Study of Helicopter Performance and Terminal Instrument Procedures

DTIC Science & Technology

1980-06-01

possible employment of decelerating or other innovative approaches to be discussed in Section 3 and may be employed to advantage in reviewing missed...330J Puma is a 19 passenger medium helicopter manufactured by Societe Nationale Industrielle Aerospatiale of Marignane, France and marketed in the...for use by the French and British armed forces. It is manufactured by the Helicopter Divison of Societe Nationale Industrielle Aerospatiale of Marignane

Assessing the Impact Participation in Science Journalism Activities Has on Scientific Literacy among High School Students

ERIC Educational Resources Information Center

Farrar, Cathy

2012-01-01

As part of the National Science Foundation Science Literacy through Science Journalism (SciJourn) research and development initiative (http://www.scijourn.org; Polman, Saul, Newman, and Farrar, 2008) a quasi-experimental design was used to investigate what impact incorporating science journalism activities had on students' scientific literacy.…

Optics Microwave Interactions (Interactions entre optique et micro-ondes)

DTIC Science & Technology

2003-04-01

2 Z0 S21L 2 1 - ΓLas 2 Pin,1dB CP = m1dB CP 2 Ib - Ith 2 1 - S22LΓLas 2 Z0 S21L 2 1 - ΓLas 2 In a similar fashion , the 3rd order...behavior similar to a sinc function [i.e., sinx/x] squared fashion . -85 -80 -75 -70 -65 -60 -55 0 20 40 60 80 100 Fiber Length (km) Model 1 Model 1 Measured...the photocurrent in a linear fashion . On the other hand in HBT, in addition to photo-generated electrons at the collector depletion region, there is an

A New Look at Genre and Authenticity: Making Sense of Reading and Writing Science News in High School Classrooms

ERIC Educational Resources Information Center

Kohnen, Angela M.

2012-01-01

This qualitative study examined the importance of the genre and authenticity as teachers sought to bring science journalism to the high school science classroom. Undertaken as part of the National Science Foundation-funded grant "Science Literacy through Science Journalism (SciJourn)," this work was conducted as a series of smaller…

Exploring the Nature of High School Student Engagement with Science and Technology as an Outcome of Participation in Science Journalism

ERIC Educational Resources Information Center

Hope, Jennifer Michelle Gauble

2012-01-01

In a mixed-methods study of high school student participants in the National Science Foundation-funded Science Literacy through Science Journalism (SciJourn) project, the new Youth Engagement with Science & Technology (YEST) Survey and classroom case studies were used to determine program impact on participant engagement with science and…

[The "Académie nationale de Médecine" and the "Société française d'Histoire de la Médecine"].

PubMed

Lefebvre, Pierre

2003-01-01

The "Académie nationale de Médecine" was created in 1902 in Paris in the same time as the "Société française d'Histoire de la Médecine" but the relationship between the two societies depended upon the characters rather than the institutions. Thus two recent common experiences of the recent past urged to strengthen their links.

Fashoda: Turning Point in Anglo-French Relations: a Study in Military-Political Affairs.

DTIC Science & Technology

1976-01-01

volume number: France, Minist~re des Affaires Etrangres, Documents diplomatiques frangais, 1871-1914 (1st series, 16 volumes; Paris: Imprimerie Nationale...1929-59), XIT, no. 152. b. Documents cited in secondary works are cited here as they are in those works: Archives Nationales, 53, AP: Papiers de ...Documents on the Origins of the War 3.1. Biblioteque de l’Institut (Library of the French Institute) D.D.F. Documents diplomatiques frangais (French

2-D Acousto-Optic Signal Processors for Simultaneous Spectrum Analysis and Direction Finding

DTIC Science & Technology

1990-11-01

National Dfense Defence nationale 2-D ACOUSTO - OPTIC SIGNAL PROCESSORS FOR SIMULTANEOUS SPECTRUM ANALYSIS 00 AND DIRECTION FINDING (U) by NM Jim P.Y...Wr pdft .1w I0~1111191 3 05089 National DIfense Defence nationale 2-D ACOUSTO - OPTIC SIGNAL PROCESSORS FOR SIMULTANEOUS SPECTRUM ANALYSIS AND DIRECTION...Processing, J.T. Tippet et al., Eds., Chapter 38, pp. 715-748, MIT Press, Cambridge 1965. [6] A.E. Spezio," Acousto - optics for Electronic Warfare

Multiscale Materials Science: A Mathematical Approach to the Role of Defects and Uncertainty

DTIC Science & Technology

2015-03-01

ADDRESS(ES) Ecole Nationale des Ponts et Chaussees 6 et 8 avenue Blaise Pascal, Cite Descartes , Champs sur Marne 77 455 Marne la Vallee Cedex 2...nationale des ponts et chaussees 6 et 8 avenue Blaise-Pascal, Cite Descartes Champs-sur-Marne F-77455 Mame-la-Vallee cedex 2 www.enpc.fr tel...CHAUSSEES 6, AVENUE BLAISE PASCAL 6 ET 8 CITE DESCARTES CHAMPS SUR MARNE, 77420 FR 13d. BUSINESS OFFICE CONTACT: CAROLINA GARCIA-OLMEDO 13e

Lessons from U.S. Allies in Security Cooperation with Third Countries: The Cases of Australia, France, and the United Kingdom

DTIC Science & Technology

2011-01-01

Force 2030, Defence White Paper 2009, May 2, 2009c. b Commission du Livre blanc, Défense et Sécurité Nationale: Le Livre Blanc, Paris : Odile Jacob...Australia, France, the UK, and the United States. However, unless an exercise was part of the original training package, many times those skills are not...May 2, 2009c; Commission du Livre blanc, Défense et Sécurité Nationale: Le Livre Blanc, Paris : Odile Jacob/La Documentation Française, June 2008

Foreword

NASA Astrophysics Data System (ADS)

Aime, C.; Soummer, R.

This book reports the proceedings of the second Journées d'Imagerie grave{a} Très Haute Dynamique et Détection d'Exoplanètes (Days on High Contrast Imaging and Exoplanets Detection) that were held in Nice in October, 6-10, 2003 with the joint efforts of the Collège de France, the Observatoire de la Côte d'Azur, the CNRS (Centre National de la Recherche Scientifique) and the Laboratoire Universitaire d'Astrophysique de Nice which organized the meeting. The first Journées led to the publication of Volume 8, 2003 EAS Publications Series: Astronomy with High Contrast Imaging: From Planetary Systems to Active Galactic Nuclei that collected 33 papers presented during the session of May, 13-16, 2002. It covered a very large domain of research in high contrast imaging for exoplanet detection: astrophysical science (from protoplanetary disks to AGNs), instruments and techniques (from coronagraphy to nulling), data processing. These Journées took place because of the need of a working session giving enough time to the participants to explain their work and understand that of their colleagues. The second Journées took the form of an École thématique du CNRS. The courses were held in French, but the reports are in English. The present edition reports 29 courses and short presentations given at this occasion. The texts correspond to original presentations, and a few communications, too similar to those of 2002, were not reported here to avoid duplication. This makes the two books complementary. The general theme of the school was similar to that of the former meeting, with a marked teaching objective. The courses and presentations were also more centered in optics and instrumental techniques. The main idea was to study what we could call “exoplanetographs”, instruments using apodisation, coronagraphy, nulling or other techniques to directly record the light of an exoplanet. Fundamental aspects of signal processing were deferred to a third edition of the school. A very short explanation of how the reports are ordered is given here. The Journées of 2003 started with the delocalized lectures (delocalized means here “not in Paris”!) of the Collège de France, of Antoine Labeyrie who wrote a report on Removal of coronagraphy residues with an adaptive hologram. Three invited seminars follow: Olivier Guyon (Pupil remapping techniques), Daniel Rouan (Ultra-nulling interferometers), and Kjetil Dohlen (Phase masks in astronomy). An illustration from Daniel Rouan's talk on the properties of Prouhet-Thué-Morse series was also selected for the cover figure of this edition. These papers are followed by the courses and communications given during the 4 days of the school, in a slightly different order of their presentation. The first two days were on atmospheric turbulence and adaptive optics for coronagraphy, and also coronagraphic space projects. Steve Ridgway gives a general introduction to the problem (Astronomy with high contrast imaging). This is followed by a presentation on Fourier and Statistical Optics: Shaped and Apodized apertures (Claude Aime), The effect of a coronagraph on the statistics of adaptive optics pinned speckles (Claude Aime and Rémi Soummer). A general introduction to the problem of atmospheric turbulence is made by Julien Borgnino. A presentation of the Concordia site with emphasis on its advantages for high contrast imaging is given by Eric Fossat. Several presentations relative to numerical simulations of Adaptive Optics and coronagraphy follow: Marcel Carbillet (AO for very high contrast imaging), Lyu Abe and Anthony Boccaletti share two presentations on Numerical simulations for coronagraphy. These presentations are followed by reports on experiments: Sandrine Thomas (SAM-the SOAR adaptive module), Pierre Baudoz (Cryogenic IR test of the 4QPM coronagraph), Anthony Boccaletti (Coronagraphy with JWST in the thermal IR). Pierre Bourget (Hg-Mask Coronagraph) ends this part with a coronagraph using a mercury drop as a Lyot mask. The next session focused on nulling interferometry and we gather here the corresponding contribution. Two complementary reports on theory and experiment of Bracewell interferometry were made by Yves Rabbia (Theoretical aspects of Darwin) and Marc Ollivier (Experimental aspects of Darwin). Olivier Absil gave a report on the ground based nulling interferometer experiment (Effects of atmospheric turbulence on GENIE) and Valérie Weber on MAII (Nulling interferometric broadbord). A comparison between nulling and different classes of coronagraphs was made by Olivier Guyon (Coronagraphy vs. nulling). A few prospective papers have been regrouped at the end of the book: Interferometric remapped array nulling (Lyu Abe), Multiple-stage apodized Lyot coronagraph (Claude Aime and Rémi Soummer), Piston sensor using dispersed speckles (Virginie Borkowski), Principle of a coaxial achromatic interfero coronagraph (Jean Gay), Coronagraphic imaging on the VLTI with VIDA (Olivier Lardière), Phase contrast apodisation (Frantz Martinache) The last section regroups science aspects and results on sky, using high contrast imaging: Low mass companions searches using high dynamic range imaging (Jean-Luc Beuzit). The last paper by Claire Moutou (Ground-based direct imaging of exoplanets) can be read as a prospective conclusion of the Journées. C. Aime and R. Soummer

Dynamic Resource Allocation to Improve Service Performance in Order Fulfillment Systems

DTIC Science & Technology

2009-01-01

efficient system uses economies of scale at two points: orders are batched before processing, which reduces processing costs, and processed or- ders ...the ef- fects of batching on order picking processes is well-researched and well-understood ( van den Berg and Gademann, 1999). Because orders are...a final so- journ time distribution. Our work builds on existing research in matrix-geometric methods by Neuts (1981), Asmussen and M0ller (2001

Toward a Profile of Soviet Behavior in International Financial Markets,

DTIC Science & Technology

1987-08-01

offered even better terms than indicated in Table 3. In October 1986, Banque Nationale de Paris managed a $300 million Table 3 TERMS OF SOVIET BORROWING...I ’, Bank, Claim-. 1 All ()%% C)A111-HIS Ilep in I eceiuhtr 19 2 26 211 Ie )een i e r I I Os󈧐 lt4.222 I )ecerlher !A, 1 hi , he le n i tr 1- Iat tr...French hank. In the BIS reporting scheme, this transaction is no (lifTerent t’roi at deposit by a British bank in Banque Nationale (de Paris. But just

Science Town 2.0: An integrating Concept for S&T Support for Multi-Agency Crisis and Disaster Management

DTIC Science & Technology

2012-12-01

la Reine (en droit du Canada), telle que représentée par le ministre de la Défense nationale, 2012 DRDC CSS TM 2012-029 i...importantes forces d’application de la loi et de sécurité nationale de l’histoire du Canada. L’empreinte de la sécurité du théâtre d’opérations des Jeux...sécurité et de défense par la mise en place d’une « ville scientifique » mobile. La réussite du déploiement des

VizieR Online Data Catalog: Baade's variables in Sagitta and Cygnus (Skiff, 1997)

NASA Astrophysics Data System (ADS)

Skiff, B. A.

2002-10-01

The tables below show identifications and precise positions for a group of variables found by Walter Baade (1928AN....232...65B) during his Bergedorfer days. The stars reported in this survey are of some historical interest because it was as a result of this work that Baade conceived ideas that led to his later recognition of the two stellar populations among Galactic stars (cf. Osterbrock, 1995, Journ. Hist. Astron., 26, 1). (3 data files).

Assessing the impact participation in science journalism activities has on scientific literacy among high school students

NASA Astrophysics Data System (ADS)

Farrar, Cathy

As part of the National Science Foundation Science Literacy through Science Journalism (SciJourn) research and development initiative (http://www.scijourn.org ; Polman, Saul, Newman, and Farrar, 2008) a quasi-experimental design was used to investigate what impact incorporating science journalism activities had on students' scientific literacy. Over the course of a school year students participated in a variety of activities culminating in the production of science news articles for Scijourner, a regional print and online high school science news magazine. Participating teachers and SciJourn team members collaboratively developed activities focused on five aspects of scientific literacy: placing information into context, recognizing relevance, evaluating factual accuracy, use of multiple credible sources and information seeking processes. This study details the development process for the Scientific Literacy Assessment (SLA) including validity and reliability studies, evaluates student scientific literacy using the SLA, examines student SLA responses to provide a description of high school students' scientific literacy, and outlines implications of the findings in relation to the National Research Council's A Framework for K-12 Science Education: Practices, Crosscutting Concepts, and Core Ideas (2012) and classroom science teaching practices. Scientifically literate adults acting as experts in the assessment development phase informed the creation of a scoring guide that was used to analyze student responses. Experts tended to draw on both their understanding of science concepts and life experiences to formulate answers; paying close attention to scientific factual inaccuracies, sources of information, how new information fit into their view of science and society as well as targeted strategies for information seeking. Novices (i.e., students), in contrast, tended to ignore factual inaccuracies, showed little understanding about source credibility and suggested unproductive information seeking strategies. However, similar to the experts, novices made references to both scientific and societal contexts. The expert/novice comparison provides a rough description of a developmental continuum of scientific literacy. The findings of this study including student results and Generalized Linear Mixed Modeling suggest that the incorporation of science journalism activities focused on STEM issues can improve student scientific literacy. Incorporation of a wide variety of strategies raised scores on the SLA. Teachers who included a writing and revision process that prioritized content had significantly larger gains in student scores. Future studies could broaden the description of high school student scientific literacy and measured by the SLA and provide alternative pathways for developing scientific literacy as envisioned by SciJourn and the NRC Frameworks.

Privacy Laws and Biobanking in Germany.

PubMed

Hoppe, Nils

2016-03-01

While the possibility of enacting a sui generis Biobank Act has been debated in Germany at great length, as of yet the country has not implemented any biobankspecific legislation. Instead, oversight is available via a network of research and privacy laws, including those of the European Union. The Nationale Kohorte, Germany's large-scale, population-based epidemiological research biobank, is funded by the Federal Ministry of Education and Research, and there are currently 108 registered bio-banks throughout Germany. The current system, including the structure and study design of the Nationale Kohorte, privileges the protection of personal information even at the cost of socially desirable research; it remains to be seen if forthcoming legislation will shift this balance. © 2016 American Society of Law, Medicine & Ethics.

Modeling of Heavy Metal Transformation in Soil Ecosystem

NASA Astrophysics Data System (ADS)

Kalinichenko, Kira; Nikovskaya, Galina N.

2017-04-01

The intensification of industrial activity leads to an increase in heavy metals pollution of soils. In our opinion, sludge from biological treatment of municipal waste water, stabilized under aerobic-anaerobic conditions (commonly known as biosolid), may be considered as concentrate of natural soil. In their chemical, physical and chemical and biological properties these systems are similar gel-like nanocomposites. These contain microorganisms, humic substances, clay, clusters of nanoparticles of heavy metal compounds, and so on involved into heteropolysaccharides matrix. It is known that microorganisms play an important role in the transformation of different nature substances in soil and its health maintenance. The regularities of transformation of heavy metal compounds in soil ecosystem were studied at the model of biosolid. At biosolid swelling its structure changing (gel-sol transition, weakening of coagulation contacts between metal containing nanoparticles, microbial cells and metabolites, loosening and even destroying of the nanocomposite structure) can occur [1, 2]. The promotion of the sludge heterotrophic microbial activities leads to solubilization of heavy metal compounds in the system. The microbiological process can be realized in alcaligeneous or acidogeneous regimes in dependence on the type of carbon source and followed by the synthesis of metabolites with the properties of flocculants and heavy metals extragents [3]. In this case the heavy metals solubilization (bioleaching) in the form of nanoparticles of hydroxycarbonate complexes or water soluble complexes with oxycarbonic acids is observed. Under the action of biosolid microorganisms the heavy metals-oxycarbonic acids complexes can be transformed (catabolised) into nano-sizing heavy metals- hydroxycarbonates complexes. These ecologically friendly complexes and microbial heteropolysaccharides are able to interact with soil colloids, stay in the top soil profile, and improve soil structure due to the formation of water-stable aggregates. The alkaligeneous microbiological process in natural ecosystems by co-metabolism of appropriate carbon source is more advantages for environment. Thus the possibility of solubilization of heavy metal compounds in the soil due to stimulating its biological activities of native microorganisms is proved. The studies on the interactions in the system of sludge solid has allowed to develop the "green" biotechnological process of heavy metals solubilization in contaminated soils and sludges. 1. Kalinichenko KV, Nikovskaya GN, and Ulberg ZR (2012) Bioextraction of heavy metals from colloidal sludge systems. Colloid Journ. 74(5) : 553-557. 2. Kalinichenko KV, Nikovskaya GN, and Ulberg ZR (2013) Changes in the surface properties and stability of biocolloids of a sludge system upon extraction of heavy metals. Colloid Journ. 75(3) : 274-278. 3. Nikovskaya GN, Kalinichenko KV (2013) Bioleaching of heavy metals from sludge after biological treatment of municipal effluent. Journ. of Water Chem. and Techn. 35(2) : 80-85.

Synthese et Caracterisation de Nanocomposites d'Argile et de Graphene Formes a Partir de Precurseurs Organiques =

NASA Astrophysics Data System (ADS)

Boussaboun, Zakariae

Les mineraux d'argile sont des catalyseurs possibles pour la formation du graphene a partir de precurseurs organiques, comme le saccharose. Les argiles sont abondantes, securitaires et economiques pour la formation du graphene. L'objectif principal de ce memoire est de demontrer qu'il est possible de synthetiser un materiau hybride contenant de l'argile et du graphene. La preparation de ces materiaux carbones a base de l'argile (bentonite et cloisite) et le saccharose a ete realisee selon deux methodes. La premiere methode est faite en trois etapes : 1) periode de contact entre l'argile et la source de carbone dans un environnement humide, 2) infiltration de la matiere carbonee et transformation au four a micro-onde, 3) chauffage a 750°C sous azote pour obtenir des materiaux carbones. Par contre la deuxieme methode est faite en deux etapes, sans micro-onde, et avec une augmentation de la quantite de source de carbone (saccharose et alginate). La caracterisation du materiau a permis de suivre les reactions de transformation de la source de carbone vers le graphene. Cette caracterisation a ete faite par la spectroscopie IRTF et Raman, l'analyse thermogravimetrique (TGA), la surface specifique (methode BET) et le microscope electronique a balayage (MEB). La conductivite electrique a ete mesuree par un spectrometre dielectrique et en fonction de la pression appliquee avec un multimetre. Le materiau realise etait incorpore dans une matrice avec un polyethylene a basse densite pour avoir un polymere avec des caracteristiques specifiques. La conductivite thermique a ete ensuite mesuree suivant la norme ASTM E1530. L'echantillon realise avec la deuxieme methode avec une proportion de bentonite pour 5 proportions de saccharose (M2 B1 : S5) signale la possibilite de produire des materiaux de graphene a partir de ressources naturelles. La surface specifique a considerablement augmente de (75,88 m2/g) pour bentonite non traiter a (139,76 m2/g) pour l'echantillon (M2 B1 : S5). Une augmentation significative de la conductivite par pression (95,3 S/m sous une pression de 6,5 MPa par rapport a 1,45*10 -3 S/m pour la bentonite) et la conductivite thermique dans le polyethylene basse densite a une concentration de 10% d'additif (0,332 W/m.K a 0,279 W/m.K) ont ete observes pour le meme echantillon M2 B1 : S5 comparativement a la bentonite non traitee. Les applications possibles sont par exemple les senseurs et les actuateurs par pression.

