, ce qui rend très surprenante la lecture de ces articles. On peut mentionner la liste des problèmes théoriques posés par la description phénoménologique qui est celle de cette série d'articles : la généralisation de lois d'échelle en dehors de zones critiques n'est pas absolument nouvelle, par contre la simplicité des lois reliant l'exposant v à la température pose problème ; le sens des temps de relaxation utilisés est sans doute également à préciser. Enfin les modes considérés semblent n'intervenir dans les propriétés thermodynamiques que par un facteur par mode, comme si seulement l'énergie potentielle devait intervenir, les termes cinétiques ne participant pas vraiment aux transitions de phase. Tout cela pose donc problème, et l'on peut se demander si un pareil modèle peut être compatible avec tout ce qui est connu par ailleurs en physique statistique. Mais s'il rend bien compte de beaucoup de résultats expérimentaux, ce sont ces derniers qui seraient en difficulté avec la mécanique statistique. Il a donc semblé préférable de publier le modèle, sa justification expérimentale et de poser quelques problèmes, tant aux théoriciens, qui pourraient expliquer pourquoi un tel modèle rend compte de résultats observés, qu'aux expérimentateurs, qui pourraient reprendre certaines mesures, et délimiter le caractère plus ou moins général du modèle.

  10. Mesure Objective De L'attenuation et De L'effet D'occlusion Des Protecteurs Auditifs a Partir Des Potentiels Evoques Stationnaires et Multiples =

    NASA Astrophysics Data System (ADS)

    Valentin, Olivier

    Selon l'Organisation mondiale de la sante, le nombre de travailleurs exposes quotidiennement a des niveaux de bruit prejudiciables a leur audition est passe de 120 millions en 1995 a 250 millions en 2004. Meme si la reduction du bruit a la source devrait etre toujours privilegiee, la solution largement utilisee pour lutter contre le bruit au travail reste la protection auditive individuelle. Malheureusement, le port des protecteurs auditifs n'est pas toujours respecte par les travailleurs car il est difficile de fournir un protecteur auditif dont le niveau d'attenuation effective est approprie a l'environnement de travail d'un individu. D'autre part, l'occlusion du canal auditif induit une modification de la perception de la parole, ce qui cree un inconfort incitant les travailleurs a retirer leurs protecteurs. Ces deux problemes existent parce que les methodes actuelles de mesure de l'effet d'occlusion et de l'attenuation sont limitees. Les mesures objectives basees sur des mesures microphoniques intra-auriculaires ne tiennent pas compte de la transmission directe du son a la cochlee par conduction osseuse. Les mesures subjectives au seuil de l'audition sont biaisees a cause de l'effet de masquage aux basses frequences induit par le bruit physiologique. L'objectif principal de ce travail de these de doctorat est d'ameliorer la mesure de l'attenuation et de l'effet d'occlusion des protecteurs auditifs intra-auriculaires. L'approche generale consiste a : (i) verifier s'il est possible de mesurer l'attenuation des protecteurs auditifs grâce au recueil des potentiels evoques stationnaires et multiples (PEASM) avec et sans protecteur auditif (protocole 1), (ii) adapter cette methodologie pour mesurer l'effet d'occlusion induit par le port de protecteur auditifs intra-auriculaires (protocole 2), et (iii) valider chaque protocole par l'intermediaire de mesures realisees sur sujets humains. Les resultats du protocole 1 demontrent que les PEASM peuvent etre utilises pour mesurer objectivement l'attenuation des protecteurs auditifs : les resultats obtenus a 500 Hz et 1 kHz demontrent que l'attenuation mesuree a partir des PEASM est relativement equivalente a l'attenuation calculee par la methode REAT, ce qui est en accord avec ce qui etait attendu puisque l'effet de masquage induit par le bruit physiologique aux basses frequences est relativement negligeable a ces frequences. Les resultats du protocole 2 demontrent que les PEASM peuvent etre egalement utilises pour mesurer objectivement l'effet d'occlusion induit par le port de protecteurs auditifs : l'effet d'occlusion mesure a partir des PEASM a 500 Hz est plus eleve que celui calcule par l'intermediaire de la methode subjective au seuil de l'audition, ce qui est en accord avec ce qui etait attendu puisqu'en dessous d'1 kHz, l'effet de masquage induit par le bruit physiologique aux basses frequences est source de biais pour les resultats obtenus par la methode subjective car il y a surestimation des seuils de l'audition en basse frequence lors du port de protecteurs auditifs. Toutefois, les resultats obtenus a 250 Hz sont en contradiction avec les resultats attendus. D'un point de vue scientifique, ce travail de these a permis de realiser deux nouvelles methodes innovantes pour mesurer objectivement l'attenuation et l'effet d'occlusion des protecteurs auditifs intra-auriculaires par electroencephalographie. D'un point de vue sante et securite au travail, les avancees presentees dans cette these pourraient aider a concevoir des protecteurs auditifs plus performants. En effet, si ces deux nouvelles methodes objectives etaient normalisees pour caracteriser les protecteurs auditifs intra-auriculaires, elles pourraient permettre : (i) de mieux apprehender l'efficacite reelle de la protection auditive et (ii) de fournir une mesure de l'inconfort induit par l'occlusion du canal auditif lors du port de protecteurs. Fournir un protecteur auditif dont l'efficacite reelle est adaptee a l'environnement de travail et dont le confort est optimise permettrait, sur le long terme, d'ameliorer les conditions des travailleurs en minimisant le risque lie a la degradation de leur appareil auditif. Les perspectives de travail proposees a la fin de cette these consistent principalement a : (i) exploiter ces deux methodes avec une gamme frequentielle plus etendue, (ii) explorer la variabilite intra-individuelle de chacune des methodes, (iii) comparer les resultats des deux methodes avec ceux obtenus par l'intermediaire de la methode "Microphone in Real Ear" (MIRE) et (iv) verifier la compatibilite de chacune des methodes avec tous les types de protecteurs auditifs. De plus, pour la methode de mesure de l'effet d'occlusion utilisant les PEASM, une etude complementaire est necessaire pour lever la contradiction observee a 250 Hz.

  11. Three, six, or twelve months of dual antiplatelet therapy after DES implantation in patients with or without acute coronary syndromes: an individual patient data pairwise and network meta-analysis of six randomized trials and 11 473 patients.

    PubMed

    Palmerini, Tullio; Della Riva, Diego; Benedetto, Umberto; Bacchi Reggiani, Letizia; Feres, Fausto; Abizaid, Alexandre; Gilard, Martine; Morice, Marie-Claude; Valgimigli, Marco; Hong, Myeong-Ki; Kim, Byeong-Keuk; Jang, Yangsoo; Kim, Hyo-Soo; Park, Kyung Woo; Colombo, Antonio; Chieffo, Alaide; Sangiorgi, Diego; Biondi-Zoccai, Giuseppe; Généreux, Philippe; Angelini, Gianni D; Pufulete, Maria; White, Jonathon; Bhatt, Deepak L; Stone, Gregg W

    2017-04-07

    We sought to determine whether the optimal dual antiplatelet therapy (DAPT) duration after drug-eluting stent (DES) placement varies according to clinical presentation. We performed an individual patient data pairwise and network meta-analysis comparing short-term (≤6-months) versus long-term (1-year) DAPT as well as 3-month vs. 6-month vs 1-year DAPT. The primary study outcome was the 1-year composite risk of myocardial infarction (MI) or definite/probable stent thrombosis (ST). Six trials were included in which DAPT after DES consisted of aspirin and clopidogrel. Among 11 473 randomized patients 6714 (58.5%) had stable CAD and 4758 (41.5%) presented with acute coronary syndrome (ACS), the majority of whom (67.0%) had unstable angina. In ACS patients, ≤6-month DAPT was associated with non-significantly higher 1-year rates of MI or ST compared with 1-year DAPT (Hazard Ratio (HR) 1.48, 95% Confidence interval (CI) 0.98-2.22; P = 0.059), whereas in stable patients rates of MI and ST were similar between the two DAPT strategies (HR 0.93, 95%CI 0.65-1.35; P = 0.71; Pinteraction = 0.09). By network meta-analysis, 3-month DAPT, but not 6-month DAPT, was associated with higher rates of MI or ST in ACS, whereas no significant differences were apparent in stable patients. Short DAPT was associated with lower rates of major bleeding compared with 1-year DAPT, irrespective of clinical presentation. All-cause mortality was not significantly different with short vs. long DAPT in both patients with stable CAD and ACS. Optimal DAPT duration after DES differs according to clinical presentation. In the present meta-analysis, despite the fact that most enrolled ACS patients were relatively low risk, 3-month DAPT was associated with increased ischaemic risk, whereas 3-month DAPT appeared safe in stable CAD. Prolonged DAPT increases bleeding regardless of clinical presentation. Further study is required to identify the optimal duration of DAPT after DES in individual patients based on their relative ischaemic and bleeding risks. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email: journals.permissions@oup.com.

  12. Applicability evaluation of Deep Eutectic Solvents-Cellulase system for lignocellulose hydrolysis.

    PubMed

    Gunny, Ahmad Anas Nagoor; Arbain, Dachyar; Nashef, Enas Muen; Jamal, Parveen

    2015-04-01

    Deep Eutectic Solvents (DESs) have recently emerged as a new generation of ionic liquids for lignocellulose pretreatment. However, DESs contain salt components which tend to inactivate cellulase in the subsequent saccharification process. To alleviate this problem, it is necessary to evaluate the applicability of the DESs-Cellulase system. This was accomplished in the present study by first studying the stability of cellulase in the presence of selected DESs followed by applicability evaluation based on glucose production, energy consumption and kinetic performance. Results showed that the cellulase was able to retain more than 90% of its original activity in the presence of 10% (v/v) for glycerol based DES (GLY) and ethylene glycol based DES (EG). Furthermore, both DESs system exhibited higher glucose percentage enhancement and lower energy consumption as compared to diluted alkali system. Among the two DESs studied, EG showed comparatively better kinetic performance. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. Etude de la formation de resonances electroniques et de leur role dans la fragmentation neutre de molecules d'interet biologique

    NASA Astrophysics Data System (ADS)

    Lepage, Martin

    1998-12-01

    Cette these est presentee a la Faculte de medecine de l'Universite de Sherbrooke en vue de l'obtention du grade de Ph.D. en Radiobiologie. Elle contient des resultats experimentaux enregistres avec un spectrometre d'electrons a haute resolution. Ces resultats portent sur la formation de resonances electroniques en phase condensee et de differents canaux pour leur decroissance. En premier lieu, nous presentons des mesures d'excitations vibrationnelles de l'oxygene dilue en matrice d'argon pour des energies des electrons incidents de 1 a 20 eV. Les resultats suggerent que le temps de vie des resonances de l'oxygene est modifie par la densite d'etats d'electrons dans la bande de conduction de l'argon. Nous presentons aussi des spectres de pertes d'energie d'electrons des molecules de tetrahydrofuranne (THF) et d'acetone. Dans les deux cas, la position en energie des pertes associees aux excitations vibrationnelles est en excellent accord avec les resultats trouves dans la litterature. Les fonctions d'excitation de ces modes revelent la presence de plusieurs nouvelles resonances electroniques. Nous comparons les resonances du THF et celles de la molecule de cyclopentane en phase gazeuse. Nous proposons une origine commune aux resonances ce qui implique qu'elles ne sont pas necessairement attribuees a l'excitation des electrons non-apparies de l'oxygene du THF. Nous proposons une nouvelle methode basee sur la spectroscopie par pertes d'energie des electrons pour detecter la production de fragments neutres qui demeurent a l'interieur d'un film mince condense a basse temperature. Cette methode se base sur la detection des excitations electroniques du produit neutre. Nous presentons des resultats de la production de CO dans un film de methanol. Le taux de production de CO en fonction de l'energie incidente des electrons est calibre en termes d'une section efficace totale de diffusion des electrons. Les resultats indiquent une augmentation lineaire du taux de production de CO en fonction de l'epaisseur du film et de la dose d'electrons incidente sur le film. Ces donnees experimentales cadrent dans un modele simple ou un electron cause la fragmentation de la molecule sans reaction avec les molecules avoisinantes. Le mecanisme propose pour la fragmentation unimoleculaire du methanol est la formation de resonances qui decroissent dans un etat electronique excite. Nous suggerons l'action combinee de la presence d'un trou dans une orbitale de coeur du methanol et de la presence de deux electrons dans la premiere orbitale vide pour expliquer la dehydrogenation complete du methanol pour des energies des electrons entre 8 et 18 eV. Pour des energies plus grandes, la fragmentation par l'intermediaire de l'ionisation de la molecule a deja ete suggeree. La methode de detection des etats electroniques offre une alternative a la detection des excitations vibrationnelles puisque les spectres de pertes d'energie des electrons sont congestionnes dans cette region d'energie pour les molecules polyatomiques.