Des furoncles résistants aux antibiotiques: penser à la myiase !!

PubMed Central

Ajili, Faida; Abid, Rim; Bousseta, Najeh; Mrabet, Ali; Karoui, Ghazi; Louzir, Bassem; Battikh, Riadh; Othmani, Salah

2013-01-01

Les myiases sont des infections parasitaires par des larves de mouches. La localisation cutanée doit être évoquée de retour d'un pays tropical devant une évolution inhabituelle de lésions cutanées. Nous rapportons une observation d'un militaire tunisien, ayant séjourné en République Démocratique du Congo. Il était atteint de myiase cutanée simulatrice d'une furonculose résistante aux antibiotiques. L'intérêt de cette observation est de souligner l'importance d’évoquer la myiase dont le traitement est simple et rapide chez un patient de retour de zone d'endémie. PMID:24106569

The Computerization of the National Library in Paris.

ERIC Educational Resources Information Center

Lerin, Christian; Bernard, Annick

1986-01-01

Describes the organization and automation plan of the Bibliotheque Nationale (Paris, France) that was begun in 1981. Highlights include the method of moving toward computerization; technical choices; the choosing procedure (pre-qualification, bench-mark test); short term and pilot operations; and preparation for the implementation of the…

The Quebec National Library on the Web.

ERIC Educational Resources Information Center

Kieran, Shirley; Sauve, Diane

1997-01-01

Provides an overview of the Quebec National Library (Bibliotheque Nationale du Quebec, or BNQ) Web site. Highlights include issues related to content, design, and technology; IRIS, the BNQ online public access catalog; development of the multimedia catalog; software; digitization of documents; links to bibliographic records; and future…

Étude descriptive du processus d’évaluation et de documentation de la douleur postopératoire dans un hôpital universitaire

PubMed Central

Bergeron, Dave A; Leduc, Geneviève; Marchand, Serge; Bourgault, Patricia

2011-01-01

Plusieurs études démontrent que les patients reçoivent souvent un traitement insatisfaisant de la douleur en contexte postopératoire. Le but de la présente étude descriptive était d’examiner et d’analyser diverses données ayant trait au soulagement de 40 patients après une intervention chirurgicale non urgente. Les patients ont rempli un journal de douleur afin d’évaluer le niveau d’intensité et de désagrément engendré par la douleur durant les trois premières journées postopératoires. Une analyse du dossier a permis de vérifier la documentation de l’évaluation de la douleur par le personnel infirmier. Les résultats indiquent que la douleur en contexte postopératoire est peu et inadéquatement évaluée et peu documentée par le personnel infirmier. Lorsque la douleur est évaluée selon une échelle numérique, les infirmières ont tendance à la sous-évaluer en comparaison avec l’évaluation notée par les patients. Pour la première journée postopératoire, l’intensité moyenne de la douleur documentée par les infirmières est de 1,57 (±0,23) sur une échelle numérique de 0 à 10, alors que l’intensité moyenne documentée par les patients est de 3,82 (±0,41). Cette étude fait ainsi ressortir qu’il n’y a pas de corrélation significative entre l’intensité de la douleur documentée par l’infirmière et celle notée par le patient, ce qui peut expliquer en partie un soulagement non optimal. PMID:21499582

21 CFR Appendix B to Subpart A of... - List of Authorities

Code of Federal Regulations, 2011 CFR

2011-04-01

... Control Farmacéutico. For medicinal products for veterinary use: Ministerio de Agricultura, Pesca y...: Agence du Médicament. For veterinary medicinal products: Agence Nationale du Médicament Vétérinaire..., Dipartimento Farmaci e Farmacovigilanza. For medicinal products for veterinary use: Ministero della Sanità...

Border Jumping: Strategic and Operational Considerations in Planning Cross-Border Raids Against Insurgent Sanctuaries

DTIC Science & Technology

2013-06-01

POLITICAL COSTS .......25 D. THE OVERALL TIMING OF NICARAGUAN CROSS-BORDER OFFENSIVES...27 E. THE TERMINATION OF NICARAGUAN CROSS-BORDER RAIDS...Exploit, and Analyze FARC Revolutionary Armed Forces of Colombia FDN Nicaraguan Democratic Force FLN Front de Libération Nationale FSLN Sandinista

Technical use of compact micro-onde devicesa)

NASA Astrophysics Data System (ADS)

Sortais, P.; Lamy, T.; Médard, J.; Angot, J.; Sudraud, P.; Salord, O.; Homri, S.

2012-02-01

Due to the very small size of a COMIC (Compact MIcrowave and Coaxial) device [P. Sortais, T. Lamy, J. Médard, J. Angot, L. Latrasse, and T. Thuillier, Rev. Sci. Instrum. 81, 02B31 (2010), 10.1063/1.3272878] it is possible to install such plasma or ion source inside very different technical environments. New applications of such a device are presented, mainly for industrial applications. We have now designed ion sources for highly focused ion beam devices, ion beam machining ion guns, or thin film deposition machines. We will mainly present new capabilities opened by the use of a multi-beam system for thin film deposition based on sputtering by medium energy ion beams. With the new concept of multi-beam sputtering (MBS), it is possible to open new possibilities concerning the ion beam sputtering (IBS) technology, especially for large size deposition of high uniformity thin films. By the use of multi-spots of evaporation, each one corresponding to an independent tuning of an individual COMIC ion source, it will be very easy to co-evaporate different components.

IFLA General Conference, 1985. Division of Bibliographic Control. Sections on Bibliography, Cataloging, and Classification. Papers.

ERIC Educational Resources Information Center

International Federation of Library Associations, The Hague (Netherlands).

Papers on cataloging and classification which were presented at the 1985 International Federation of Library Associations (IFLA) conference include: (1) "Online Cataloging at the Bibliotheque Nationale (Francoise Finelli and Serge Salomon, France); (2) "Development of National Press Repertoire in the Condition of Multinational State: Its…

International Meeting on Business Start-up (Lille, France, November 26-28, 1992).

ERIC Educational Resources Information Center

Melis, Africa, Ed.; Peigne, Florence, Ed.

1992-01-01

An international meeting explored work on business start-up undertaken jointly by CEDEFOP (European Centre for the Development of Vocational Training) and France's Agence Nationale pour la creation d'entreprise. One opening presentation (Melis) addressed the basic idea underlying the research: to identify and highlight the role of training and…

Tyche 3.0 Simulation Engine Project Review

DTIC Science & Technology

2014-10-09

la Reine (en droit du Canada), telle que représentée par le ministre de la Défense nationale, 2014 DRDC-RDDC-2014-C220 Page 2 RECORD OF...During the technical evaluation, it was found that the representation of internal data as class objects and collections had performance drawbacks and

Segmentation of the Striatum Using Data Fusion

DTIC Science & Technology

2001-10-25

palsy. Ann Neurol 1999; 45:1 65-74. [3] Barra V. in Fusion d’images 3D du cerveau : études de modèles et applications. Ph.D. Thesis, Université...in Segmentation des structure internes du cerveau . Ph. D. Thesis, Ecole Nationale Supérieure des Télécommunications, Paris (France), 1998. [15

Variations au cours de la journée de l'incorporation in vivo de la leucine tritiée dans les protéines du cervelet et du cerveau du jeune rat normal et hypothyroïdien. Daily variations of the in vivo [3H] leucine incorporation into the cerebellar and cerebral proteins of the normal and hypothyroid young rat [(author's transl)].

PubMed

Dainat, J; Rebière, A

1978-02-15

In the normal and hypothyroid 6-day-old rat, the specific radioactivity (RSA) and the relative RSA (ratio of the RSA to the [3H] lecine concentration of the acido soluble phase) of the cerebral and cerebellar proteins, changes during the day synchronally. They show a maximum at 15.00 h and a minimum at 0.300 h. At all stages studied, these values are significantly lower in the hyothyroid animals than in normal ones.

L'Harmonisation des langues Maliennes: Entre l'intregration nationale et regionale (The Harmonization of the Malian Languages: Between National and Regional Integration).

ERIC Educational Resources Information Center

Ouane, Adama

1991-01-01

Assesses efforts to standardize the Malian languages, including the standardization of orthography and the creation of terminology in the Mandingo-Peul Project. Points to conflicts between technical and political considerations, and between local tendencies and balances among languages and the need to respect the ecolinguistics of the country.…

Self-Cleaning Coatings

DTIC Science & Technology

2014-06-01

Canada), telle que representee par le ministre de la Defense nationale, 2014 i Abstract Under certain conditions, military coatings...μm Particle C: a compound of fluorinated polymer and polypropylene , mean particle size 9 μm Due to the fact that all three types of particles have...functional particles, which are either pure fluorinated polymer or compound of fluorinated polymer and polypropylene , possessing certain degrees of

Cultural Dimensions of Digital Library Development, Part II: The Cultures of Innovation in Five European National Libraries (Narratives of Development)

ERIC Educational Resources Information Center

Dalbello, Marija

2009-01-01

This article presents the narrative accounts of the beginnings of digital library programs in five European national libraries: Biblioteca nacional de Portugal, Bibliotheque nationale de France, Die Deutsche Bibliothek, the National Library of Scotland, and the British Library. Based on interviews with policy makers and developers of digital…

Local network interconnection through a satellite point-to-multipoint link. Ph.D. Thesis - Ecole Nationale Superieure des Telecommunications, 6 Jul. 1985

NASA Technical Reports Server (NTRS)

Duarte, O. Muniz Bandeira

1986-01-01

Four architectures to implement a point to multipoint satellite link protocol for communication services offered by the Telecom 1 satellite network are presented. A safe communication service with error correction and flow control facilities is described. It is shown that a time transparent communication system combines simplicity and cost advantages.

Zone Nationale D'Etude de L'Environnment: Un Guide (National Environmental Study Area: A Guide).

ERIC Educational Resources Information Center

National Park Service (Dept. of Interior), Washington, DC.

This booklet, the French version of SE 014 817, is a guide for teachers and resource managers who are interested in establishing National Environmental Study Areas (NESA) or interested in receiving NESA recognition for their on-going environmental study area programs. It outlines the characteristics and procedures of the program; the nature,…

Préface

NASA Astrophysics Data System (ADS)

Aspect, Alain

2004-11-01

COLOQ est une conférence regroupant, tous les deux ans, la communauté scientifique et industrielle nationale travaillant dans les domaines des lasers, de l'optique non-linéaire et de l'optique quantique. Elle s'est tenue pour sa huitième édition à Toulouse, du 3 au 5 septembre 2004, sur le campus de I'INSA. Comme il est de tradition tous les quatre ans, COLOQ était couplé avec Horizons de l'optique, avec en particulier une journée commune dont le programme avait été préparé en concertation par les deux comités scientifiques. Depuis sa création, COLOQ a pour but de favoriser les rencontres entre les chercheurs des différents laboratoires nationaux publics ou privés travaillant sur les lasers et l'optique quantique au sens large. C'est un moyen privilégié de resserrer les liens de cette communauté et d'y intégrer les jeunes chercheurs. Ces derniers y trouvent l'occasion de se connaître, de se faire connaître, de découvrir la communauté à laquelle ils appartiennent et d'élargir leurs connaissances des thèmes qui la structurent. La participation de 230 chercheurs et d'une vingtaine d'exposants de matériels spécialisés dans les lasers et l'optoélectronique témoigne de la vitalité de COLOQ et de son audience dans les laboratoires et chez les industriels de l'optique. Le programme de COLOQ 8 comportait d'une vingtaine de conférences générales données par des chercheurs de renom international, et des séances de communications par affiches, occasions privilégiées de rencontres et d'échanges. Les exposés ont porté sur des sujets particulièrement actifs au niveau national et international, avec un accent sur des thèmes importants pour la région toulousaine : contrôle cohérent, optique et nanosciences, optique et astronomie, sans oublier la traditionnelle rubrique phénomènes fondamentaux, éclectique pour ne pas dire hétéroclite, mais si représentative d'une des ambitions de COLOQ qui est d'offrir à ses participants une ouverture sur les recherches de base d'aujourd'hui qui seront peut-être les outils quotidiens de l'optique de demain. Quant aux 169 communications par affiches elles ont, suivant la règle, couvert sans restriction tous les sujets de l'optique actuelle. Ce volume spécial du Journal de Physique IV regroupe la majorité des conférences invitées et des communications par affiches. Profitant de la participation des mondes académique et industriel, un forum sur “innovation et nouveaux débouchés pour l'optique” a permis de dégager des raisons d'espoir pour l'emploi des chercheurs en optique. Enfin, renouvelant l'expérience d'éditions précédentes, la dernière demi journée a été consacrée à deux conférences qui étaient ouvertes à un public élargi, notamment les étudiants de l'université et des classes préparatoires ainsi que leurs enseignants. Si Antoine Labeyrie nous a laissés sans voix avec ses projets “hyperfuturistes” d'hypertélescopes à l'échelle du million de kilomètres, Pierre Lena nous a donné un moment de vrai bonheur en célébrant le mariage sans cesse renouvelé du toujours jeune couple que sont l'optique et l'astronomie : qu'il soit remercié aussi pour le magnifique teste publié dans ce volume. COLOQ se devait d'honorer la mémoire de deux personnalités hors du commun de l'optique, Jean Brossel et Gilbert Grynberg. Tous ceux qui avaient connu l'un ou l'autre ont pu apprécier la justesse des évocations, par d'anciens collaborateurs, de l'oeuvre scientifique mais aussi des personnalités de ces deux grands physiciens. On trouvera les textes de ces interventions émouvantes dans ce recueil. La réussite de COLOQ 8 est évidemment due; avant tout, à la qualité scientifique des présentations, mais elle repose aussi sur l'action conjuguée des comités d'organisation national et local. Au niveau local, Françoise Lozes et Jacques Vigué ont mobilisé les membres du LCAR-IRSAMC et du LAAS pour l'organisation conjointe - particulièrement réussie - de COLOQ et Horizons de l'Optique, qui ont pu bénéficier de l'aide de I'INSA pour les locaux. COLOQ ne serait pas ce qu'il est sans le généreux soutien des diverses instances publiques nationales, régionales, locales, et à la forte participation des sociétés industrielles du secteur optoélectronique et laser qui nous ont permis de maintenir les frais d'inscription à un niveau particulièrement raisonnable, en particulier pour les jeunes. Que tous ces donateurs, dont on trouvera la liste dans ce volume soient ici remerciés ! Une mention spéciale à la Société Française d'Optique qui facilite tellement l'organisation de COLOQ depuis de nombreuses années. Au moment de quitter la présidence du comité scientifique national de COLOQ, après quatre éditions m'ayant permis de parcourir l'hexagone du nord an sud et de l'est à l'ouest, je tiens à témoigner de la richesse et de la vitalité de la communauté française de l'optique, que j'ai pu apprécier aussi bien au sein du comité scientifique national que des divers comités locaux de Strasbourg, Bordeaux, Rennes, Toulouse. C'est aussi l'occasion de dire mon émerveillement renouvelé devant la vitalité de notre discipline, qui ne cesse d'ouvrir de nouveaux champs de recherche, et où des sujets très “amonts”, parfois exotiques, donnent régulièrement lieu à des développements techniques et industriels qui ont un impact sur toute la société. Je ne vois pas que cette vitalité donne le moindre signe d'essoufflement, bien au contraire - je suis sûr que les prochaines éditions de COLOQ en témoigneront, et je souhaite que ce message soit entendu par les plus jeunes qui s'interrogent sur leur avenir professionnel. Alain Aspect Orsay, printemps 2004

New Caledonia: The Fragile Peace

DTIC Science & Technology

1990-06-01

Jane Tiburzio, teacher in North Province Jean-Marie Tjibaou, president , Front de Liberation Nationale Kanake Socialiste (deceased) Sarah Walls , Sydney...status. New Caledonia’s extremely rich nickel and possibly other mineral resources and the sizable French population make the territory a key link in...remaining 23 were held hostage in a cave. Negotiations to free the hostages failed, and on May 5 French commandos assaulted the cave. Nineteen Kanaks

Combat Resource Allocation Planning in Naval Engagements

DTIC Science & Technology

2007-08-01

presented and discussed in this report. The coordination problems are discussed in the companion report [2]. The developed Agent and Multi-agent-based...Technology Chef de file au Canada en matière de science et de technologie pour la défense et la sécurité nationale WWW.drdc-rddc.gc.ca Defence R&D Canada R & D pour la défense Canada

Security Classification Using Automated Learning (SCALE): Optimizing Statistical Natural Language Processing Techniques to Assign Security Labels to Unstructured Text

DTIC Science & Technology

2010-12-01

recommend [13]. 2.2 Commercial content scanning technology In [16], a companion piece to this paper, Magar completed a thorough review of commercially...defense Canada Chef de file au Canada en matiere de science et de technologie pour la defense et la securite nationale DEFENCE ~~EFENSE (_.,./ www.drdc-rddc.gc.ca

Acousto-Optic Spectrum Analyzer: Temporal Response and Detection of Pulsed Signals.

DTIC Science & Technology

1986-12-01

ACOUSTO - OPTIC SPECTRUM ANALYZER: TEMPORAL RESPONSE AND I/i DETECTION OF PULSED SIGUALS(U) DEFENCE RESEARCH ESTABLISHMENT OTTANA (ONTARIO) J...8217:. -.....:.-...............--.. - ---:-..--.-..,. ,: i’,.. IJT~c FILE C P National Defe’ se + Deence nationale 0 0 ACOUSTO - OPTIC SPECTRUM ANALYZER: TEMPORAL RESPONSE AND DETECTION 0 OF PULSED...Ottawa |S, .±~ |-----------------------..,---.-- -- - - - rNatiorna! Defen~se Deterice r dornale ACOUSTO - OPTIC SPECTRUM ANALYZER: TEMPORAL RESPONSE

The INSU and DMN network of ST radars

NASA Technical Reports Server (NTRS)

Petitdidier, M.; Klaus, V.; Baudin, F.; Crochet, M.; Penazzi, G.; Quinty, P.

1986-01-01

Due to their capabilities of measuring wind profiles with good time and height resolution, Stratosphere-Troposphere (ST) are well adapted to carry out atmospheric research. In France, a Very High Frequency (VHF) and an Ultrahigh Frequency (UHF) ST radar are working for research purposes. The INSU (Institut National des Sciences de l'Univers) and the DMN (Direction de la Meteorologie Nationale) networks are discussed.

Caracterisation Physique des Sols Camp Militaire de Petawawa (Physical Characterization of the Soil in Military Camp of Petawawa).

DTIC Science & Technology

1979-10-01

AD-AO95 392 DEFENCE RESEARCH ESTABLISHMENT OTTAWA (ONTARIO) FI6 8/13 CARACTERISATION PHY SI QUE DES SOLS CAMP MILITAIRE DE PETAWAWA (P--ETC(U) OCT 79...defense nationale 2b, GROUP Ottawa, Ontario -KIA-04----- , I D )kI1,vlt Nr Ti fti CARACTERISATION PHYSIQUE DES SOLS, BASE DES FORCES CANADIENNES PETAWAAA I

Cumulative Viral Load and Virologic Decay Patterns after Antiretroviral Therapy in HIV-Infected Subjects Influence CD4 Recovery and AIDS

DTIC Science & Technology

2011-05-20

study). The Antiproteases Cohorte Agence Nationale de Recherches sur le SIDA EP 11 study. J Infect Dis 186: 710–714. 8. Hermankova M, Ray SC, Ruff C... Sida (ANRS) CO3 Aquitaine Cohort. Clin Infect Dis 49: 1109–1116. 59. Choi AI, Shlipak MG, Hunt PW, Martin JN, Deeks SG (2009) HIV-infected persons

Mobile Ad Hoc Networks: An Evaluation of Smartphone Technologies

DTIC Science & Technology

2011-10-01

National Defence, 2011 c© Sa Majesté la Reine (en droit du Canada), telle que représentée par le ministre de la Défense nationale, 2011 Abstract A...déploiement de protocoles au cours d’opérations des FC ; 4. le développement d’une implémentation de validation de principe sur un téléphone

The influence of international and domestic events in the evolution of forest inventory and reporting consistency in the United States

Treesearch

W. Brad Smith

2009-01-01

This article takes a brief chronological look at resource inventory and reporting and links to international influences. It explores events as drivers of more consistent data within the United States and highlights key dates and events in the evolution of inventory policy and practice. From King George to L?Ecole nationale forestiere to the Food and Agriculture...

Energetic Materials Hazard Initiation: DoD Assessment Team Final Report

DTIC Science & Technology

1987-05-05

which the Department of De - fense is now emphasizing (JROC, 1986). Although this aspect of hazards reduction primarily involves fielded systems and the...source of deficiency in the impact testing. Some efforts are reported in which phototransistors, IR sensors and/or pressure sensors are used to detect...Montgomery (1959), and Moore (1973). Recent research on the electrostatic discharge sensitivity of solid propellant samples was begun at Societe Nationale des

Opportunities for Tomorrow: National Learning Needs Assessment Summary Report = Des Possibilities pour L'Avenir: Rapport Sommaire sur L'Evaluation Nationale des Besoins en Apprentisage.

ERIC Educational Resources Information Center

Communications, Energy & Paperworkers Union of Canada, Ottawa (Ontario).

The Communications, Energy, and Paperworkers Union of Canada assessed literacy learning needs. In focus group discussions, members were asked their perception of such needs in the face of changes in the workplace and society; local union officers (LUOs) were asked how they saw the role of unions in supporting members' literacy learning; employers…

Hybrid Warfare: Implications for CAF Force Development

DTIC Science & Technology

2014-08-01

of National Defence, 2014 © Sa Majesté la Reine (en droit du Canada), telle que représentée par le ministre de la Défense nationale, 2014...the spirit of international law. Finally, these basic definitions, however flawed, serve an additional purpose. Any investigation into the...Beyond official internal lessons learned reports from various militaries much useful information is contained in, for example, the many and topically

Survey of Commercial Technologies for Face Recognition in Video

DTIC Science & Technology

2014-09-01

by Defence Research and Development Canada’s Centre for Security Science, in partnership with Public Safety Canada. Led by Canada Border Services...Reine (en droit du Canada), telle que représentée par le ministre de la Défense nationale, 2014 Science and Engineering Directorate Border...Objectives CO1 – Engage in rapid assessment, transition and deployment of innovative technologies for public safety and security practitioners to achieve

Architecture and Assessment: Privacy Preserving Biometrically Secured Electronic Documents

DTIC Science & Technology

2015-01-01

very large public and private fingerprint databases comprehensive risk analysis and system security contribution to developing international ...Safety and Security Program which is led by Defence Research and Development Canada’s Centre for Security Science, in partnership with Public Safety...201 © Sa Majesté la Reine (en droit du Canada), telle que représentée par le ministre de la Défense nationale, 201 Science and Engineering

Cultural Dimensions of Digital Library Development, Part I: Theory and Methodological Framework for a Comparative Study of the Cultures of Innovation in Five European National Libraries

ERIC Educational Resources Information Center

Dalbello, Marija

2008-01-01

This study examines the influence of culture on digital libraries of the first wave. The local cultures of innovation of five European national libraries (Biblioteca nacional de Portugal, Bibliotheque nationale de France, Die Deutsche Bibliothek, the National Library of Scotland, and the British Library) are reconstructed in case histories from…

Net Assessment in the 1930s

DTIC Science & Technology

1990-10-01

SHA Carton 7N2515, and Henri Navarre , Le Service de Renseignments. 1871-1944 (Paris, 1978), p. 79. 86. Gauchd, Le Deuxieme Bureau, p. 133, and SHA...circumstances tended to dilute the intelligence analysis of these operations. Although individual officers like Charles de Gaulle, Percy Hobart, and...Comit6 Permanent de Defense Nationale without revealing too much of their deliberations to the Germans and Italians and their domestic political critics

Urban Population Control in a Counterinsurgency

DTIC Science & Technology

2005-01-01

national liberation war by nationalists and Islamists. The enemy was France, colonialism and Christianity. In 1940-1945, French and Arab nationalist...During 1956 and 1957, the National Liberation Army (Armée de Libération Nationale -- ALN), the FLN’s military arm, successfully applied guerrilla hit...Individual homes in this area normally have a courtyard where trees and flowers grow, chickens scratch and cars and bicycles are parked . One enters the

(Low-level radioactive waste management techniques)

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

Van Hoesen, S.D.; Kennerly, J.M.; Williams, L.C.

1988-08-08

The US team consisting of representatives of Oak Ridge National Laboratory (ORNL), Savannah River plant (SRP), Idaho National Engineering Laboratory (INEL), and the Department of Energy, Oak Ridge Operations participated in a training program on French low-level radioactive waste (LLW) management techniques. Training in the rigorous waste characterization, acceptance and certification procedures required in France was provided at Agence Nationale pour les Gestion des Dechets Radioactif (ANDRA) offices in Paris.

Building a More Resilient Haitian State

DTIC Science & Technology

2010-01-01

See World Health Organization. Wolff, Laurence, Education in Haiti: The Way Forward, Washington, D.C.: Programa de Promoción de la Reforma Educativa de ...Provide sufficient donor funding to implement a reformulated strategy for administrative reform based on Programme-Cadre de Réforme de l’Etat...Ministry of Educa- tion and Training (Ministère de l’Education Nationale et de la Formation Professionnelle, or MENFP) should subsidize private- school

Compte rendu de la table ronde du 36ème Congrès de la SFB à Cassis (1-3 Juin 2016), première partie: brûlures chimiques, brûlures électriques

PubMed Central

Le Floch, R.; Laguerre, J.; Perrot, P.

2016-01-01

Summary La table ronde du congrès 2016 de la SFB a duré toute la journée du 2 juin et portait sur les brûlures non thermiques. A la différence du résumé concernant les brûlures radiques, qui est en cours de réalisation par les auteurs des communications, celui-ci a été commis par les auteurs de cet article, à partir des notes prises en séance et de la vidéo réalisée pendant la communication. Le lecteur voulant approfondir le sujet pourra se rapprocher de l’auteur de la communication, systématiquement cité. PMID:28289367

CapDEM Exercise Gamma: Results and Discussion

DTIC Science & Technology

2011-06-01

DU MATERIEL Assurer la gestion et la prestation de services d’infrastructure fiables. L’utilisation d’infrastructures de ...Reine (en droit du Canada), telle que représentée par le ministre de la Défense nationale, 2011 DRDC Ottawa TR 2011-044 i Abstract...définition, l’ingénierie et la gestion collaboratives des capacités (DIGCap). L’objectif principal de ce dernier volet de la Stratégie

Defence Output Measures: An Economics Perspective

DTIC Science & Technology

2011-11-01

Des budgets de la comptabilité des intrants, des extrants, de la gestion et des ressources ont été utilisés comme mesures relatives aux résultats...Sa Majesté la Reine (en droit du Canada), telle que représentée par le ministre de la Défense nationale, 2011 Abstract …….. This Contract Report...présent rapport de contrat examine la mesure des extrants en matière de

U.S. (ARRADCOM) Test Results for NATO Round-Robin Test on High Explosives

DTIC Science & Technology

1981-05-01

Round-Robin Test Hersteller: (Manufacturer) Probenbezeichnung: (sample symbol ) Fa. Dynamit Nobel AG (W-Germany) Werk Leverkusen-Schlebusch S - 1...0,050 % 0,004 % Beim Zufügen von 0,002 n KMnO,-Lösung zu einem durch Kochen mit Wasser er-. haltenem Auszug keine Entfärbung in 1 h (no...Hersteller: (manufacturer) Fa. Soc. Nationale des Poudres et Explosifs (SNPE) Poudrerie de Sorgues, Frankreich Probenbezeichnung: (sample symbol

Modelling Metrics for Mine Counter Measure Operations

DTIC Science & Technology

2014-08-01

the Minister of National Defence, 2014 © Sa Majesté la Reine (en droit du Canada), telle que représentée par le ministre de la Défense nationale, 2014...a random search derived by Koopman is widely used yet it assumes no angular dependence (Ref [10]). In a series of publications considering tactics...Node Placement in Sensor Localization by Optimization of Subspace Principal Angles, In Proceedings of IEEE International Conference on Acoustics

The 2007 Surge in Iraq: An Alternative View

DTIC Science & Technology

2014-11-01

la Reine (en droit du Canada), telle que représentée par le ministre de la Défense nationale, 2014 DRDC-RDDC-2014-R105 i Abstract...9 Figure 4 US, international (coalition partners), and ISF troop strength. . . . . . . . . . . . . . . . . 14 Figure 5 Sum of monthly SIGACT...Testing the Surge: Why Did Violence Decline in Iraq in 2007?” International Security, 37(1), (2012), pp. 7–40. 9 A SIGACT usually refers to

Recherche universitaire et priorites nationales: l'effet du financement public sur la recherche energie solaire au Canada (University Research and National Priorities: The Effect of Public Financing on Solar Energy Research in Canada).

ERIC Educational Resources Information Center

Dalpe, Robert; Gingras, Yves

1990-01-01

The role of two main sources of university research financing in solar energy is examined to assess whether they oriented research in the direction of government programs. The strongest relationship appears to be in journal publication patterns. This scientific community has acquired the capacity to tap varying sources. (Author/MSE)

European Science Notes Information Bulletin (ESNIB) Reports on Current European/Middle Eastern Science

DTIC Science & Technology

1988-11-01

campus of the brane electric fields; and double layer Symposia included were on ceramics, Consejo Superior de Investigaciones structure theory and...units of the Ecole Nationale Superieure des Mines de Paris (ENSMP) - is discussed. Studies at the Center for Applied Mathematics include work for...Workshop on Low-Temperature Devices for De - tection of Low Energy Neutrino and Dark Matter are discussed. The topics are: the motivating ex

Teacher Transformation: An Exploration of Science Teachers' Changing Professional Identities, Knowledge, and Classroom Practices

NASA Astrophysics Data System (ADS)

Whitacre, Michelle Phillips

This qualitative, multiple case study examines five teachers' experiences with a National Science Foundation-funded professional development (PD) program focused on science literacy. Using a three dimensional conceptual framework combining transformative learning theory, communities of practice, and sociocultural conceptions of identity it explores: the ways the "Science Literacy through Science Journalism" (SciJourn) project built professional community and influenced teacher learning; the influence of the project on participating science teachers' professional identities, knowledge, and classroom practices; and the ways teachers were or were not transformed by participation in the project. To this end, data from surveys and phenomenological interviews were analyzed through qualitative textual analysis and narrative analysis. Four of the teachers experienced a change in their stories to live by, aka, an identity shift. Three predominant themes emerged across these cases. These included a changed conceptualization of science literacy, the importance of student engagement and authenticity, and the value of SciJourn's professional development and community. The changed conceptualization of science literacy was particularly salient as it challenged these teachers' assumptions, led them to rethink how they teach science literacy, and also influenced them to re-evaluate their teaching priorities beyond the PD. Consequently, this study concludes that PD efforts should focus as much, or more, on influencing teachers' ideas regarding what and how they teach and less on teaching strategies. A close comparison between two teachers' diverging experiences with the program showed that student engagement played a significant role in teachers' perceptions of the value of project, suggesting that whether or not teachers sustain a new practice is closely tied to their students' feedback. Additionally, this analysis showed that a teacher's individualized needs and sense of efficacy in implementing a specific reform effort are of consequence. Thus, in order to be influential, PD must somehow speak to a teacher's individualized needs, whether or not these needs are specifically stated at the program's onset. Aside from wanting to implement a project, a teacher also needs to believe that he or she is capable of successfully doing so. In considering transformative learning theory as a conceptual framework, the research presented here gives evidence that certain phases of transformation may be more significant than others, and phase two (self-examination with feelings of fear, anger, guilt, or shame) should be expanded to include a wider range of emotions.

Cockade-textured cataclasite and silica gel from damage zone in carbonated ultramafics: markers of cycles of seismic activity?

NASA Astrophysics Data System (ADS)

Scarsi, Marco; Crispini, Laura; Garofalo, Paolo; Capponi, Giovanni

2016-04-01

Shallow crustal processes occurring during seismic slips and generating fracture networks are of great interest due to their complex interplay with a spectrum of other geological processes . Our study focuses on faults with peculiar core textures, similar to those of "cockade breccia" (Genna et al., 1996) and "clast cortex grains" (Rempe et al., 2014), and on their relation with syntectonic hydrothermal alteration linked with Au bearing-quartz and chalcedony veins. Our work aims to study the enviromental conditions for the formation of such peculiar texture, their relation with the hydrothermal vein system and their potential as shallow seismic indicators. We present field, microstructural and petrochemical data of a peculiar damage zone of fault rocks located in carbonated peridotites and serpentinites of the Ligurian Alps (Voltri Massif, Italy). These are mainly reverse faults, which are coeval with syntectonic Au-bearing quartz veins and chalcedony veins (Giorza et al., 2010), in which lherzolites occupy the hangingwall of the faults and serpentinites the footwall. The fault rocks show evidence for carbonation, as olivine and serpentine are clearly transformed into an assemblage made of magnesite, dolomite and minor ankerite. The damage zones of the faults are serpentinite-rich and about 10 m in thickness, while the cataclasite cores are carbonate-rich and ca. 1 m thick. The top of the fault core shows the occurrence of a chalcedony shear veins with chatter marks and slikenlines on the surface. The "cockade breccia" is made of spherical aggregates of Fe-Mg carbonates and are 1 mm to 3 cm in size. These aggregates show cores of microcrystalline Fe-Mg carbonates, and concentric outer layers of relatively coarser Fe-Mg carbonates with radial or laminated texture. In some cases, these aggregates show evidence for rotation along secondary slip zones. We interpret all these features as the products of chemical interaction between the olivine and serpentine initially present within the fault rocks and the hydrothermal fluid that flowed within these faults. These interactions were probably similar to those occurring within the coeval Au- and chalcedony veins. Field evidence and theoretical considerations indicate that the reverse faults could have experienced stages of fault-valve behaviour (Sibson et al., 1998), which consisted in cycles of fluid pressure build-ups, fault opening, fluid flushing, and mineral precipitation during the seismic failure of the faults. These cycles varied transiently fault permeabilities. During the fluid pressure build up stage the radial coarse grains developed, while during the fluid flushing stage the clast cortex grains developed their laminated texture. The Au-quartz and chalcedony veins could have formed during the stages of fluid pressure drops following fault slip (Sibson et al., 1998, 2004). References Capponi G. & Crispini L., 1997, Progressive shear deformation in the metasediments of the Voltri Group (Ligurian Alps, Italy): occurence of structure recording extension parallel to the regional foliation, Boll. Soc. Geol. It., 116, 267-277. Genna A., Jébrack M., Marcoux E., Milési J.P., 1996, Genesis of cockade breccias in the tectonic evolution of the Cirotan epithermal gold system, West Java, Can. Journ. of Earth Sci., 33, 93-102. Giorza A., 2010, Late to post-metamorphic hydrotermalism in the Voltri Unit (Lavagnina Lakes Area, NW Alps). Structural-Petrological-Geochemical approach, PhD Thesis, University of Turin. Rempe M., Smith S. A. F., Ferri F., Mitchell T. M., 2014, Clast-cortex aggregates in experimental and natural calcite-bearing fault zones, Journ. Of Struct. Geol., 68, 142-157. Sibson R. H., 2004, Controls of maximum fluid overpressure defining conditions for mesozonal mineralization, Journ. of Struct. Geol., 26, 6-7, 1127-1136. Sibson R. H., Robert F., Poulsen H., 1998, High-angle reverse faults, fluid-pressure cycling, and mesothermal gold-quartz deposits, Geology, 16, 551-555. Spagnolo C., 2006, Late orogenic tectonics in the eastern sector of the Ligurian Alps, PhD Thesis, Univesity of Genoa.

Nonstandard Support Concepts in USAF Managed Security Assistance Program

DTIC Science & Technology

1977-06-01

example of this approach is found in the sale of Boeing 747 aircraft to the government of Iran for use as military transports (8Z). These aircraft were...would result in close-out action. RSAF would pay --or transportation packaging and handling for on-shelf assets to close out the account. (14) An...SABCA, and Fabrique Nationale d’ Armes de Guerre; the German companies of Hamburger Flugzeugbau, Weser Flugzeugbau, and Foche-Wolfe; and the Netherlands

Unifying Capability Integration Analysis - Initial Insights

DTIC Science & Technology

2011-09-01

mesure d’accomplir; Gestion des capacités – la mesure dans laquelle les FC seront en mesure de combler leurs besoins en matière de ...forces (DF) au sein du ministère de la Défense nationale (MDN). Au cours des quatre dernières années, des militaires et des analystes en matière de ...centralisée et descendante de développement des forces (DF) au sein du ministère de la

Statement of Operational Requirements (SOR): Guidance for Creating an SOR for Less Lethal Weapons

DTIC Science & Technology

2011-12-01

Canadian Police Research Centre (CPRC) and managed by Defence Research and Development Canada (DRDC) under the Centre for Security Science (CSS...telle que représentée par le ministre de la Défense nationale, 2011 Abstract …….. In recent years, Canadian law enforcement has attracted increased...initial step towards the creation of a Canadian Less Lethal Weapon (LLW) approval process, a workshop was held at Defence Research and Development

Practical Considerations of Design, Fabrication and Tests for Composite Materials,

DTIC Science & Technology

1982-09-01

ORGANIZATION ADVISORY GROUP FOR AEROSPACE RESEARCH AND DEVELOPMENT (ORGANISATION DU TRAITE DE L’ATLANTIQUE NORD) .1 AGARD Lecture Series No. 124...of Materials Science University of Bath Claverton Down Bath AB2 7AY UK SPEAKERS Dr A.R. Bunsell Dr J.J.Gerharz Ecole Naioiiale Sup~rieure des Fra...unhofer Institfit fuer Mines de Paris Betriebsfestigkeit (IBF) Centre des Mat~riaux Darmstadt Route Nationale 7, B.P. 87 Germany 91003 Evry Cedex France

Evaluation of Different Features for Face Recognition in Video

DTIC Science & Technology

2014-09-01

and Security Program (CSSP) which is led by Defence Research and Development Canada’s Centre for Security Science, in partnership with Public ...Minister of National Defence, 2014 © Sa Majesté la Reine (en droit du Canada), telle que représentée par le ministre de la Défense nationale, 2014...deployment of innovative technologies for public safety and security practitioners to achieve specific objectives; 4. Threats/Hazards F – Major trans-border

Using Sentence-Level Classifiers for Cross-Domain Sentiment Analysis

DTIC Science & Technology

2014-09-01

National Defence, 2014 © Sa Majesté la Reine (en droit du Canada), telle que représentée par le ministre de la Défense nationale, 2014 DRDC-RDDC...domain sentiment classification via spectral feature alignment. In Proceedings of the 19th international conference on World Wide Web, WWW ’10...Dennis, S. 5. DATE OF PUBLICATION (Month and year of publication of document.) September 2014 6a. NO. OF PAGES (Total containing information

Evaluation of Shelter Ventilation by Model Tests. Option 2

DTIC Science & Technology

1984-09-01

HUMUERS, 7449 N. Natchez Ave. FEMPL Work Unit 12.171 Niles, Illinois 60648 II. CONTROLLING OFFICE NAME AND ADDRESS IL REPORT DATE Federal Emergency...lights could be controlled through a voltage regulator. These lights 2-1 GARD ELEVATION VIEW Earth Berm Wndow 3’ x 3’ Winindow Interior of Shelter 32...Nationale 1 36 Rue J. B. Esch Luxembourg (Grand-Duche) Ministero dell Interno 1 Director General Protectione Civile Rome, Italy Civile Emergency Planning

Simulation of the CRIPT Detector

DTIC Science & Technology

2015-03-01

National Defence, 2015 c© Sa Majesté la Reine (en droit du Canada), telle que réprésentée par le ministre de la Défense nationale, 2015 Abstract The...iron slabs of the spectrometer. The red plates are the panels containing the scintillator bars. 3 3 Monte Carlo Geometry The geometry of the detector is...instead of hollow), • parts were in wrong location (eg. spectrometer iron plates). To fix this, Computer Aided Design ( CAD ) drawings were provided for

Discussion on the Modelling and Processing of Signals fom an Acousto-Optic Spectrum Analyzer.