  14. Interplay among patient empowerment and clinical and person-centered outcomes in type 2 diabetes. The BENCH-D study.

    PubMed

    Rossi, Maria Chiara; Lucisano, Giuseppe; Funnell, Martha; Pintaudi, Basilio; Bulotta, Angela; Gentile, Sandro; Scardapane, Marco; Skovlund, Soren Eik; Vespasiani, Giacomo; Nicolucci, Antonio

    2015-09-01

    We evaluated empowerment in T2DM and identified its correlates. A sample of individuals self-administered the Diabetes Empowerment Scale-Short Form (DES-SF) and other 9 validated instruments (person-centered outcomes). Correlates of DES-SF were identified through univariate and multivariate analyses. For person-centered outcomes, ORs express the likelihood of being in upper quartile of DES-SF (Q4) by 5 units of the scale. Overall, 2390 individuals were involved. Individuals in Q4 were younger, more often males, had higher levels of school education, lower HbA1c levels and prevalence of complications as compared to individuals in the other quartiles. The likelihood of being in Q4 was directly associated with higher selfreported self-monitoring of blood glucose (SDSCA6-SMBG) (OR=1.09; 95% CI: 1.03-1.15), higher satisfaction with diabetes treatment (GSDT) (OR=1.15; 95% CI: 1.07-1.25), perceived quality of chronic illness care and patient support (PACIC-SF) (OR=1.23; 95% CI: 1.16-1.31), and better person-centered communication (HCC-SF) (OR=1.10; 95% CI: 1.01-1.19) and inversely associated with diabetes-related distress (PAID-5) (OR=0.95; 95% CI: 0.92-0.98). Adjusted DES-SF mean scores ranged between centers from 69.8 to 93.6 (intra-class correlation=0.10; p<0.0001). Empowerment was associated with better glycemic control, psychosocial functioning and perceived access to person-centered chronic illness care. Practice of diabetes center plays a specific role. DES-SF represents a process and outcome indicator in the practice of diabetes centers. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  15. Comparisons of PBDE composition and concentration in fish collected from the Detroit River, MI and Des Plaines River, IL

    USGS Publications Warehouse

    Rice, C.P.; Chernyak, S.M.; Begnoche, L.; Quintal, R.; Hickey, J.