DTIC Science & Technology

1987-06-01

AD-AIBS 639 DISCUSSION ON THE MODELLING AND PROCESSIN OF SIGNALS 1/1 FOR RN ACOUSTO - OPTIC SPECTRUM ANALYZER(U)G DFENCE RESERCH ESTABGLISHMENT OTTANA...8217’~ AV - I National DefenseI Defence nationale DISCUSSION ON THE MODELLING AND PROCESSING OF SIGNALS FROM AN ACOUSTO - OPTIC SPECTRUM ANALYZER by Guy...signals generated by an Acousto - Optic Spectrum Analyzer (AOSA). It also shows how this calculation can be related to pulse modu- lated signals. In its

Harbour Siren: Technical Recommendations Report

DTIC Science & Technology

2011-05-01

de recommandations et une feuille de route à court terme pour l’interopérabilité dans la gestion des urgences (IGU) et l’interopérabilité du système...Majesté la Reine (en droit du Canada), telle que représentée par le ministre de la Défense nationale, 2011 DRDC Atlantic CR 2010-179 i...maritime du Groupe de travail interministériel sur la sûreté maritime (GTISM). Le document présente un ensemble d’observations et de

Coalition Interoperability Measurement Frameworks Literature Survey

DTIC Science & Technology

2011-08-01

National Defence, 2011 © Sa Majesté la Reine (en droit du Canada), telle que représentée par le ministre de la Défense nationale, 2011 Abstract...interarmées élabore actuellement ce cadre et les travaux sont parrainés par le Groupe du Sous- ministre adjoint ( Gestion de l’information). L’intérêt...Groupe du Sous-ministre adjoint ( Gestion de l’information). Le type d’interopérabilité qui nous intéresse : 1. touche les Cinq pays (Australie

Virtual Reality (VR) as a Disruptive Technology

DTIC Science & Technology

2011-07-01

gestion et l’emploi de la M & S en tant que ressource du ministère de la Défense nationale (MDN). Quels sont les principaux facteurs favorables...represented by the Minister of National Defence, 2011 © Sa Majesté la Reine (en droit du Canada), telle que représentée par le ministre de la Défense...nous expliquerons comment la RV pourrait être mise au service de l’instruction militaire en répondant à des questions précises du

Risk Assessment References: Documented Literature Search

DTIC Science & Technology

2012-10-01

the Minister of National Defence, 2012 © Sa Majesté la Reine (en droit du Canada), telle que représentée par le ministre de la Défense nationale...vise à démontrer la valeur de l’approche scientifique pour améliorer les capacités de gestion des situations d’urgence en se concentrant sur...l’évaluation des risques et les infrastructures essentielles. Au cours de la première phase du projet, RDDC a effectué une analyse documentaire

eSecurity Portfolio : Overview, Analysis of Value Added, and Way Ahead

DTIC Science & Technology

2014-11-01

de mesurer l’ampleur et la profondeur du portefeuille, en plus de consolider et de récapituler les produits livrables pour que les...Reine (en droit du Canada), telle que représentée par le ministre de la Défense nationale, 2014 DRDC-RDDC-2014-R113 i Abstract …….. The...ii DRDC-RDDC-2014-R113 Résumé …….. La communauté de pratique de la sécurité électronique du Centre des

Building Resilient Communities Workshop Report

DTIC Science & Technology

2014-06-01

Reine (en droit du Canada), telle que représentée par le ministre de la Défense nationale, 2014 CSSP-2013-CD-1120...EMBC) [ Gestion des urgences Colombie-Britannique], le Programme canadien pour la sûreté et la sécurité (PCSS) et Recherche et développement pour la ...comptes rendus de la mise à jour du rapport du RCERD sur la résilience des communautés autochtones. L’événement a aussi donné une tribune pour un groupe

The Meta-Organization: A Research and Conceptual Landscape

DTIC Science & Technology

2011-06-01

la Reine (en droit du Canada), telle que représentée par le ministre de la Défense nationale...une approche globale en nous intéressant plus particulièrement aux problèmes pernicieux, à la convergence et à l’association, et à la gestion des ...rédigé dans le cadre du projet de modélisation de la collaboration et de la prise de décisions méta-organisationnelles financé par le

Development of Measures of Effectiveness and Performance from Cognitive Work Analysis Products

DTIC Science & Technology

2012-02-01

la Reine (en droit du Canada), telle que représentée par le ministre de la Défense nationale, 2012 DRDC Atlantic CR 2011...le nouveau concept du système. Ce rapport vise à déterminer si les résultats du travail de conception peuvent aider à élaborer des mesures de ...l’information (IIDS). Le contrat actuel comportait deux objectifs : élaborer des mesures de l’efficacité (MOE) et du rendement (MOP) pour

V2010 Security Planning and Operations: A Social Network Study of Key Information Sharing Relationships

DTIC Science & Technology

2011-05-01

la scurit. Je vous remercie de votre temps et de votre contribution. Susan G. McIntyre Knowledge Management/ Gestion du savoir...National Defence, 2011 © Sa Majesté la Reine (en droit du Canada), telle que représentée par le ministre de la Défense nationale, 2011 DRDC CSS TR 2011...avantages du renforcement de la communication horizontale au sein du gouvernement fédéral, surtout en présence d’organismes de

A PVDF Trigger and Tilt Detector for Projectile Impact Experiments

DTIC Science & Technology

1991-11-01

trigger include a fast rise time signal and a predictable signal magnitude. The circuit of a piezoelectric PVDF trigger is modeled in Figure 2-1; the...TR 91-640 DISTRIBUTION Copies Copies Chief of Naval Research Chairman Attn: ONR 1132P (R. Miller ) 1 Department of Defense Explosives ONT 20T (L. V...C. S. Coffey) 1 Washington, DC 20540 (J. Davis) 1 (D. L. Demske) 1 Socidth Nationale des Poudres (J. W. Forbes) 1 et Explosifs (R. H. Guirguis ) 1 Attn

Hierarchical Goal Analysis of Dynamic Decision Making in Microworld Experiments

DTIC Science & Technology

2009-03-01

7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS( ES ) Defence R&D Canada - Toronto,1133 Sheppard Avenue West,PO Box 2000,Toronto, Ontario, Canada M3M...3B9, 8. PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING/MONITORING AGENCY NAME(S) AND ADDRESS( ES ) 10. SPONSOR/MONITOR’S ACRONYM(S) 11. SPONSOR...Majesté la Reine (en droit du Canada), telle que représentée par le ministre de la Défense nationale, 2009 DRDC Toronto TM 2008-211 i

Anthropomorphic Phantom Radiation Dosimetry at the NATO Standard Reference Point at Aberdeen Proving Ground,

DTIC Science & Technology

1987-04-01

and would still be well under 10(C. .% % p., I V a- E p - -12 - IABLE 8 (a) TLD results for phantom dosimetry - all values shown are measured charge...SAI. Conclusions The current DREO dosimetry system-consisting of bubble, CR39 and TLD dosimeters - has proven capable of producing meaningful results at...MC FILE CoPy’ Defence nationale 00 ANTHROPOMORPHIC PHANTOM RADIATION DOSIMETRY AT THE NATO STANDARD OREFERENCE POINT AT ABERDEEN PROVING GROUND by T

Technology Insertion and Management: Options for the Canadian Forces

DTIC Science & Technology

2010-01-01

Minister of National Defence, 2010 © Sa Majesté la Reine ( en droit du Canada), telle que représentée par le ministre de la Défense nationale, 2010...semble indiquer qu’un changement de paradigme est en cours dans la façon dont les militaires élaborent et emploient la technologie à utiliser avec leurs...coûts-avantages fondée sur l’optimisation des options en matière d’insertion technologique. ii DRDC CORA TM 2010-015 This page

Likelihood Ratio Test Polarimetric SAR Ship Detection Application

DTIC Science & Technology

2005-12-01

menu. Under the Matlab menu, the user can export an area of an image to the MatlabTM MAT file format, as well as call RGB image and Pauli...must specify various parameters such as the area of the image to analyze. Export Image Area to MatlabTM (PoIGASP & COASP) Generates a MatlabTM file...represented by the Minister of National Defence, 2005 (0 Sa majest6 la reine, repr(sent(e par le ministre de la Defense nationale, 2005 Abstract This

Cesium cation templated selective synthesis of a "cone-shaped" sugar macrotricyclic cryptand: A dual anion-cation molecular recognition of potassium tartrate.

PubMed

Porwanski, S; Moretti, F; Dumarcay-Charbonnier, F; Marsura, A

2016-05-01

Cesium templated Staudinger-aza-Wittig tandem reaction (S.A.W.) has been used in the synthesis of a bis-diazacrown-bis-cellobiosyl-tetra-ureido cryptand. A novel macrotricyclic compound having a "cone-shaped" configuration was selectively obtained. Additionally, first results on potential recognition properties of the cryptand are also given. Copyright © 2015 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

Laser Safety Manual for DREO

DTIC Science & Technology

1993-11-01

milieu de travail securitaire dans les laboratoires de recherche utilisant de la radiation laser. L ’"American National Standard for the Safe Use of...d6fense nationale de poursuites l ~gales. i~i. I I EXECUTIVE SUMMARY Laser beams are currently used for some R&D activities at DREO. As laser radiation...par un appared as described in CFAO 66-4. must be strictly observed, laser peut provoquer des br-tilures de la reline et de la peau . Les mesures de

VENUS Ranging Study

DTIC Science & Technology

2014-12-01

Majesté la Reine (en droit du Canada), telle que réprésentée par le ministre de la Défense nationale, 2014 Abstract The underwater acoustic propagation...50 km des capteurs sous-marins situés aux nœuds du réseau VENUS dont les données acoustiques et sismiques sont accessibles au public sur Internet...Southwest British Columbia, Geophysical Journal International , 170(2), 800–812. [15] Hamilton, E. L. (1979), Vp/Vs and Poisson’s ratios in marine

Analysis of Metrics for Human Detection behind Walls Using Experimental 3-D Synthetic Aperture Radar Imagery

DTIC Science & Technology

2014-12-01

Reine (en droit du Canada), telle que représentée par le ministre de la Défense nationale, 2014 Abstract …….. Defence Research and Development... International Symposium on Phased Array Systems and Technology, 551-558 (2010). [10] Chetty, K., Smith, G. E., Woodbridge, K., “Through-the-wall sensing of...radar,” IEEE International Conference on Communications and Signal Processing, 579-583 (2011). [13] Sévigny, P., DiFilippo, D., Laneve, T., Chan, B

3D Face Generation Tool Candide for Better Face Matching in Surveillance Video

DTIC Science & Technology

2014-07-01

Safety and Security Program (CSSP) which is led by Defence Research and Development Canada’s Centre for Security Science, in partnership with Public ...by the Minister of National Defence, 2014 © Sa Majesté la Reine (en droit du Canada), telle que représentée par le ministre de la Défense nationale... public safety and security practitioners to achieve specific objectives; 4. Threats/Hazards F – Major trans-border criminal activity – e.g. smuggling

Simulation Tool for Optimizing Non-Combatant Evacuation (STONE): Optimization of Evacuation Time and Transportation Resource Utilization

DTIC Science & Technology

2015-05-01

2015 © Sa Majesté la Reine (en droit du Canada), telle que représentée par le ministre de la Défense nationale, 2015 Abstract A Non-Combatant Evacuation...Standing Senate Committee on Foreign Affairs and International Trade recommended that more frequent assessments of NEO plans be conducted...étrangères et du commerce international a recommandé que des évaluations dans ses missions à l’étranger soient faites plus fréquemment

Experimental Evaluation of the IP Address Space Randomisation (IASR) Technique and Its Disruption to Selected Network Services

DTIC Science & Technology

2014-11-01

Canada (Department of National Defence), 2014 c© Sa Majesté la Reine en droit du Canada (Ministère de la Défense nationale), 2014 Abstract In recent...2006), Network security mechanisms utilising network address translation, International journal of critical infrastructures, 2(1), 10–49. [5] Dunlop...Lu, S. (2008), Full service hopping for proactive cyber-defense, In ICNSC 2008: IEEE International Conference on Networking, Sensing and Control, pp

A Bayesian Approach to Estimating Detection Performance in a Multi-Sensor Environment

DTIC Science & Technology

2014-09-01

National Defence, 2014 © Sa Majesté la Reine (en droit du Canada), telle que représentée par le ministre de la Défense nationale, 2014 DRDC...emphasis can be seen in CF publications such as the Maritime Capability Planning Guidance (MCPG) 2010 [3]. To make effective use of these new remote...fixed installation, ship, aircraft, or satellite. Ships of a certain size or type are required by the International Maritime Organization (IMO) to

LRIT and AIS: An Analysis of October 2010 Data

DTIC Science & Technology

2014-10-01

Reine (en droit du Canada), telle que représentée par le ministre de la Défense nationale, 2014 DRDC Atlantic TM 2012-234 i Abstract...There have been amendments in the recent decade to Chapter V of the 1974 International Convention for the Safety of Life at Sea (SOLAS) which is...des modifications ont été apportées au chapitre V de la Convention internationale de 1974 pour la sauvegarde de la vie humaine en mer (SOLAS), qui

Properties of Fuels Employed in a Gas Turbine Combustor Program.

DTIC Science & Technology

1983-09-01

potence nateonale PROPERTIES OF FUELS EMPLOYED IN A GAS TURBINE COMBUSTOR PROGRAM by .J.R. Coleman and L.D. Gallop JAN 1O t84’ La.I DEFENCE ROSOARCH...ESTABLISHMENT OTTAWA T~INCAMNTE M4 1-05 - ottwa , National Dibense3 Detence nationale PROPERTIES OF FUELS EMPLOYED IN A GAS TURBINE COMBUSTOR PROGRAM by...made of the physical and chemical properties of sixteen fuels employed in an aircraft gas turbine combustor programme. Several of these are specification

Assessment of Nuclear Medicine Capabilities in Responding to a Radiological Terrorism Event

DTIC Science & Technology

2006-09-01

Defence, 2006 © Sa Majesté la Reine , représentée par le ministre de la Défense nationale, 2006 DRDC Ottawa TM 2006-237 i Abstract...important suite à un tel incident. Il serait donc avantageux d’établir des points de contact officiels avec cette communauté, de développer du matériel...both didactic and clinical training. Didactic course work includes: mathematics, chemistry, physics, computer science, radiation protection, anatomy

Experimental Investigations on the Distortion of ISAR Images Using Different Radar Waveforms

DTIC Science & Technology

2003-09-01

des cibles fera partie int~grante d’une nouvelle approche pour la gestion des donn~es relatives A l’espace de combat, comme les nouvelles initiatives de ... risque de tir fratricide en conditions de combat. En somme, l’identification des cibles, particuli~rement en mode de non-cooperation, jouera un r~le...Defence, 2003 © Sa majest6 la reine, repr~sent~e par le ministre de la Defense nationale, 2003 Abstract Experimental results have shown that the

Local Criticality and non-Fermi Liquid Behavior in Heavy Fermions

NASA Astrophysics Data System (ADS)

Si, Qimiao

2002-03-01

Quantum criticality provides a means to understand the apparent non-Fermi liquid phenomena in strongly correlated metals. Heavy fermion metals have emerged as a prototype system; many of them explicitly display a magnetic QCP. Experiments have shown that the quantum critical behavior is much richer than expected. One surprise came from neutron scattering, which found that the spin dynamics is anomalous not only near the antiferromagnetic wavevectors but also essentially everywhere in the Brillouin zone. In this talk, I will review the experiments and describe our theoretical work on the subject [1,2,3]. The notion of "local criticality" will be introduced and will be argued to apply to the heavy fermions. Some broader implications of the results will also be discussed. [1] Q. Si, S. Rabello, K. Ingersent, and J. L. Smith, Nature 413, 804 (2001). [2] Q. Si, J. L. Smith and K. Ingersent, Int. Journ. Mod. Phys. B13, 2331 (1999). [3] J. L. Smith and Q. Si, Phys. Rev. B61, 5184 (2000).

Mesure de la conductivité complexe et de la résistance de surface de films supraconducteurs YBaCuO

NASA Astrophysics Data System (ADS)

Mehri, F.; Lepercq, P.; Carru, J. C.; Playez, E.; Thivet, C.; Perrin, A.; Chambonnet, D.

1994-11-01

We describe in this paper 2 non destructive measurement methods in microwaves (18-26 GHz) well-suited to the characterization of conducting and superconducting thin films. From the experimental values we show that it is possible to infer, without any hypothesis, the following parameters : σ^*, R_s, X_s and λ between 20 K and 300 K. Some examples are given with metallic and superconducting samples from various origins. At 22 GHz and below 75 K, YBaCuO films deposited on MgO have a surface resistance inferior to bulk copper one. Dans cet article nous décrivons 2 méthodes de mesure non destructives adaptées à la caractérisation en microondes (18-26 GHz) de films minces conducteurs et supraconducteurs. A partir des valeurs expérimentales nous montrons qu'il est possible d'en déduire les grandeurs caractéristiques à savoir σ^*, R_s, X_s et λ entre 20 K et 300 K. Nous donnons des exemples de caractérisation de films métalliques et supraconducteurs provenant de différentes origines. A 22 GHz, en dessous de 75 K, les films YBaCuO déposés sur MgO ont une résistance de surface inférieure à celle du cuivre massif.

Interactions in Natural Colloid Systems "Biosolids" - Soil and Plant

NASA Astrophysics Data System (ADS)

Kalinichenko, Kira V.; Nikovskaya, Galina N.; Ulberg, Zoya R.

2016-04-01

The "biosolids" are complex biocolloid system arising in huge amounts (mln tons per year) from biological municipal wastewater treatment. These contain clusters of nanoparticles of heavy metal compounds (in slightly soluble or unsoluble forms, such as phosphates, sulphates, carbonates, hydroxides, and etc.), cells, humic substances and so on, involved in exopolysaccharides (EPS) net matrix. One may consider that biosolids are the natural nanocomposite. Due to the presence of nitrogen, phosphorus, potassium and other macro- and microelements (heavy metals), vitamins, aminoacids, etc., the biosolids are a depot of bioelements for plant nutrition. Thus, it is generally recognized that most rationally to utilize them for land application. For this purpose the biocolloid process was developed in biosolids system by initiation of microbial vital ability followed by the synthesis of EPS, propagation of ecologically important microorganisms, loosening of the structure and weakening of the coagulation contacts between biosolids colloids, but the structure integrity maintaining [1,2]. It was demonstrated that the applying of biosolids with metabolizing microorganisms to soil provided the improving soil structure, namely the increasing of waterstable aggregates content (70% vs. 20%). It occurs due to flocculation ability of biosolids EPS. The experimental modelling of mutual interactions in systems of soils - biosolids (with metabolizing microorganisms) were realized and their colloid and chemical mechanisms were formulated [3]. As it is known, the most harmonious plant growth comes at a prolonged entering of nutrients under the action of plant roots exudates which include pool of organic acids and polysaccharides [4]. Special investigations showed that under the influence of exudates excreted by growing plants, the biosolids microelements can release gradually from immobilized state into environment and are able to absorb by plants. Thus, the biosolids can serve as an active component of soil substrate. Soil enrichment with biosolids nanocomposite resulted in an improving of its structures, a faster growth of plants and substantial harvest increase, as compared with control (unfertilized) soil. 1. Kalinichenko KV, Nikovskaya GN, and Ulberg ZR (2012) Bioextraction of heavy metals from colloidal sludge systems. Colloid Journ. 74(5): 553-557. 2. Kalinichenko KV, Nikovskaya GN, and Ulberg ZR (2013) Changes in the surface properties and stability of biocolloids of a sludge system upon extraction of heavy metals. Colloid Journ. 75(3): 274-278. 3. Nikovskaya GN, et al (2006) The influence of different reclamation agents and microorganisms on the aggregative stability of the colloidal fraction of meadow chernozem soil. Colloid Journal. 68 (3): 345-349. 4. Dakora FD, Phillips DA (2002) Root exudates as mediators of mineral acquisition in low-nutrient environments. Plant and Soil. 1: 35-47.

Surface soil characterization of explosives and metals at the Land Force Central Area Training Centre (LFCA TC) Meaford, Ontario (Phase 2) Final report

DTIC Science & Technology

2009-10-01

Environment and Director General Environment © Her Majesty the Queen in Right of Canada, as represented by the Minister of National Defence, 2009 © Sa...Majesté la Reine (en droit du Canada), telle que représentée par le ministre de la Défense nationale , 2009 DRDC Valcartier TR 2009-218 i...evaluation of the soil contamination by explosives and metals. In parallel, the Institut national de la recherche scientifique (INRS) conducted

C6 GPMG and 40 mm AGL Weapon Integrated on RWS Mounted on TAPV Platform: Probability of Hit Methodology

DTIC Science & Technology

2010-09-01

nationale, 2010 DRDC Valcartier CR 2010-237 i Abstract …….. A probability of hit ( PHit ) methodology has been developed to characterize the...CFB (Canadian Forces Base). Résumé …..... Une méthodologie de probabilité d’impact ( PHit ) a été développée pour caractériser la performance globale...the crew commander and gunner from their respective crew stations inside the vehicle. A probability of hit ( PHit ) methodology has been developed to

Optimal Alignment of Search and Rescue Response Posture with Historical Incident Occurrence

DTIC Science & Technology

2014-04-01

and Development Canada Scientific Report DRDC-RDDC-2014-R12 April 2014 © Her Majesty the Queen in Right of Canada, as represented by the Minister of...National Defence, 2014 © Sa Majesté la Reine en droit du Canada, telle que représentée par le ministre de la Défense nationale, 2014 Abstract The ...hour response posture (RP2hrs) for remaining hours. This report details the data, modelling and analysis for optimizing CAF SAR RP30 hours. Based on

Study on Cyber Security and Threat Evaluation in SCADA Systems

DTIC Science & Technology

2012-03-01

la sécurité de l’infrastructure essentielle du Canada. DRDC CSS CR 2012-06 vii • Les cadres de gestion des cybermenaces et des ...Reine (en droit du Canada), telle que représentée par le ministre de la Défense nationale, 2012 DRDC CSS CR 2012-06 i Abstract …….. This...ii DRDC CSS CR 2012-06 Résumé …..... Le présent rapport fait la synthèse des résultats du projet PTSP 02-0347eSec

Toward the Development of a Canadian Less Lethal Weapon Approval Process: A Study of Contemporary Process Models

DTIC Science & Technology

2011-10-01

la Reine (en droit du Canada), telle que représentée par le ministre de la Défense nationale, 2011...validés par l’autorité d’approbation. Lorsqu’il n’existe pas de normes officielles, on utilise une approche de gestion du risque qui comprend une plus...gouvernance qui reprend les éléments clés du modèles du Royaume-Uni, l’incorporation d’un processus de gestion du risque, un énoncé des

Current Flow Through Two Dimensional Arrays of Metal Nanoparticles as a Novel Sensor Platform

DTIC Science & Technology

2009-05-01

Suffield TM 2009-068; R & D pour la défense Canada – Suffield; août 2009. Les indicateurs d’exposition de type macarons sont une composante essentielle...fait que ces films de nanoparticules sont très at- trayants comme génération future des indicateurs d’exposition de type macaron personnel. Les ...Minister of National Defence, 2009 c© Sa Majesté la Reine (en droit du Canada), telle que représentée par le ministre de la Défense nationale

LL and E awarded E and D contract area in eastern Algeria

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

Not Available

1992-12-07

This paper reports that a Louisiana Land and Exploration Co. unit has been awarded on exploration and production contract in Algeria by state oil company Enterprise Nationale Sonatrach. LL and E Algeria Ltd.'s contract covers two blocks in the central Ghadames oil basin of eastern Algeria. LL and E said the contract, yet to be submitted for government approval, calls for a minimum investment of $33 million during a 5 year work program that includes seismic acquisition and drilling a minimum of three wildcats.

A Two-Ended Shooting Technique for Calculating Normal Modes in Underwater Acoustic Propagation,

DTIC Science & Technology

1985-09-01

tnad~ I’or Public rL.00uq cmd ina ts 85 12 _ 8 126 UNLIMITED DISTRIBUTION * I ’ National Defence Defense Nationale Research and Bureau de Recherche...d6crit un algorithme de calcul des modes acoustiques normaux en mer. L’algoritbme est applicable & un prof il arbitraire do densit6 et do vitesse du son... profondeur do roncontre au milieu, habituellement pr&s du point do vitesse du son minimum. on amfiliore par it~ration la solution dlesaai jusqu’& ce

Technologies for Protection and Resistance Enhancement of Critical Infrastructures againstExtreme Fire

DTIC Science & Technology

2014-05-01

in Right of Canada, as represented by the Minister of National Defence, 2014 © Sa Majesté la Reine (en droit du Canada), telle que représentée par le ...extreme fire protection of critical infrastructures. Résumé …..... Le présent rapport fournit de l’information qui pourrait aider à élaborer des...démarches nationales pour une atténuation du risque émergeant des conditions d’incendie extrêmes pour les infrastructures essentielles (IE). Les résultats

The French Polemic: Nationalism, Racism and Atlanticism in the Past, Present and Future

DTIC Science & Technology

1993-12-01

where the climate and topography are very similar to that of their nation of origin. "󈧔Rapport de la Commission Nationale Consultative des Droits de ...Interpreting the French Revolution, Editions de !a Maison des Sciences de 1’ Homme , 1981. Gobineau, A., The Inequality of Human Races, Howard Fertig...8 0 jL .13 6. L -25-11 1 i1J8 74 0 > /NS BY PPPLIEO IMPGE, INC. Wihtol de Wenden, C., "North African Immigration and the French Political imaginary

Findings of the Test and Evaluation Proof of Concept Trial at the NCOT Facility

DTIC Science & Technology

2002-04-01

Submitted by: M. L . Matthews, R. D. G. Webb, A. R. Keeble Humansystems Incorporated® 111 Farquhar Street, 2nd Floor Guelph, Ontario N1H 3N4 Project...Report DRDC- Toronto No. CR-2002-056 Q\\ l Humansystems Incorporated April2002 NCOT: Proof of Concept P517839.PDF [Page: 4 of 39] ~· ©HER MAJESTY THE...QUEEN IN RIGHT OF CANADA (2002) as represented by the Minister of National Defense ©SA MAJESTE LA REINE EN DROIT DUE CANADA (2002) Defense Nationale

An investigation of the Attenuation Provided by the Surefire EP3 Sonic Defender (Trademark) Earplug

DTIC Science & Technology

2008-05-01

Reine (en droit du Canada), telle que représentée par le ministre de la Défense nationale, 2008 DRDC Toronto TR 2008-040 i Abstract...Surefire chez cinq hommes et cinq femmes. Selon le fabricant, un orifice percé dans le bouchon permet aux sons dont le niveau est sans danger de ...dispositif avec l’orifice ouvert et fermé en l’absence de bruits impulsifs. Cinq hommes et cinq femmes y ont participé. Le seuil d’audibilité de chaque

Spectra of M Asteroids V1.0

NASA Astrophysics Data System (ADS)

Fornasier, S.; Clark, B. E.; Migliorini, A.; Ockert-Bell, M.

2011-08-01

This data set contains reduced composite visual and near-infrared spectra of thirty M-type asteroids, observed over the years 2004-2008 and presented in Fornasier et al. (2010). The spectra were taken with the Dolores and NICS instruments at the Telescopio Nationale Galileo (TNG) in La Palma, with the EMMI and SOFI instruments at the ESO New Technology Telescope (NTT) in Chile, and with the SPeX instrument at the Infrared Telescope Facility (IRTF) in Hawaii. The individual spectra from the various instruments used to produce the composite spectra are also included.

Power Analysis for a Proposed Group Randomized Control Trial (GRCT) on the Road to Mental Readiness (R2MP) Program

DTIC Science & Technology

2014-08-01

the Minister of National Defence, 2014 © Sa Majesté la Reine (en droit du Canada), telle que représentée par le ministre de la Défense nationale...specifically for the target GRCT population. The internal consistency and factorial validity of this new measure has been established in a series of studies...measure. Journal of general internal medicine. 2001;16(9):606-13. [11] Richards K, Fikretoglu D. Using Administrative Data to Inform the Design of a

Biometrics of Intent: From Psychophysiology to Behaviour

DTIC Science & Technology

2009-11-01

pourrons comparer les profils de sujets individuels avec la base de données normatives. La mise sur pied de cette banque de données constitue donc la...of National Defence, 2009 © Sa Majesté la Reine (en droit du Canada), telle que représentée par le ministre de la Défense nationale, 2009 DRDC...intentionnel des états émotionnels négatifs engendrés par le stress. Ce qui est proposé ici, c’est un cadre théorique préliminaire qui applique les

Mid-wave IR Signatures of CFAV Quest in the North Atlantic Summer and Winter Climates

DTIC Science & Technology

2008-05-01

hiver, ce qui laisse supposer qu’elle pose un plus grand risque de détection du navire. DRDC Atlantic TM 2007-312 i This page intentionally left blank...consacrer ses efforts de gestion des signatures infrarouge. L’objectif final de l’obtention d’un moyen d’optimiser la signature infrarouge des navires...que représentée par le ministre de la Défense nationale, 2008 Original signed by Zahir A. Daya Original signed by Dave Hopkin Original signed by Ron

Minutes of the Explosive Safety Seminar (18th) Held at San Antonio, Texas on 12-14 September 1978. Volume 2

DTIC Science & Technology

1978-09-14

AT THE PONT- DE -BUIS GUN-POWDER FACTORY ON 7TH AUGUST 1975 1089 Mr. Jean Quinchon EXPLOSIVE INCIDENT DURING DEMOLITION GROUND OPERATIONS 1097 Mr...OCCURRED AT THE PONT- DE -BUIS GUN-POWDER FACTORY ON 7TH AUGUST 1975 Mr. Jean Quinchon Societe Nationale Des Poudres Et Explosifs Paris, France The...Pont- de -Buis National Gun-Powder Factory in the department of Finistere was built in the reign of LOUIS XIV to supply the Brest naval dock-yards

Design and Test Results of AMIGO: A Novel Remote Ground Sensor System

DTIC Science & Technology

2007-01-01

prix ou dans l’IR à prix élevé); le corps principal équipé de capteurs et de composants électroniques de base à faible prix ; et une plate-forme...reine, représentée par le ministre de la Défense nationale, 2007 DRDC Valcartier TR 2005-272 i Abstract The objectives of the project...Observation) a pour but d’étudier les technologies relatives aux systèmes de détecteurs autonomes au sol (DAS) et de mettre au point, puis de

Deutsches "Nationales Krebshilfe-Monitoring" 2015-2019 - Studienprotokoll und erste Ergebnisse.

PubMed

Schneider, Sven; Görig, Tatiana; Schilling, Laura; Breitbart, Eckhard W; Greinert, Rüdiger; Diehl, Katharina

2017-09-01

Das Projekt "Nationales Krebshilfe-Monitoring zur Solariennutzung" (National Cancer Aid Monitoring of Tanning Bed Use, NCAM) ist eine deutsche Großstudie mit dem Ziel, die wichtigsten Risikofaktoren für Hautkrebs zu beobachten: natürliches Sonnenlicht und künstliche UV-Strahlung. NCAM ist eine bundesweite Querschnittstudie mit zunächst vier Runden der Datenerfassung (sogenannten Wellen) zwischen 2015 und 2018. Jedes Jahr wird eine bundesweit repräsentative Stichprobe aus 3.000 Personen im Alter von 14 bis 45 Jahren befragt. Die Querschnittsbefragung wird durch eine Kohorte von n = 450 aktuellen Solariennutzern ergänzt. Die erste Welle im Jahr 2015 ergab eine Gesamtprävalenz der Solariennutzung von 29,5 %. Elf Prozent aller Teilnehmer hatten in den vergangenen zwölf Monaten ein Solarium genutzt. Zu den Determinanten der aktuellen Solariennutzung gehörten jüngeres Alter, weibliches Geschlecht und Vollzeit-/Teilzeitbeschäftigung. Die hauptsächlichen Beweggründe, die für die Nutzung eines Solariums genannt wurden, waren Entspannung und Attraktivitätssteigerung. NCAM ist weltweit die erste Studie zur Überwachung der Risikofaktoren für Hautkrebs in jährlichen Intervallen anhand einer großen, landesweit repräsentativen Stichprobe. Erste Ergebnisse deuten darauf hin, dass Millionen Deutsche trotz Warnungen der WHO Solarien nutzen, und dass viele dieser Nutzer Jugendliche sind - trotz gesetzlicher Beschränkungen, die das Ziel haben, die Nutzung von Solarien durch Minderjährige zu verhindern. © 2017 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

Optimal RSOM-hub Locations for Northern Operations: A MAJAID Scenario Analysis

DTIC Science & Technology

2011-08-01

droit du Canada), telle que représentée par le ministre de la Défense nationale, 2011 Abstract …….. This paper presents an analysis of a...militaires et les opérations de maintien en puissance. Au cours de cette étude, les mesures de rendement ont été établies en vue d’évaluer l’efficacité...analyse plus approfondie des données réelles devrait être menée. • Au cours de l’analyse, la simulation du transport tactique était fondée sur le CH146

Engine Fluid Leakage Detection: A Feasibility Study

DTIC Science & Technology

2011-07-01

2011 © Sa Majesté la Reine (en droit du Canada), telle que représentée par le ministre de la Défense nationale, 2011 DRDC Atlantic TM 2011-050 i... de détecter tout problème possible lié à la sécurité ou aux performances des moteurs à turbine à gaz d’aéronefs. Le signalement immédiat d’une fuite...carburant ou d’huile moteur nuisent non seulement aux performances d’un moteur, mais elles représentent également une menace réelle pour la sécurité de

Validation of New Crack Monitoring Technique for Victoria Class High-Pressure Air Bottles

DTIC Science & Technology

2014-06-01

technique de corrélation d’images numériques a été employée pour mesurer le champ de déforma- tion dans la zone située du côté opposé à l’entaille... la Reine en droit du Canada (Ministère de la Défense nationale), 2014 Abstract High-pressure air bottles are used in the Victoria class submarines to...charges cycliques pouvant provoquer l’apparition et favoriser la croissance de fissures de fatigue. L’ob- servation d’une marque interne semblable à une

Research Using In Vivo Simulation of Meta-Organizational Shared Decision-making (SDM). Task 4: Modeling of Communication and Decision Functions within a Shared Decision-making (SDM) Framework

DTIC Science & Technology

2011-12-01

la Reine (en droit du Canada), telle que représentée par le ministre de la Défense nationale 2011, Abstract...modélisation des fonctions de communication et de prise de décision dans le cadre de la prise de décision partagée (PDP) du volet de travail « Recherche par... la simulation in-vivo sur la prise de décision partagée des méta-organisations ». Cette composante du programme

Status of Day Care in Canada, 1984: A Review of the Major Findings of the National Day Care Study, 1984 = Situation de la garde de jour au Canada, 1984: Revue des principales conclusions tirees de l'etude nationale menee en 1984 sur la garde de jour.

ERIC Educational Resources Information Center

National Day Care Information Centre, Ottawa (Ontario).

Intended to give Canadians a general overview of the country's day care services, the study was undertaken by the Social Service Programs Branch, Health and Welfare, Canada. Begun in 1971 and updated yearly since 1973, the national survey provides an inventory of day care spaces which can be used to measure future growth in day care and to…

Status of Day Care in Canada, 1983: A Review of the Major Findings of the National Day Care Study, 1983. = Situation de la garde de jour au Canada, 1983: Revue des principales conclusions de l'etude nationale sur la garde de jour en 1983.

ERIC Educational Resources Information Center

National Day Care Information Centre, Ottawa (Ontario).

The major purpose of the Status of Day Care in Canada reports is to gather information from the provinces concerning day care spaces in order to determine the growth of day care from year to year. In addition to reporting the increase in the availability of day care services from 1973 to 1983, this report provides data on the ages of children…

[Pachymeningitis].

PubMed

Fain, O; Mekinian, A

2017-09-01

Pachymeningitis is a fibrosing and inflammatory process, which involves the dura mater. Some pachymeningitis are cranial and induce headaches and cranial nerve palsies. Others are spinal and responsible for nerve roots or spinal cord compression. MRI shows contrast enhancement thickening of the dura mater. Etiologies are infectious (syphilis, tuberculosis, etc.) or inflammatory (sarcoidosis, granulomatosis with polyangiitis, IgG4-related disease, idiopathic). Corticosteroids are the main treatment. The use of immunosuppressive drugs or rituximab is yet to be determined and probably adapted to each etiology. Copyright © 2017 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Contractor Final Report: For the Technology Demonstration of the Joint Network Defence and Management System (JNDMS)

DTIC Science & Technology

2013-10-01

opérationnel. Importance: Nous avons démontré des fonctions cruciales en utilisant des outils d’entreprise pour comprendre en profondeur un domaine...by the Minister of National Defence, 2009 © Sa Majesté la Reine ( en droit du Canada), telle que représentée par le ministre de la Défense nationale...interarmées de défense et de gestion des réseaux (SIDGR), en vertu du contrat W7714-04-0875/001/SV. Il touche l’exécution et les résultats de cette

Telemetre Laser a Onde Entretenue a 10.6 micrometers avec Postdetection non Lineaire: Etude d’un Systeme a un Laser (A 10.6 micrometer Amplitude Modulated Telemeter Laser with Nonlinear Postdetection: Study of a Single Laser System),

DTIC Science & Technology

1981-04-01

Courbes de variation de u et de la profondeur de modulation a en fonction de la tension appliquge V FIGURE - 4 jo NON CLASSIFIE 14 On peut donc...ET DEVELOPPEMENT RESEARCH AND DEVELOPMENT BRANCH MINISTERE DE LA DEFENSE NATIONALE UNCLASSIFIED DEA CETO AINADEFNC CANADA UNI. IMITED DISTRIBUTiIN CND...RECHERCHES POUR LA DEFENSE DEFENCE RESEARCH ESTABLISHMENT VALCARTIER Tel: (418) 844-4271 Quebec, Canada April/avril 1981 UNCLASSIFIED, /41/7z *I .. , NON

[Unusual leukoencephalopathy of post-partum].

PubMed

Hsaini, Y; Karouache, A; Bourazza, A

2011-08-01

Neurologic complications of post-partum are serious and usually secondary to eclampsia or stroke. We here report a 26-year-old female who presented with severe headaches, blurred vision, and repeated generalized seizures secondary to posterior reversible encephalopathy that occurred after a caesarean section for fetal death in utero. Outcome was favourable. Although uncommon, this neurologic complication of the post-partum should be discussed in the presence of any sign of encephalopathy occurring in the context of acute hypertension. Copyright © 2010 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Tailoring Wettability Through the Surface Modification of Electro-spun Polymers by Plasma and Sol-gel Treatments

DTIC Science & Technology

2014-11-01

Sa Majesté la Reine (en droit du Canada), telle que représentée par le ministre de la Défense nationale, 2014 DRDC-RDDC-2014-R102 i...avec la surface des matériaux est d’une importance fondamentale pour de nombreux processus, dont l’adhésion, les réactions chimiques, le transport...hydrodynamique et la nettoyabilité des surfaces. Les propriétés des surfaces peuvent se situer dans une gamme allant d’un caractère hydrophile ou

Resilience of Critical Infrastructure to Extreme Fires - Gaps and Challenges

DTIC Science & Technology

2014-04-01

du Canada), telle que représentée par le ministre de la Défense nationale, 2014 3 Abstract …….. This report provides the results of the study...the results of the two fire tests. Résumé …..... Le présent rapport fournit les résultats de l’étude menée par le Conseil national de recherches du...d’entreposage de carburants ou de véhicule-citerne. L’effondrement des tours du World Trade Centre, le 11 septembre 2001, et celui de l’échangeur du pont

Optical Disk Technology and the Library. Part 1: The Technology and Its Applications. Part 2: The National Library Videodisc Demonstration Project. Canadian Network Papers Number 9 = Technologie du Videodisque et la Bibliotheque. Premiere partie: La Technologie et ses Applications. Deuxieme partie: Projet de Demonstration du Videodisque a la Bibliotheque Nationale. Documents sur les Reseaux Canadiens Numero 9.