    2002-01-01

    Polybrominated diphenyl ethers (PBDEs) were identified in fish collected from the Detroit River, MI and Des Plaines Rivers, IL. In the Detroit River fish, carp and large mouth bass, the congener patterns were dominated by the 2,2′,4,4′-tetrabromo (BDE-47) congener; however, in Des Plaines River carp the dominant isomers were the heptabromo congeners BDE-181 and BDE-183 and lesser amounts of another heptabromo congener, BDE-190, and two hexabromo congeners, BDE-154 and BDE-153. Three possible sources exist for these less-commonly identified PBDE congeners: (a) waste discharge from manufacturing or discarded products near the river, (b) public owned treatment work (POTW) effluents which constitute more than 75% of the flow in the Des Plaines River, (c) or formation of these congeners by debromination of in-place deposits of decabromodiphenyl ether. Average concentration totals (sum of concentrations for seven of the dominant PBDE congeners) were similar on a wet weight bases for the carp (5.39 ng/g wet weight) and large mouth bass (5.25 ng/g) in the Detroit River samples; however, the bass were significantly higher, ρ=0.01, when compared on a lipid basis (bass-163 ng/g vs. carp-40.5 ng/g lipid weight). Some of the PBDE congeners were positively correlated with increasing lipid levels in both fish species. Average total PBDE concentrations in the carp from the Des Plaines River (12.48 ng/g wet weight) were significantly higher, ρ=0.01, than in carp from the Detroit River. The residues were isolated using standard organochlorine methods for fish and analyzed using gas chromatography/mass spectrometry-negative chemical ionization methods.

  16. Solvatochromic probe behavior within choline chloride-based deep eutectic solvents: effect of temperature and water.

    PubMed

    Pandey, Ashish; Pandey, Siddharth

    2014-12-18

    Deep eutectic solvents (DESs) have shown potential as promising environmentally friendly alternatives to conventional solvents. Many common and popular DESs are obtained by simply mixing a salt and a H-bond donor. Properties of such a DES depend on its constituents. Change in temperature and addition of water, a benign cosolvent, can change the physicochemical properties of DESs. The effect of changing temperature and addition of water on solvatochromic probe behavior within three DESs formed from choline chloride combined with 1,2-ethanediol, glycerol, and urea, respectively, in 1:2 mol ratios termed ethaline, glyceline, and reline is presented. Increase in temperature results in reduced H-bond donating acidity of the DESs. Dipolarity/polarizability and H-bond accepting basicity do not change with changing temperature of the DESs. The response of the fluorescence probe pyrene also indicates a decrease in the polarity of the DESs as temperature is increased. Addition of water to DES results in increased dipolarity/polarizability and a decrease in H-bond accepting basicity. Except for pyrene, solvatochromic probes exhibit responses close to those predicted from ideal-additive behavior with slight preferential solvation by DES within the aqueous mixtures. Pyrene response reveals significant preferential solvation by DES and/or the presence of solvent-solvent interactions, especially within aqueous mixtures of ethaline and glyceline, the DESs constituted of H-bond donors with hydroxyl functionalities. FTIR absorbance and Raman spectroscopic measurements of aqueous DES mixtures support the outcomes from solvatochromic probe responses. Aqueous mixtures of ethaline and glyceline possess relatively more interspecies H-bonds as compared to aqueous mixtures of reline, where interstitial accommodation of water within the reline molecular network appears to dominate.

  17. Very late outcomes of drug-eluting stents coated with biodegradable polymers: insights from the 5-year follow-up of the randomized PAINT trial

    PubMed Central

    Marchini, Julio F.; Gomes, Wilton F.; Moulin, Bruno; Perin, Marco A.; Oliveira, Ludmilla A.R.R.; Arruda, J. Airton; Lima, Valter C.; Lima, Antonio A.G.; Caramori, Paulo R.A.; Medeiros, Cesar R.; Barbosa, Mauricio R.; Brito, Fabio S.; Ribeiro, Expedito E.