ERIC Educational Resources Information Center

Duchesne, Roddy; Sonnemann, Sabine S.

This report is intended to assist Canadian libraries in assessing potential library applications of optical disk technology. Part 1 provides a general outline of the technology and describes a number of library applications and projects. Descriptions are purposely general and illustrative in nature since the technology and its applications are…

International Workshop on Advances in Inorganic Fibre Technology Held in Melbourne, Australia on August 13 - 14, 1992

DTIC Science & Technology

1992-08-14

o Air -cured 0 1-Octyne-cured,/ S1-Hexyne I -cured 1 10- E C 5 011 0 L I I I 1200...1825 °C o TWS-400, 2h * TWS-400, 4h 52 INORGANIC FIBRES FOR CDMPOSITE MATERIALS A.R. BUNSELL Ecole Nationale Sup6rieure des Mines de Paris Centre des ...7stalblishm~ent in U.K. It was soon estab.li sheia -t1at .uazlit; of ?M precursor ani o temperatUra ther.:-A3_ stubilisation con iition3 are - tw.. o

The Concentration Probability Density Function With Implications for Probabilistic Modeling of Chemical Warfare Agent Detector Responses for Source Reconstruction

DTIC Science & Technology

2008-05-01

efforts de gestion rétroactive des situations d’urgence actuelles comportant l’mission cachée d’agents chi- miques, biologiques et radiologiques (CBR...Sa Majesté la Reine (en droit du Canada), telle que représentée par le ministre de la Défense nationale, 2008 Original signed by E. Yee Original...context of the source reconstruction problem. DRDC Suffield TR 2008-077 i Résumé On a étudié les relations entre des moments variés de

Finite Elements, Design Optimization, and Nondestructive Evaluation: A Review in Magnetics, and Future Directions in GPU-based, Element-by-Element Coupled Optimization and NDE

DTIC Science & Technology

2013-07-18

Nationale Supérieure d’Ingénieurs Electriciens de Grenoble (ENSIEG) group led by J.C. Sabonnadiere, J.L. Coulomb and G. Meunier would bring mathematical...1985. [11] J.L. Coulomb , “Analyse tridimensionnelle des champs électriques et magnétiques par la méthode des éléments finis,” These de Doctorat...computations by the virtual work principle [10]. However Coulomb [11-13] of the ENSIEG group identified a one-step solution for the computation of

The topological pressure-temperature phase diagram and crystal structures of the dimorphic system spiperone.

PubMed

Robert, B; Perrin, M-A; Coquerel, G; Céolin, R; Rietveld, I B

2016-03-01

The topological pressure-temperature phase diagram for the dimorphism of spiperone, a potent neuroleptic drug, has been constructed using literature data and improved crystal structures obtained with new crystallographic data from single-crystal X-ray diffraction at various temperatures. It is inferred that form II, which is the more dense form and exhibits the lower melting temperature, becomes the more stable phase under pressure. Under ambient conditions, form I is more stable. Copyright © 2015 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

Intellectual Property Rights: Lecture Series Held in London, (United Kingdom) on 21-22 October 1991, in Brussels (Belgium) on 24-25 October 1991 and in Arlington, Virginia on 6-7 November 1991

DTIC Science & Technology

1991-01-01

des rdalitfs diverses ct niouvantes sous I’cffet croisd des 6volutions techniques et &conomIques. I en rdsulte tine...r6le est croissant. Si un tel mouvement s’observe dans nombre de pays, cla ne signifie pas qu’il leur soit commun. En effet, la confrontation des ...conceptions nationales, voire rgionales, est dIdj engagdc en raison de l’internationalisation des activitds de transfert de technologies et de

[Inherited primitive and secondary polycythemia].

PubMed

Barba, T; Boileau, J-C; Pasquet, F; Hot, A; Pavic, M

2016-07-01

Myeloproliferative disorders and secondary polycythemia cover most of the polycythemia cases encountered in daily practice. Inherited polycythemias are rare entities that have to be suspected when the classical causes of acquired polycythemia have been ruled out. Recent advances were made in the understanding of these pathologies, which are still little known to the physicians. This review reports the state of knowledge and proposes an algorithm to follow when confronted to a possible case of inherited polycythemia. Copyright © 2015 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

[Pleural effusion: diagnosis and management].

PubMed

Pastré, J; Roussel, S; Israël Biet, D; Sanchez, O

2015-04-01

Pleural effusion management is a common clinical situation associated with numerous pulmonary, pleural or extra-pulmonary diseases. A systematic approach is needed to enable a rapid diagnosis and an appropriate treatment. Pleural fluid analysis is the first step to perform which allows a presumptive diagnosis in most cases. Otherwise, further analysis of the pleural fluid or thoracic imaging or pleural biopsy may be necessary. This review aims at highlighting the important elements of the work-up required by a pleural effusion. Copyright © 2014 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Trends in food intake in French children from 1999 to 2007: results from the INCA (étude Individuelle Nationale des Consommations Alimentaires) dietary surveys.

PubMed

Lioret, Sandrine; Dubuisson, Carine; Dufour, Ariane; Touvier, Mathilde; Calamassi-Tran, Gloria; Maire, Bernard; Volatier, Jean-Luc; Lafay, Lionel

2010-02-01

The objectives of the present study were to assess the intake of different food groups in French children aged 3-17 years (n 1455), and to analyse trends since a dietary survey undertaken 8 years ago. Dietary intake was evaluated using data from the 2006-7 cross-sectional INCA2 national dietary survey (étude Individuelle Nationale sur les Consommations Alimentaires), based on a 7 d food record. Dietary intake (percentage of subjects consuming the food group and amount eaten) was assessed for thirty-nine food categories. We observed variations in food consumption by age, sex, North-South regional gradient, seasonal period and educational level of the responding parent. Trends in dietary intake between 1999 and 2007 were determined by comparing the INCA1 (n 1126) and the INCA2 surveys. Both surveys had been carried out using the same methodology. The findings showed a decrease in energy intake in children aged 3-14 years, due to a reduction in the consumption of foods of animal origin and sweetened products. In adolescents aged 15-17 years, energy intake remained rather stable; during this 8-year period, the consumption of meat decreased, whereas the consumption of savoury snacks such as sandwiches and hamburgers significantly increased. These trends occurred during a time of growing concern about overweight and the associated co-morbidities in France. A number of public health measures were implemented over this period to improve dietary habits and physical activity patterns in children and adults. The periodic monitoring of dietary patterns through the INCA surveys is an essential part of the surveillance network in France.

Water and beverage consumption among children aged 4-13 years in France: analyses of INCA 2 (Étude Individuelle Nationale des Consommations Alimentaires 2006-2007) data.

PubMed

Vieux, Florent; Maillot, Matthieu; Constant, Florence; Drewnowski, Adam

2016-09-01

To examine the consumption of plain water among children in France and compare total water intakes with guidelines issued by the European Food Safety Authority (EFSA). Nationally representative data were used to assess food, beverage and water consumption by sex, age group (4-8 years, 9-13 years), income-to-poverty ratio, eating occasion and location. Beverages were classified into nine groups: water (tap or bottled), milk, 100 % fruit juice, sodas, fruit drinks, hot beverages, sports drinks and flavoured waters. Total water volume in relation to energy intake (litres/kcal) was also examined. INCA 2 study (Étude Individuelle Nationale des Consommations Alimentaires 2006-2007). French children (n 835) aged 4-13 years. Total water intakes were accounted for by plain water (34 %), beverages (26 %) and food moisture (40 %). Plain water could be tap (18 %) or bottled (16 %). Older children drank more plain water than did younger children and boys drank more plain water than did girls. No socio-economic gradient for plain water consumption was observed. About 90 % of children did not meet the EFSA water intake recommendations. The daily water shortfall ranged from 367 to 594 ml/d. Water-to-energy ratio was 0·75-0·77 litres/1000 kcal (4184 kJ). Children drank milk at breakfast and plain water during lunch and dinner. Caloric beverages provided 10 % of dietary energy; consumption patterns varied by eating location. Total water intakes among young children in France were below EFSA-recommended levels. Analyses of beverage consumption patterns by eating occasion and location can help identify ways to increase water consumption among children.

Water-waves frequency upshift of the spectral mean due to wind forcing

NASA Astrophysics Data System (ADS)

Eeltink, Debbie; Chabchoub, Amin; Brunetti, Maura; Kasparian, Jerome; Kimmoun, Olivier; Branger, Hubert

2017-04-01

The effect of wind forcing on monochromatic modulated water waves was investigated both numerically and experimentally in the context of the Modified Non-Linear Schrödinger (MNLS) equation framework. While wind is usually associated with a frequency downshift of the dominant spectral peak, we show that it may induce an upshift of the spectral mean due to an asymmetric amplification of the spectrum. Here the weighted average spectral mean is equal to the ratio of the momentum of the envelope to its norm and it detects any asymmetries in the spectrum (Segur et al. 2005). Wind can however indirectly induce frequency downshifts, by promoting dissipative effects like wave breaking. We highlight that the definition of the up- and downshift in terms of peak frequency or average frequency is critical for a relevant discussion. In our model, the wind input consists of a leading order forcing term that amplifies all frequencies equally and induces a broadening of the spectrum, and a higher order asymmetric term (Brunetti et al. 2014; Brunetti & Kasparian 2014) that amplifies higher frequencies more than lower ones and induces a permanent upshift of the spectral mean. The effect of MNLS + wind is exactly opposite to MNLS + viscosity, where the lower order viscosity terms damp the whole spectrum, while the higher order viscosity terms damp higher frequencies more than lower ones and thus causes a permanent downshift, as evidenced by Carter & Govan (2016). We corroborated the model with wave tank experiments conducted in the IRPHE/Pytheas large wind-wave facility located in Marseille, France. Wave data analysis show the temporary downshift in the spectral peak sense caused by the wind, and the temporary upshift in the spectral mean sense characteristic of the MNLS. As the tank-length was limited, we used long-range simulations to obtain upshift in the spectral mean sense caused by the wind. The limit of the model is reached when breaking events occur. We acknowledge financial support from the Swiss National Science Foundation (project 200021-155970), the Labex MEC (French ANR-10-LABX-0092) and the A*MIDEX project (ANR-11-IDEX-0001-02). • Brunetti, M. and Kasparian, J. 2014 "Modulational instability in wind-forced waves". Physics Letters A, 378: 48, 3626-3630. • Brunetti, M., Marchiando, N., Berti, N. and Kasparian, J. 2014 "Nonlinear fast growth of water waves under wind forcing". Physics Letters A 378: 1415, 1025-1030. • Carter, J. D. and Govan, A. 2016 "Frequency downshift in a viscous fluid." Eur. Journ. Mech. - B/Fluids 59: 177-185. • Segur, H., Henderson, D., Carter, J., Hammack, J., Li, C.-M., Pheiff, D. and Socha, K. 2005 "Stabilizing the Benjamin-Feir instability". Journ. Fluid Mechanics, 539: 229-271.

Research Using In Vivo Simulation of Meta-Organizational Shared Decision Making (SDM). Task 2: Development of an Experimental Plan for In Vivo Exercise and Simulation

DTIC Science & Technology

2011-12-01

la Reine (en droit du Canada), telle que représentée par le ministre de la Défense nationale, 2011 DRDC CSS CR 2011-31 ii...participants. Résumé …..... Introduction : Ce rapport présente la Tâche 2 du projet « Recherche par la simulation in-vivo sur la prise de décision partagée...environnement sur la prise de décision partagée in-vivo des opérations de gestion des urgences et pour colliger des données

Hydrogeological Investigations in Deep Wells at the Meuse/Haute Marne Underground Research Laboratory

NASA Astrophysics Data System (ADS)

Delay, Jacques; Distinguin, Marc

ANDRA (Agence Nationale pour la Gestion de Déchets Radioactifs) has developed an integrated approach to characterizing the hydrogeology of the carbonate strata that encase the Callovo-Oxfordian argillite at the Meuse/Haute-Marne Laboratory site. The argillites are difficult to characterize due to their low permeability. The barrier properties of the argillites can be inferred from the flow and chemistry properties of the encasing Oxfordian and Dogger carbonates. Andras deep hole approach uses reverse air circulation drilling, geophysical logging, flow meter logging, geochemical sampling, and analyses of the pumping responses during sampling. The data support numerical simulations that evaluate the argillites hydraulic behaviour.

New Advanced Mass Casualty Breathing System for Oxygen Therapy: Phase 1

DTIC Science & Technology

2006-10-01

of National Defence, 2006 © Sa Majesté la Reine , représentée par le ministre de la Défense nationale, 2006 DRDC Toronto TM 2006-201 i...Toronto a été chargé d’examiner la performance du masque PulmanexMD Hi-OxMD (Hi-Ox) à des débits d’oxygène (O2) de 4 litres par minute (L·min-1) en...d’examiner la performance du masque PulmanexMD Hi-OxMD (Hi-Ox) à des débits d’oxygène (O2) de 4 litres par minute (L·min-1). Le masque Hi-Ox est un

Profil de la néphropathie diabétique à l’Hôpital Général de Référence Nationale de N'Djamena (Tchad)

PubMed Central

Hamat, Ibrahim; Abderraman, Guillaume Mahamat; Cisse, Mouhamadou Moustapha; Youssouf, Mahamat; Djafar, Matar Saboune; Mbainguinam, Dionadji; Fotclossou, Tara

2016-01-01

Introduction Le diabète sucré constitue un véritable problème de santé et ses complications touchent plusieurs organes dont les reins. Un diagnostic précoce de la néphropathie diabétique permet de prendre en charge les patients plus efficacement et de façon multidisciplinaire, de retarder sa progression vers l'insuffisance rénale chronique. Peu d'études ont été faites en Afrique dans ce domaine. Au Tchad, nous ne disposons pas de données statistiques sur l'atteinte rénale liée au diabète. C'est pourquoi nous nous proposons d'étudier la néphropathie diabétique avec pour objectifs d'analyser le profil de la néphropathie diabétique des patients de l'hôpital général de référence nationale de N'Djamena. Méthodes Nous avions mené une étude transversale descriptive à l'Hôpital Générale de Référence Nationale de N'Djamena d'avril à septembre 2012. Etaient inclus dans l'étude tous les patients diabétiques hospitalisés ou suivis dans les services de néphrologie et d'endocrinologie. Résultats Il y avait 54 cas de néphropathie diabétique sur 181 patients soit 29,80%. L'âge de plus de 50 ans représentait 87%, le sexe masculin dominait avec 67%, la durée d'évolution du diabète au moment de la découverte de la néphropathie était de 10,25 ans, la pression artérielle moyenne était de 138 mm Hg, l'HbA1C était supérieur à 6,5% dans 74,5%, l'insuffisance rénale terminale était retrouvée dans 26,90%, une protéinurie à 2,65 g/24 h était détectée dans 60,30%. 57,4% des patients avaient une rétinopathie diabétique au stade III. Conclusion Au Tchad, la fréquence de la néphropathie diabétique est de l'ordre de 29,83%. C'est une affection qui touche les hommes avec une moyenne d'âge de 58,7 ans. Le diabète de type 2 est le plus fréquent avec 90,7% des cas. Les facteurs de risque mal contrôlés pouvaient conduire la néphropathie diabétique vers une altération de la fonction rénale notamment l'HTA (70,8%), un déséquilibre glycémique (66,7%) et une protéinurie (62,5%). PMID:27795790

Effects of Integrated Hearing Protection Headsets on the Quality of Radio Communications (Effets des Casques D’ecoute Munis d’un Dispositif Integre de Protection de L’Ouie sur la Qualite des Communications Radio)

DTIC Science & Technology

2009-07-01

National Defence, 2009 © Sa Majesté la Reine (en droit du Canada), telle que représentée par le ministre de la Défense nationale, 2009 DRDC Toronto TR...Parallèlement, on a évalué le degré d’acceptation de l’utilisateur à l’aide d’un questionnaire. Méthode: Cinq hommes ayant un seuil d’audition...hearing protection and usability. Résumé …..... L’intelligibilité de la parole en provenance d’un poste radio personnel (PRR) muni de casques

Final closure of a low level waste disposal facility

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

Potier, J.M.

1995-12-31

The low-level radioactive waste disposal facility operated by the Agence Nationale pour la Gestion des Dechets Radioactifs near La Hague, France was opened in 1969 and is scheduled for final closure in 1996. The last waste package was received in June 1994. The total volume of disposed waste is approximately 525,000 m{sup 3}. The site closure consists of covering the disposal structures with a multi-layer impervious cap system to prevent rainwater from infiltrating the waste isolation system. A monitoring system has been set up to verify the compliance of infiltration rates with hydraulic performance objectives (less than 10 liters permore » square meter and per year).« less

The topological phase diagram of cimetidine: A case of overall monotropy.

PubMed

Céolin, R; Rietveld, I B

2017-03-01

Cimetidine is a histamine H 2 -receptor antagonist used against peptic ulcers. It is known to exhibit crystalline polymorphism. Forms A and D melt within 0.35 degrees from each other and the enthalpies of fusion are similar as well. The present paper demonstrates how to construct a pressure-temperature phase diagram with only calorimetric and volumetric data available. The phase diagram provides the stability domains and the phase equilibria for the phases A, D, the liquid and the vapor. Cimetidine is overall monotropic with form D the only stable solid phase. Copyright © 2016 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

Psychiatric and substance use disorders in HIV/hepatitis C virus (HCV)-coinfected patients: does HCV clearance matter? [Agence Nationale de Recherche sur le SIDA et les Hépatites Virales (ANRS) HEPAVIH CO13 cohort].

PubMed

Michel, L; Lions, C; Winnock, M; Lang, J-P; Loko, M-A; Rosenthal, E; Marchou, B; Valantin, M-A; Morlat, P; Roux, P; Sogni, P; Spire, B; Poizot-Martin, I; Lacombe, K; Lascoux-Combe, C; Duvivier, C; Neau, D; Dabis, F; Salmon-Ceron, D; Carrieri, M P

2016-11-01

The objective of this nested study was to assess the prevalence of psychiatric disorders in a sample of HIV/hepatitis C virus (HCV)-coinfected patients according to their HCV status. The nested cross-sectional study, untitled HEPAVIH-Psy survey, was performed in a subset of HIV/HCV-coinfected patients enrolled in the French Agence Nationale de Recherche sur le SIDA et les Hépatites Virales (ANRS) CO13 HEPAVIH cohort. Psychiatric disorders were screened for using the Mini International Neuropsychiatric Interview (MINI 5.0.0). Among the 286 patients enrolled in the study, 68 (24%) had never received HCV treatment, 87 (30%) were treatment nonresponders, 44 (15%) were currently being treated and 87 (30%) had a sustained virological response (SVR). Of the 286 patients enrolled, 121 patients (42%) screened positive for a psychiatric disorder other than suicidality and alcohol/drug abuse/dependence, 40 (14%) screened positive for alcohol abuse/dependence, 50 (18%) screened positive for drug abuse/dependence, 50 (17.5%) were receiving an antidepressant treatment and 69 (24%) were receiving an anxiolytic. Patients with an SVR did not significantly differ from the other groups in terms of psychiatric disorders. Patients receiving HCV treatment screened positive less often for an anxiety disorder. The highest rate of drug dependence/abuse was among HCV treatment-naïve patients. Psychiatric disorders were frequent in HIV/HCV-coinfected patients and their rates were comparable between groups, even for patients achieving an SVR. Our results emphasize the need for continuous assessment and care of coinfected patients, even after HCV clearance. Drug addiction remains an obstacle to access to HCV treatment. Despite the recent advent and continued development of directly acting antiviral agents (DAAs), it is still crucial to offer screening and comprehensive care for psychiatric and addictive disorders. © 2016 British HIV Association.

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.

[Evolutionary medicine: A new look on health and disease].

PubMed

Bauduer, F

2017-03-01

Evolutionary medicine represents an innovative approach deriving from evolutionary biology. It includes the initial Darwin's view, its actualization in the light of progresses in genetics and also dissident theories (i.e. non gene-based) particularly epigenetics. This approach enables us to reconsider the pathophysiology of numerous diseases, as for instance, infection, and our so-called diseases of civilization especially obesity, type 2 diabetes, allergy or cancer. Evolutionary medicine may also improve our knowledge regarding inter-individual variation in susceptibility to disease or drugs. Furthermore, it points out the impact of our behaviors and environment on the genesis of a series of diseases. Copyright © 2016 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

[Hereditary angioedema: a therapeutic revolution].