    2014-01-01

    Background Few studies have examined the very long-term outcomes after implantation of drug-eluting stents (DES) coated with biodegradable polymers (BP). This report presents the 5-year clinical follow-up of patients treated with BP-DES in the randomized PAINT trial. Methods The PAINT study is a prospective, multicenter randomized controlled trial that allocated 274 patients for treatment with two BP-DES formulations [paclitaxel-eluting stents (PES) or sirolimus-eluting stents (SES)] or bare metal stents (BMS) in a 1:2:2 ratio, respectively. The primary end-point of this sub-study was defined as the composite of the major cardiac adverse events (MACE) cardiac death, myocardial infarction (MI) or ischemia-driven target vessel revascularization (TVR) at 5 years. Results The 5-year MACE rates were different among the groups: 35.3%, 22.5% and 16.9% for BMS, PES and SES, respectively (P<0.05 for both DES vs. bare stent comparisons). The primary end-point was mainly driven by TVR: 31.8%, 14.1% and 12.2% for bare stents, PES and SES, respectively (P<0.05 for both DES vs. bare stent comparisons). The incidence of stent thrombosis (ST) was null for BMS during the entire follow-up. There was no definite or probable ST in the SES group after the second year, while one patient (1.0%) presented with a definite ST episode in the PES group between 4 and 5 years. Conclusions The tested biodegradable-polymer coated stents releasing either paclitaxel or sirolimus, compared with same bare metal platform, sustained their effectiveness in reducing combined major adverse cardiac events and re-intervention without an increase in ST during 5 years of follow-up. PMID:25610805

  18. IVUS Findings in Late and Very Late Stent Thrombosis. A Comparison Between Bare-metal and Drug-eluting Stents.

    PubMed

    Fuentes, Lara; Gómez-Lara, Josep; Salvatella, Neus; Gonzalo, Nieves; Hernández-Hernández, Felipe; Fernández-Nofrerias, Eduard; Sánchez-Recalde, Ángel; Alfonso, Fernando; Romaguera, Rafael; Ferreiro, José Luis; Roura, Gerard; Teruel, Luis; Gracida, Montserrat; Marcano, Ana Lucrecia; Gómez-Hospital, Joan-Antoni; Cequier, Ángel

    2018-05-01

    Stent thrombosis (ST) is a life-threatening complication after stent implantation. Intravascular ultrasound is able to discern most causes of ST. The aim of this study was to compare intravascular ultrasound findings between bare-metal stents (BMS) and drug-eluting stents (DES) in patients with late (31 days to 1 year) or very late ST (> 1 year). Of 250 consecutive patients with late or very late ST in 7 Spanish institutions, 114 patients (45.5% BMS and 54.5% DES) were imaged with intravascular ultrasound. Off-line intravascular ultrasound analysis was performed to assess malapposition, underexpansion, and neoatherosclerosis. The median time from stent implantation to ST was 4.0 years with BMS and 3.4 years with DES (P = .04). Isolated malapposition was similarly observed in both groups (36.5% vs 46.8%; P = .18) but was numerically lower with BMS (26.6% vs 48.0%; P = .07) in patients with very late ST. Isolated underexpansion was similarly observed in both groups (13.5% vs 11.3%; P = .47). Isolated neoatherosclerosis occurred only in patients with very late ST and was more prevalent with BMS (22.9%) than with DES (6.0%); P = .02. At 2.9 years' follow-up, there were 0% and 6.9% cardiac deaths, respectively (P = .06) and recurrent ST occurred in 4.0% and 5.2% of patients, respectively (P = .60). Malapposition was the most common finding in patients with late and very late ST and is more prevalent with DES in very late ST. In contrast, neoatherosclerosis was exclusively observed in patients with very late ST and mainly with BMS. Copyright © 2017 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  19. Identifying Candidate Reprogramming Genes in Mouse Induced Pluripotent Stem Cells.

    PubMed

    Gao, Fang; Li, Jingyu; Zhang, Heng; Yang, Xu; An, Tiezhu

    2017-08-01

    Factor-based induced reprogramming approaches have tremendous potential for human regenerative medicine, but the efficiencies of these approaches are still low. In this study, we analyzed the global transcriptional profiles of mouse induced pluripotent stem cells (miPSCs) and mouse embryonic stem cells (mESCs) from seven different labs and present here the first successful clustering according to cell type, not by lab of origin. We identified 2131 different expression genes (DEs) as candidate pluripotency-associated genes by comparing mESCs/miPSCs with somatic cells and 720 DEs between miPSCs and mESCs. Interestingly, there was a significant overlap between the two DE sets. Therefore, we defined the overlap DEs as "consensus DEs" including 313 miPSC-specific genes expressed at a higher level in miPSCs versus mESCs and 184 mESC-specific genes in total and reasoned that these may contribute to the differences in pluripotency between mESCs and miPSCs. A classification of "consensus DEs" according to their different expression levels between somatic cells and mESCs/miPSCs shows that 86% of the miPSC-specific genes are more highly expressed in somatic cells, while 73% of mESC-specific genes are highly expressed in mESCs/miPSCs, indicating that the miPSCs have not efficiently silenced the expression pattern of the somatic cells from which they are derived and failed to completely induce the genes with high expression levels in mESCs. We further revealed a strong correlation between oocyte-enriched factors and insufficiently induced mESC-specific genes and identified 11 hub genes via network analysis. In light of these findings, we postulated that these key hub genes might not only drive somatic cell nuclear transfer (SCNT) reprogramming but also augment the efficiency and quality of miPSC reprogramming.

  20. Digging deeper into the Southern skies: a compact Milky Way companion discovered in first-year Dark Energy Survey data

    NASA Astrophysics Data System (ADS)

    Luque, E.; Queiroz, A.; Santiago, B.; Pieres, A.; Balbinot, E.; Bechtol, K.; Drlica-Wagner, A.; Neto, A. Fausti; da Costa, L. N.; Maia, M. A. G.; Yanny, B.; Abbott, T.; Allam, S.; Benoit-Lévy, A.; Bertin, E.; Brooks, D.; Buckley-Geer, E.; Burke, D. L.; Rosell, A. Carnero; Kind, M. Carrasco; Carretero, J.; Cunha, C. E.; Desai, S.; Diehl, H. T.; Dietrich, J. P.; Eifler, T. F.; Finley, D. A.; Flaugher, B.; Fosalba, P.; Frieman, J.; Gerdes, D. W.; Gruen, D.; Gutierrez, G.; Honscheid, K.; James, D. J.; Kuehn, K.; Kuropatkin, N.; Lahav, O.; Li, T. S.; March, M.; Marshall, J. L.; Martini, P.; Miquel, R.; Neilsen, E.; Nichol, R. C.; Nord, B.; Ogando, R.; Plazas, A. A.; Romer, A. K.; Roodman, A.; Sanchez, E.; Scarpine, V.; Schubnell, M.; Sevilla-Noarbe, I.; Smith, R. C.; Soares-Santos, M.; Sobreira, F.; Suchyta, E.; Swanson, M. E. C.; Tarle, G.; Thaler, J.; Tucker, D.; Walker, A. R.; Zhang, Y.

    2016-05-01

    We use the first-year Dark Energy Survey (DES) data down to previously unprobed photometric depths to search for stellar systems in the Galactic halo, therefore complementing the previous analysis of the same data carried out by our group earlier this year. Our search is based on a matched filter algorithm that produces stellar density maps consistent with stellar population models of various ages, metallicities, and distances over the survey area. The most conspicuous density peaks in these maps have been identified automatically and ranked according to their significance and recurrence for different input models. We report the discovery of one additional stellar system besides those previously found by several authors using the same first-year DES data. The object is compact, and consistent with being dominated by an old and metal-poor population. DES 1 is found at high significance and appears in the DES images as a compact concentration of faint blue point sources. Assuming different spatial profile parameterizations, the best-fitting heliocentric distance and total absolute magnitude in the range of 77.6-87.1 kpc and -3.00 ≲ MV ≲ -2.21, respectively. The half-light radius of this object, rh ˜ 10 pc and total luminosity are consistent with it being a low-mass halo cluster. It is also found to have a very elongated shape (ɛ ˜ 0.57). In addition, our deeper probe of DES first-year data confirms the recently reported satellite galaxy candidate Horologium II as a significant stellar overdensity. We also infer its structural properties and compare them to those reported in the literature.

Top