PubMed

Bouillet, L

2012-03-01

Hereditary angioedema is a rare disease, often diagnosed with delay because of a heterogeneous clinical presentation. Before diagnosis, patients frequently present subcutaneous edema or abdominal pains during many years. Laryngeal edema can be life-threatening. Hereditary angioedema may impair the quality of life of the patients and their social and professional life. It is important that the physicians recognize and treat the disease as soon as possible after the first attacks. Since the past five years, new drugs developed for hereditary angioedema have changed dramatically the outcome of this disorder. The objective of this review is to detail the new therapeutic guidelines. Copyright © 2012 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

[Antineutrophil cytoplasmic antibodies associated with infective endocarditis: Literature review].

PubMed

Langlois, V; Marie, I

2017-07-01

Antineutrophil cytoplasmic antibodies (ANCA) associated with infective endocarditis are a rare disorder. The condition can mimic primary systemic vasculitis (i.e. granulomatosis with polyangiitis, microscopic polyangiitis, and eosinophilic granulomatosis with polyangiitis). Thus, a wrong diagnosis of valvular involvement related to primary systemic vasculitis can be made in patients exhibiting ANCA associated with infective endocarditis. Because treatment of both conditions is different, this wrong diagnosis will lead to dramatic consequences in these latter patients. This review reports the state of knowledge and proposes an algorithm to follow when confronted to a possible case of ANCA associated with infective endocarditis. Copyright © 2016 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Synthesis, antioxidant and analgesic activities of Schiff bases of 4-amino-1,2,4-triazole derivatives containing a pyrazole moiety.

PubMed

Karrouchi, K; Chemlal, L; Taoufik, J; Cherrah, Y; Radi, S; El Abbes Faouzi, M; Ansar, M

2016-11-01

A series of Schiff bases of 4-amino-1,2,4-triazole derivatives containing pyrazole (5a-h) were synthesized from condensation of 4-amino-5-(5-methyl-1H-pyrazol-3-yl)-4H-1,2,4-triazole-3-thiol (3) derivative with various aromatic aldehydes (4a-h). The structures of the synthesized compounds were elucidated by IR, 1 H NMR, 13 C NMR, and mass spectrometry. All the synthesized compounds (5a-h) were screened for their in vivo analgesic and in vitro antioxidant activities revealing significant analgesic and antioxidant properties. Copyright © 2016 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

[The plague: A disease that is still haunting our collective memory].

PubMed

Peiffer-Smadja, N; Thomas, M

2017-06-01

Although the plague has practically disappeared from Europe since the beginning of the 20th century, it is still present in everyone's memory. Owing to three pandemics, it has left an indelible mark on mankind and has given rise to many popular phrases, paintings, books or more recently movies and video games. After a brief description of the plague as a disease, we will try to trace the history of the plague through some of the works of art it inspired and then to show how the plague is still haunting our collective memory. Copyright © 2017 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

[Primary infection with cytomegalovirus: An infectious cause of splenic infarction].

PubMed

Kassem, H; Khamadi, K; Farrugia, C; Ho Hio Hen, N; El Gharbi, T; Turner, L

2017-08-01

Cytomegalovirus-associated thrombosis has been extensively reported in the medical literature, mainly in immune-compromised patients. However, the association with splenic infarcts has rarely been reported. We report a 32-year-old Caucasian and immunocompetent woman who presented with a splenic infarction during a primary infection with CMV. The differential diagnostic ruled out embolic, hematologic, gastrointestinal and coagulation disorders. The outcome was favorable with symptomatic treatment. A primary infection with CMV must be added to the diagnostic work-up in the presence of a febrile splenic infarction, especially when it is associated with a biological mononucleosis reaction. Copyright © 2016 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Contraction et filamentation des decharges micro-ondes entretenues a la pression atmospherique: Application a la detoxication des gaz a effet de serre

NASA Astrophysics Data System (ADS)

Kabouzi, Yassine

The remediation of greenhouse gases, such as perfluorinated compounds (PFCs), constitutes a major environmental concern. Plasmas operating at atmospheric pressure offer an efficient technology for the control of toxic and greenhouse gas emission. The two main objectives of the thesis were to investigate the mechanisms of contraction and filamentation in atmospheric-pressure microwave discharges, and to examine their influence on the plasma abatement process of PFC gases in these discharges. The finite thermal conductivity of the gas discharge is responsible for the gas nonuniform heating leading to a contracted discharge column. The gas thermal conductivity and the penetration depth of the microwave electric field in the plasma are shown to set the value of the plasma radius. The degree of contraction and filamentation of microwave discharges can be controlled, and even reduced, by modulating adequately the incident microwave power. The relaxation times of heat conduction and heat release are actually observed to be of the same magnitude, and correspond to the modulation period for which the discharge shows less contraction. PFC molecules are eliminated through their fragmentation by inelastic collisions with electrons and the subsequent oxidation of these fragments. Reformation of PFC molecules is the main process limiting the abatement efficiency in atmospheric-pressure microwave discharges. As a result of discharge radial contraction, a relative "colder" space between the plasma filament and the discharge tube wall favors PFC reformation and, therefore, lowers the destruction efficiency. The PFC destruction efficiency is found to increase with absorbed microwave power. Surface-wave microwave discharges sustained at atmospheric pressure prove to be an efficient and ecological solution for emission reduction of greenhouse gases.

[The French medecine pricing committee and the medicine economic policy: Rules and competences].

PubMed

Giorgi, D

2017-09-01

The French medicine pricing committee (CEPS), a governmental and inter-institutional body exercises essential competences for the regulation of the economy of the reimbursable drugs in France. It provides a good example of administered price regulation. It also supervises the proper use of products (control of promotion, conventional control of sales volumes). Finally, it regulates the annual envelope of drug expenditures by means of discounts paid by pharmaceutical companies. The article presents the legal criteria and the doctrine of price setting used in France. It details the types of market access contracts concluded by the CEPS. It specifies the conditions governing the annual envelope of expenditures on reimbursable medicines. Copyright © 2017 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

[Hydroxychloroquine-induced hearing loss: First case of positive rechallenge and analysis of the French pharmacovigilance database].

PubMed

Chatelet, J-N; Auffret, M; Combret, S; Bondon-Guitton, E; Lambert, M; Gautier, S

2017-05-01

Several cases of hearing loss induced by hydroxychloroquine have been reported in the literature but the role of hydroxychloroquine still remains debated. We report the first case, to our knowledge, of hearing loss induced by hydroxychloroquine with a positive re challenge in a woman treated for systemic lupus. An analysis of the French pharmacovigilance database allowed to identify 23 additional cases of hearing loss in patients treated with hydroxychloroquine and, among them, 8 had systemic lupus. Despite an excellent tolerance and high efficacy-side effect ratio, this case report adds some evidence for an otoxicity of hydroxychloroquine. Copyright © 2016 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

From dipolar to multipolar interactions between ultracold Feshbach molecules

NASA Astrophysics Data System (ADS)

Quéméner, Goulven; Lepers, Maxence; Luc-Koenig, Eliane; Dulieu, Olivier

2016-05-01

Using the multipolar expansion of electrostatic and magnetostatic potential energies, we characterize the long-range interactions between two weakly-bound diatomic molecules, taking as an example the paramagnetic Er2 Feshbach molecules which were produced recently. The interaction between atomic magnetic dipoles gives rise to the usual R-3 leading term of the multipolar expansion, where R is the intermolecular distance. We show that additional terms scaling as R-5, R-7 and so on also appear, which are strongly anisotropic with respect to the orientation of the molecules. These terms can be seen as effective molecular multipole moments reflecting the spatial extension of the molecules which is non-negligible compared to R. We acknowledge the financial support of the COPOMOL project (ANR-13-IS04-0004) from Agence Nationale de la Recherche.

[Amyloidosis: Up-to-date].

PubMed

Magy-Bertrand, N

2016-08-01

Amyloidosis is mainly a systemic disease belonging to protein-folding diseases. The past 10 years have shown significant progress in typing and the clinical management of amyloidosis, in the identification of novel prognostic markers for risk-stratification, and also in the development of new therapeutic agents. Biological molecular techniques are now able to type amyloidosis which were unidentified. Cardiac MRI and biomarkers allow a precise risk-stratification, especially in AL amyloidosis. If necessary, this prognostic evaluation may lead to rapid changes in the chemotherapy treatment. Emerging treatments rely on biotherapies, gene therapy, immunotherapy and blocking analogous agents. They give hope about an increase of survival of patients with systemic amyloidosis. Copyright © 2016 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

[Postural tachycardia syndrome (PoTS): An up-to-date].

PubMed

Astudillo, L; Laure, A; Fabry, V; Pugnet, G; Maury, P; Labrunée, M; Sailler, L; Pavy-Le Traon, A

2018-06-13

Postural tachycardia syndrome (PoTS) is a multifactorial syndrome defined by an increase in heart rate ≥30bpm, within 10minutes of standing (or during a head up tilt test to at least 60°), in absence of orthostatic hypotension. It is associated with symptoms of cerebral hypoperfusion that are worse when upright and improve in supine position. Patients have an intense fatigue with a high incidence on quality of life. This syndrome can be explained by many pathophysiological mechanisms. It can be associated with Ehlers-Danlos disease and some autoimmune disorders. The treatment is based on nonpharmacological measures and treatment with propranolol, fludrocortisone or midodrine. Copyright © 2018 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier Masson SAS. All rights reserved.

Organizational Strategies for Critical Transportation Infrastructure: Characteristics of Urban Resilience. The Case of Montreal.

NASA Astrophysics Data System (ADS)

Beauregard, Stéphane; Therrien, Marie-Christine; Normandin, Julie-Maude

2010-05-01

Organizational Strategies for Critical Transportation Infrastructure: Characteristics of Urban Resilience. The Case of Montreal. Stéphane Beauregard M.Sc. Candidate École nationale d'administration publique Julie-Maude Normandin Ph.D. Candidate École nationale d'administration publique Marie-Christine Therrien Professor École nationale d'administration publique The proposed paper presents preliminary results on the resilience of organizations managing critical infrastructure in the Metropolitan Montreal area (Canada). A resilient city is characterized by a network of infrastructures and individuals capable of maintaining their activities in spite of a disturbance (Godschalk, 2002). Critical infrastructures provide essential services for the functioning of society. In a crisis situation, the interruption or a decrease in performance of critical infrastructures could have important impacts on the population. They are also vulnerable to accidents and cascading effects because on their complexity and tight interdependence (Perrow, 1984). For these reasons, protection and security of the essential assets and networks are one of the objectives of organizations and governments. But prevention and recovery are two endpoints of a continuum which include also intermediate concerns: ensuring organizational robustness or failing with elegance rather than catastrophically. This continuum also includes organizational resilience (or system), or the ability to recover quickly after an interruption has occurred. Wildavsky (1988) proposes that anticipation strategies work better against known problems while resilience strategies focus on unknown problems. Anticipation policies can unnecessarily immobilize investments against risks, while resilience strategies include the potential for a certain sacrifice in the interests of a more long-term survival and adaptation to changing threats. In addition, a too large confidence in anticipation strategies can bring loss of capacity of an organization to adapt to conditions. Each strategy must adapt to specific conditions. Where uncertainties important, resilience is probably the most appropriate. Where conditions are stable, and where future projections are generally fair, anticipating works better, although it should be used judiciously (Fiksel, 2003). Anticipation strategies immobilize specific or tangible resources and, can eventually be costly in the long-term. On the other hand, resilient systems and organizations are those that quickly acquire information about their environments, quickly change their behaviour and their structures, even if the circumstances are chaotic. They communicate easily and openly, and largely mobilize networks of expertise and support (Perrow, 1999). We conducted qualitative research to assess different variables that positively affect the organizational resilience in the management of critical infrastructure. We preferred a methodology allowing us to retain the complexity of the phenomenon, not affecting the nature of the system studied. Our methodology allows us to create pragmatic theoretical concepts (grounded theory) (Glaser and Strauss, 1967). Our main concern is not to separate the phenomenon studied in its context. This methodology allows us to better understand the coordination between the organizations network infrastructure essential by a process of "sweeping-in" (Dewey, 1938). After conducting a literature review of various concepts of our research (Comfort, L. K., 2002; Lagadec and Michel-Kerjan, 2004; Perrow, 1999; Weick and Sutcliffe, 2001; and more) we have conducted numerous interviews and distributed a questionnaire to highlight significant indicators. For the first part of this research, we targeted the transportation critical infrastructure of Montreal area because it is crucial and also this infrastructure includes public, parapublic and private organisations. The first results of this research demonstrate the contribution of different structural and functional factors that influence the intraorganizational resilience and interorganizational resilience for the transportation sector of Montreal.

Role of uncontrolled HIV RNA level and immunodeficiency in the occurrence of malignancy in HIV-infected patients during the combination antiretroviral therapy era: Agence Nationale de Recherche sur le Sida (ANRS) CO3 Aquitaine Cohort.

PubMed

Bruyand, Mathias; Thiébaut, Rodolphe; Lawson-Ayayi, Sylvie; Joly, Pierre; Sasco, Annie Jeanne; Mercié, Patrick; Pellegrin, Jean Luc; Neau, Didier; Dabis, François; Morlat, Philippe; Chêne, Geneviève; Bonnet, Fabrice

2009-10-01

Human immunodeficiency virus (HIV)-infected patients are at higher risk of malignancies. In addition to traditional determinants, a specific deleterious effect of HIV and immunodeficiency is speculated. We aimed at studying the association between immunological and virological characteristics of HIV-infected patients in care and the risk of acquired immunodeficiency syndrome (AIDS)-defining and non-AIDS-defining malignancies. Patients consecutively enrolled in the hospital-based Agence Nationale de Recherche sur le Sida (ANRS) CO3 Aquitaine Cohort were included if the duration of follow-up was >3 months during the period 1998-2006. Multivariate modeling used an extended Cox proportional hazards model for time-dependent covariates and delayed entry. The 4194 patients included in the study developed 251 first malignancies during 22,389 person-years. A higher incidence of AIDS-defining malignancies (107 cases) was independently associated with (1) both longer and current exposures to a plasma HIV RNA level >500 copies/mL (hazard ratio [HR], 1.27 per year [P<.001] and 3.30 [P<.001], respectively) and (2) both longer and current exposure to a CD4(+) cell count <200 cells/mm(3) (HR, 1.36 per year [P<.001] and 6.33 [P<.001], respectively). A higher incidence of non-AIDS-defining malignancies (144 cases) was independently associated with longer and current exposure to a CD4(+) cell count <500 cells/mm(3) (HR, 1.13 per year [P=.01] and 2.07 [P<.001], respectively) and male sex (HR, 1.69; P=.02) but not with plasma HIV RNA level (P=.49 and P=.10 for cumulative and current exposures, respectively). Uncontrolled plasma HIV RNA level was independently associated with a higher likelihood of developing AIDS-defining malignancies, whereas immunosuppression was associated with a higher risk of developing any type of malignancies. Antiretroviral treatment should aim at reaching and maintaining a CD4(+) count >500 cells/mm(3) to prevent the occurrence of malignancy, this should be integrated to malignancy-prevention policies.

Prognostic relevance of Fédération Nationale des Centres de Lutte Contre le Cancer grade and MDM2 amplification levels in dedifferentiated liposarcoma: a study of 50 cases.

PubMed

Jour, George; Gullet, Ashley; Liu, Mingdong; Hoch, Benjamin L

2015-01-01

Dedifferentiated liposarcoma represents a form of liposarcoma composed of a non-lipogenic sarcoma associated with well-differentiated liposarcoma. The prognostic significance of histological grading of the dedifferentiated component remains to be elucidated due to vague grading criteria employed in previous studies. Molecular markers of tumor behavior, including amplification levels of murine double minute-2 (MDM2) and cyclin-dependent kinase-4 (CDK4) genes, have been explored in a limited number of cases. Here we investigate whether 'Fédération Nationale des Centres de Lutte Contre le Cancer' (FNCLCC) grade and MDM2 gene amplification levels have prognostic value in dedifferentiated liposarcoma in terms of local recurrence and disease-specific survival. Fifty cases were retrieved, reviewed and FNCLCC grade was scored for the dedifferentiated component. Testing for MDM2 gene amplification was performed by fluorescence in situ hybridization. Amplification was categorized as high level (≥20 copies) and as low level (<20 copies). Follow-up data was obtained through chart review. Log-rank test and Cox proportional hazard models were used to determine the effect of grade and level of MDM2 amplification on outcomes. Our series includes 50 patients (male n=28, female n=22) with an average age of 63 years (range, 28-88) and a median follow-up of 28 months (range, 2-120). Tumors were graded as grade 1 (6%), grade 2 (58%), and grade 3 (36%). When adjusted for age, sex, site, tumor size, and margin status, grade 3 patients had a higher recurrence rate than grades 1 and 2 (HR=2.07, 95% CI: 1.24, 7.62; P=0.015). Patients with high-level MDM2 amplification had higher recurrence rate on univariate analysis (P=0.028), but not on multivariate analysis (HR=1.69, 95% CI: 0.73, 3.94; P=0.221). FNCLCC grade 3 dedifferentiation confers a worse prognosis in dedifferentiated liposarcoma in terms of local recurrence. MDM2 amplification level remains a useful diagnostic tool in dedifferentiated liposarcoma, but has no prognostic value in terms of local recurrence.

3. Côte D'Ivoire

NASA Astrophysics Data System (ADS)

Cisse, M'badiala

1996-01-01

Entreprendre une recherche sur la politique et la législation en matière d'éducation des adultes, qui couvre plusieurs secteurs, paraît une gageure pour plusieurs raisons: difficultés dans la constitution de plusieurs équipes de recherche avec plusieurs spécialistes ou personnes ressources, difficultés dans la collecte des données, étendue et complexité des domaines à explorer et des points à prendre en compte dans la rédaction, etc. En dépit de ces difficultés majeures, l'essentiel du travail a été accompli dans le souci de respecter les exigences imposées. A l'analyse, nous constatons que plusieurs partenaires interviennent dans la formation, l'éducation et l'encadrement des adultes, et que dans le secteur public, les structures ne sont pas "logées à la même enseigne": Si la formation professionnelle a bénéficié de conditions réellement favorables pour son expansion et son développement, les autres secteurs, sans avoir été négligés, n'ont pas connu les mêmes faveurs. Ainsi plusieurs lois et mesures importantes ont été votées et prises en vue de la dynamisation de la formation professionnelle, alors que le secteur de l'agriculture, qui est la base de succès du développement du pays et occupe 55% de la population, n'a pas bénéficié d'une véritable politique éducative en faveur des agriculteurs. Il en est de même pour l'alphabétisation. On déplore constamment l'absence de politique élaborée et appliquée à l'échelle nationale. Aucune mesure politique n'a été votée par l'Assemblée nationale, alors que l'alphabétisation devrait constituer le levier du développement de l'éducation des adultes en Côte d'lvoire.

Consumption of artificially and sugar-sweetened beverages and incident type 2 diabetes in the Etude Epidemiologique aupres des femmes de la Mutuelle Generale de l'Education Nationale-European Prospective Investigation into Cancer and Nutrition cohort.

PubMed

Fagherazzi, Guy; Vilier, Alice; Saes Sartorelli, Daniela; Lajous, Martin; Balkau, Beverley; Clavel-Chapelon, Françoise

2013-03-01

It has been extensively shown, mainly in US populations, that sugar-sweetened beverages (SSBs) are associated with increased risk of type 2 diabetes (T2D), but less is known about the effects of artificially sweetened beverages (ASBs). We evaluated the association between self-reported SSB, ASB, and 100% fruit juice consumption and T2D risk over 14 y of follow-up in the French prospective Etude Epidémiologique auprès des femmes de la Mutuelle Générale de l'Education Nationale-European Prospective Investigation into Cancer and Nutrition cohort. A total of 66,118 women were followed from 1993, and 1369 incident cases of T2D were diagnosed during the follow-up. Cox regression models were used to estimate HRs and 95% CIs for T2D risk. The average consumption of sweetened beverages in consumers was 328 and 568 mL/wk for SSBs and ASBs, respectively. Compared with nonconsumers, women in the highest quartiles of SSB and ASB consumers were at increased risk of T2D with HRs (95% CIs) of 1.34 (1.05, 1.71) and 2.21 (1.56, 3.14) for women who consumed >359 and >603 mL/wk of SSBs and ASBs, respectively. Strong positive trends in T2D risk were also observed across quartiles of consumption for both types of beverage (P = 0.0088 and P < 0.0001, respectively). In sensitivity analyses, associations were partly mediated by BMI, although there was still a strong significant independent effect. No association was observed for 100% fruit juice consumption. Both SSB consumption and ASB consumption were associated with increased T2D risk. We cannot rule out that factors other than ASB consumption that we did not control for are responsible for the association with diabetes, and randomized trials are required to prove a causal link between ASB consumption and T2D.

[Lemierre's syndrome: Diagnosis, exploration, treatment].

PubMed

Mesrar, H; Mesrar, J; Maillier, B; Kraoua, S; Chapoutot, L; Delclaux, B

2018-05-01

Lemierre's syndrome is a rare and severe sepsis that can rapidly lead to a life-threatening condition in the absence of early management. This syndrome described at the beginning of the 20th century combines oropharyngeal infection complicated with septic thrombosis of the internal jugular vein and septic emboli predominantly pulmonary. Fusobacterium necrophorum, anaerobic germ, Gram negative bacillus is the main germ in this "necrobacillosis". The diagnosis is should be confirmed precociously with cervicothoracic CT-scan, reference exam, and bacteriological examinations (especially in atypical forms). Its management consists of an emergency antibiotic treatment, combining a third-generation cephalosporin or a betalactam with metronidazole, anticoagulant therapy to be reserved for high-risk situations related to thrombosis. Surgical treatment may be required. Copyright © 2017 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Guidelines for the treatment of hemorrhoids (short report).

PubMed

Higuero, T; Abramowitz, L; Castinel, A; Fathallah, N; Hemery, P; Laclotte Duhoux, C; Pigot, F; Pillant-Le Moult, H; Senéjoux, A; Siproudhis, L; Staumont, G; Suduca, J M; Vinson-Bonnet, B

2016-06-01

Hemorrhoids are a common medical problem that is often considered as benign. The French Society of Colo-Proctology (Société nationale française de colo-proctologie [SNFCP]) recently revised its recommendations for the management of hemorrhoids (last issued in 2001), based on the literature and consensual expert opinion. We present a short report of these recommendations. Briefly, medical treatment, including dietary fiber, should always be proposed in first intention and instrumental treatment only if medical treatment fails, except in grade ≥III prolapse. Surgery should be the last resort, and the patient well informed of the surgical alternatives, including the possibility of elective ambulatory surgery, if appropriate. Postoperative pain should be prevented by the systematic implementation of a pudendal block and multimodal use of analgesics. Copyright © 2016. Published by Elsevier Masson SAS.

[The revolution of monoclonal antibodies in the treatment of thrombotic microangiopathy].

PubMed

Sauvètre, G; Grange, S; Froissart, A; Veyradier, A; Coppo, P; Benhamou, Y

2015-05-01

Thrombotic microangiopathies (TMA) define a syndrome characterized by the association of microangiopathic haemolytic anaemia with schistocytes, peripheral thrombocytopenia, and organ injury of variable severity. Thrombotic thrombocytopenic purpura (TTP) and atypical haemolytic uremic syndrome (HUS) are the main forms of TMA. Recent advances in the pathophysiology of those two diseases, which include in HUS the identification of a deregulation of the alternative complement pathway, and in TTP a severe deficiency in ADAMTS-13, allowed to develop specific, pathophysiology-based therapies. Therefore, rituximab and eculizumab tends to be increasingly used, and there is an urgent need to define consensual modes of administration at the international level, as well as common definitions of response evaluation and follow-up explorations. Copyright © 2014 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

[Decontamination of organophosphorus compounds: Towards new alternatives].

PubMed

Poirier, L; Jacquet, P; Elias, M; Daudé, D; Chabrière, E

2017-05-01

Organophosphorus coumpounds (OP) are toxic chemicals mainly used for agricultural purpose such as insecticides and were also developed and used as warfare nerve agents. OP are inhibitors of acetylcholinesterase, a key enzyme involved in the regulation of the central nervous system. Chemical, physical and biological approaches have been considered to decontaminate OP. This review summarizes the current and emerging strategies that are investigated to tackle this issue with a special emphasis on enzymatic remediation methods. During the last decade, many studies have been dedicated to the development of biocatalysts for OP removal. Among these, recent reports have pointed out the promising enzyme SsoPox isolated from the archaea Sulfolobus solfataricus. Considering both its intrinsic stability and activity, this hyperthermostable enzyme is highly appealing for the decontamination of OP. Copyright © 2017 Académie Nationale de Pharmacie. All rights reserved.

[Relapse of acute promyelocytic leukemia in the central nervous system revealed by isolated dementia].

PubMed

Colin, O; Julian, A; Puyade, M; Bouyer, S; Meurin, E; Blondeau, S; Houeto, J L; Neau, J P

2016-12-01

Approximately 1.5% of dementia is due to curable aetiology. We report an isolated dementia syndrome due to a meningeal relapse of acute promyelocytic leukaemia with favourable outcome after appropriate treatment. A 72-year-old woman, in remission of an acute promyelocytic leukaemia, presented a loss of autonomy for several months due to corticosubcortical dementia. Lumbar puncture showed blast cells indicating meningeal relapse of leukaemia. Intrathecal chemotherapy and arsenic trioxide obtained biological and molecular remission as well as restoration of normal cognitive functions. In patients with hematologic past history such as acute promyelocytic leukaemia, an isolated cognitive impairment should alert physicians to search for an isolated neuromeningeal relapse. Copyright © 2016 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

[Mondor's disease of penis: A case report].

PubMed

Marsaudon, E; Legal, C; Gayoux, D; Weber, O

2016-09-01

Mondor's disease is a rare superficial thrombophlebitis, historically involving the thoracic venous system of women. However, it can occur in both gender and all over the skin. We report a 40-year-old man with type one diabetes who presented with a thrombosis of the superficial dorsal vein of the penis that he treated as a fungal infection. Treatment with non-steroidal anti-inflammatory drugs and low molecular weight heparin contributed to a favorable outcome in 2 weeks. Pathogenesis and treatment of Mondor's disease remain incompletely dominated. Some predisposing factors have been highlighted in the literature. It might be interesting to add diabetes, due to its frequent pelvic problems leading to a potential venous inflammatory trigger. Copyright © 2015 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

[Sarcoidosis flare after autologous stem cell transplantation: An immune paradox?

PubMed

Marchal, A; Charlotte, F; Maksud, P; Haroche, J; Lifferman, F; Miyara, M; Choquet, S; Amoura, Z; Cohen Aubart, F

2017-09-01

Sarcoidosis is a systemic granulomatous disorder of unknown cause. Apparition or flare of previously diagnosed sarcoidosis following hematopoietic stem cell transplantation (HSCT) has rarely been reported. We report a 62-year-old woman who presented a radiological flare of sarcoidosis post-autologous stem cell transplantation for a POEMS syndrome. Imaging findings and lymph node histology, which revealed non-caseating granuloma, were consistent with the sarcoidosis diagnosis. The patient was asymptomatic and was kept free of treatment. Sarcoidosis must be considered ahead of compatible clinicoradiological presentation occurring after HSCT. Sarcoidosis can mimic metastatic cancer or lymphatic relapse. Tissue biopsies and exclusion of differential diagnosis of granuloma diseases are warranted to confirm sarcoidosis diagnosis. Copyright © 2017 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

[Clopidogrel induced thrombotic thrombocytopenic purpura].

PubMed

Karkowski, L; Wolf, M; Lescampf, J; Coppérré, B; Veyradier, A; Ninet, J; Hot, A

2011-12-01

Thrombotic thrombocytopenic purpura (TTP) is a life-threatening disorder. Drug-induced TTP is uncommon and we report a TTP associated with the use of clopidogrel. We report a 50-year-old man who presented with acute myocardial infarction and received clopidogrel therapy. He developed acute TTP ten days after clopidogrel onset. Imputability of the drug was demonstrated during a reintroduction test. Deficiency of ADAMTS 13 was confirmed and autoantibodies against ADAMTS 13 were detected. Complete remission was obtained after 24 plasma exchange sessions and adjunction of corticosteroids. Drug-induced TTP are probably immunologic, as was demonstrated in our patient. Clinicians should be aware of this possible uncommon adverse effect of clopidogrel because prompt therapy is imperative for life saving. Copyright © 2011 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Electric-field control of spin waves in multiferroic BiFeO3: Theory

NASA Astrophysics Data System (ADS)

de Sousa, Rogério; Rovillain, P.; Gallais, Y.; Sacuto, A.; Méasson, M. A.; Colson, D.; Forget, A.; Bibes, M.; Barthélémy, A.; Cazayous, M.

2011-03-01

Our recent experiment demonstrated gigantic (30%) electric-field tuning of magnon frequencies in multiferroic BiFeO3. We demonstrate that the origin of this effect is related to two linear magnetoelectric interactions that couple the component of electric field perpendicular to the ferroelectric vector to a quadratic form of the Néel vector. We calculate the magnon spectra due to each of these interactions and show that only one of them is consistent with experimental data. At high electric fields, this interaction induces a phase transition to a homogeneous state, and the multi-magnon spectra will fuse into two magnon frequencies. We discuss the possible microscopic mechanisms responsible for this novel interaction and the prospect for applications in magnonics. We acknowledge support from NSERC-Discovery (Canada) and the Agence Nationale pour la Recherche (France).

[National ethics committees and representative democracy: is the new German ethics committee more "democratic"?].

PubMed

Dagron, Stéphanie

2007-01-01

The bill passed in April 2007 by the German parliament aims to confer democratic legitimacy on the German Ethics Committee (deutscher Ethikrat) which has replaced the former National Ethics Committee (nationaler Ethikrat) set up in 2001. This law results from a wide debate which began in 2005 within the political parties about the role in democracy of the bodies charged with advising the people's representatives in the areas of biotechnology and modern medicine. In this article, the author explains why it was necessary to confer a certain democratic legitimacy on the new Ethics Committee and analyses the relation that exists between the democratic principle, the work of this type of committee and the national institutional structure retained to stimulate the debate and advise the political decision-makers, and even to prepare legislation concerning bioethics.

[The French National Compound Library: advances and future prospects].

PubMed

Mahuteau-Betzer, Florence

2015-04-01

The French National Compound Library (Chimiothèque Nationale) has been created in 2003 and is the federation of local collections. It contains more than 56 000 small molecules and natural compounds synthesised or isolated in different laboratories over the past years. This explains the diversity of the collection. The strength of this initiative is the ability to connect chemists and biologists for the development of hits. This development involves the synthesis of analogues or/and chemical tools to find new targets. These collaborations lead to the identification of new chemical probes. These probes able to modulate a biological function are essential to study biological pathways. They can also be useful for therapeutic applications. This article will describe the major achievements and perspectives of the French Chemical Library. © 2015 médecine/sciences – Inserm.

Characterization and monitoring of the Séchilienne rock slope using 3D imaging methods (Isère, France)

NASA Astrophysics Data System (ADS)

Vulliez, Cindy; Guerin, Antoine; Abellán, Antonio; Derron, Marc-Henri; Jaboyedoff, Michel; Chanut, Marie-Aurélie; Dubois, Laurent; Duranthon, Jean-Paul

2016-04-01

The Séchilienne landslide located in the Romanche Valley (Isère, France) is a well instrumented mass movements of about 650 m high and 250 m wide, with a potential volume of about 3 million m3 in the most active part (Duranthon and Effendiantz, 2004 ; Kasperski et al., 2010). The slope, which is mainly composed of micaschist, is characterized by the presence of a NE-SW sub-vertical fracturing system involved in the destabilization of the area. The rock slope has been continuously moving since the eighties decade, with a growing acceleration during the period 2009-2013 followed by a progressive stabilization during the last years. The monitoring of the active part of the rock slide is currently carried out by an instrumentation system in order to prevent a large failure. In this work, we used different 3D techniques in order to monitor the whole rock slide displacements in three dimensions, as follows: (a) First of all, we used a Terrestrial Laser Scanning to obtain high resolution point clouds (8 cm point spacing) of the rock slope geometry. Nine different fieldwork campaigns were performed during the last six years, as follows: Aug. 2009, Jul. 2010, Nov. 2011, Nov. 2012, Jun. and Nov. 2013, Jul. and Oct. 2014, May 2015, which provided a set of 3D representations of the rock slope topography over time; (b) In addition, we used three Helicopter-based Laser Scanning campaigns carried out in Jan. 2011, Feb. 2012 and Mar. 2014 acquired by the Cerema (Chanut et al., 2014); (c) Finally, more than 600 photos were taken in Apr. 2015 in order to build a photogrammetric model of the area using Structure-from-Motion (SfM) workflow in Agisoft PhotoScan software. All types of data were complementary for the study of the movement and allowed us having a good spatial vision of the evolution of the most active part of the slope. A detailed structural analysis was performed from both LiDAR and SfM point clouds using Coltop3D (Jaboyedoff et al., 2007). Eight joint sets were detected, allowing us to estimate the susceptibility of the slope to three main failure mechanisms: planar sliding, wedge sliding and flexural toppling. Moreover, we carried out the 3D tracking of several homogenous rock compartments using the roto-translation matrix technique (Oppikofer et al., 2009) in order to quantify separately the translational and rotational components of displacements. Large-scale movements (from several dm to more than 10 m) were observed in the active area with a coupling between subsidence and toppling oriented towards the valley. Lateral structures that cut the rear active part also seem to be affected by a clockwise rotation around the topple axis. The acquisition of dense and accurate terrain information using LiDAR and SfM for studying the Séchilienne landslide has been useful for quantifying the 3D displacements and clarifying the failure mechanisms involved in the complex dynamic of the active part of the slope. Chanut, M-A., Dubois, L., Duranthon, J.P. (2014) Analyse de l'évolution du mouvement de terrain de Séchilienne à partir de données LiDAR. Journées Nationales de Géotechnique et de Géologie de l'Ingénieur JNGG2014 - Bauvais. Duranthon, J. P., & Effendiantz, L. (2004). Le versant instable des «Ruines» de Séchilienne. Bulletin des laboratoires des Ponts et Chaussées, 252, 253. Jaboyedoff, M., Metzger, R., Oppikofer, T., Couture, R., Derron, M. H., Locat, J., & Turmel, D. (2007). New insight techniques to analyze rock-slope relief using DEM and 3D-imaging cloud points: COLTOP-3D software, in: Rock mechanics: Meeting Society's Challenges and demands (Vol. 1, pp. 61-68). Kasperski, J., Potherat, P., & Duranthon, J. P. (2010). Le mouvement de versant de Séchilienne: point sur l'activité du phénomène, in: Rock Slope Stability (p. 13p). Oppikofer, T., Jaboyedoff, M., Blikra, L., Derron, M. H., & Metzger, R. (2009). Characterization and monitoring of the Åknes rockslide using terrestrial laser scanning, in: Natural Hazards and Earth SystemScience, 9(3), 1003-1019.

Effects of Self-Esteem and Mortality Salience on Attitudes Toward Canadian Security: Exploring the Significance of Implicit-Explicit and Personal-Collective Distinctions (Les Effets de L’Estime de soi et de la Pregnance de la Mort sur les Attitudes a L’Egard de la Securite Canadienne: Analyse de L’Importance des Distinctions entre Implicite et Explicite d’une Part et entre Personnel et Collectif D’Autre Part)

DTIC Science & Technology

2011-04-01

la Reine (en droit du Canada), telle que représentée par le ministre de la Défense nationale, 2011 DRDC Toronto TR... la gestion de la terreur, c’est parce que les êtres humains sont les seuls à posséder la capacité de comprendre la finitude de la vie qu’ils ont...entre autres l’adhésion à une vision du monde culturellement significative et un sentiment de sécurité basé sur l’estime de soi. À ce jour,

42nd Congress of the "Groupe Français des Pesticides" (French Group of Pesticide research--GFP 2012) ENSIP, Poitiers, France, 30 May-1 June 2012.

PubMed

Chollet, Jean-François; Couderchet, Michel; Bonnemain, Jean-Louis

2014-04-01

The 42nd congress of the "Groupe Français des Pesticides" (French Group of Pesticide research--GFP 2012) took place 30 May-1 June at the "École Nationale Supérieure d’Ingénieurs de Poitiers" (ENSIP), a French generalist engineering grande école in Poitiers. Its focus is on the protection of the environment and is part of the University of Poitiers, one of the oldest universities in Europe. GFP is an annual conference where the latest developments in the field of pesticide research are presented. The topics most commonly discussed mainly concern environmental quality, monitoring, fate, and transfer of pesticides in the environment or risks associated with use of pesticides, but every year a key theme sets the tone. For this 42nd edition, the theme "Innovative strategies for plant protection" was retained.

Molecular spectroscopy for producing ultracold ground-state NaRb molecules

NASA Astrophysics Data System (ADS)

Wang, Dajun; Guo, Mingyang; Zhu, Bing; Lu, Bo; Ye, Xin; Wang, Fudong; Vexiau, Romain; Bouloufa-Maafa, Nadia; Quéméner, Goulven; Dulieu, Olivier

2016-05-01

Recently, we have successfully created an ultracold sample of absolute ground-state NaRb molecules by two-photon Raman transfer of weakly bound Feshbach molecules. Here we will present the detailed spectroscopic investigations on both the excited and the rovibrational ground states for finding the two-photon path. For the excited state, we focus on the A1Σ+ /b3 Π singlet and triplet admixture. We discovered an anomalously strong coupling between the Ω =0+ and 0- components which renders efficient population transfer possible. In the ground state, the pure nuclear hyperfine levels have been clearly resolved, which allows us to create molecules in the absolute ground state directly with Raman transfer. This work is jointly supported by Agence Nationale de la Recherche (#ANR-13- IS04-0004-01) and Hong Kong Research Grant Council (#A-CUHK403/13) through the COPOMOL project.

Spontaneous actin dynamics in contractile rings

NASA Astrophysics Data System (ADS)

Kruse, Karsten; Wollrab, Viktoria; Thiagarajan, Raghavan; Wald, Anne; Riveline, Daniel

Networks of polymerizing actin filaments are known to be capable to self-organize into a variety of structures. For example, spontaneous actin polymerization waves have been observed in living cells in a number of circumstances, notably, in crawling neutrophils and slime molds. During later stages of cell division, they can also spontaneously form a contractile ring that will eventually cleave the cell into two daughter cells. We present a framework for describing networks of polymerizing actin filaments, where assembly is regulated by various proteins. It can also include the effects of molecular motors. We show that the molecular processes driven by these proteins can generate various structures that have been observed in contractile rings of fission yeast and mammalian cells. We discuss a possible functional role of each of these patterns. The work was supported by Agence Nationale de la Recherche, France, (ANR-10-LABX-0030-INRT) and by Deutsche Forschungsgemeinschaft through SFB1027.

[Starvation ketosis in a breastfeeding woman].

PubMed

Monnier, D; Goulenok, T; Allary, J; Zarrouk, V; Fantin, B

2015-12-01

Bovine ketosis is a rare cause of metabolic acidosis. It is a starvation ketosis that appears in lactating woman. A 29-year-old woman had a previous gastric surgery one month ago while breastfeeding her 6-month child. She presented to emergency with dyspnea, fatigue, weight loss and anorexia. The explorations revealed a serious metabolic acidosis with a high anion gap, for which all other causes have been eliminated. A restrictive diet in lactating patients is a major risk of ketosis or bovine ketosis. Medico-surgical treatment of obesity during lactation seems unreasonable. Breastfeeding should be systematically sought before a medical and surgical management of obesity. With the spread of bariatric surgery, starvation ketosis is a cause of metabolic acidosis not to ignore. Copyright © 2015 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

[Castleman's disease: Rapid desensitization for hypersensitivity reaction to rituximab].

PubMed

Boin, C; Lambert, S; Thomann, P; Aujoulat, O; Kieffer, P

2016-06-01

Rapid desensitization allows secure administration of a drug and is indicated when there is no therapeutic alternative. We report a 49-year-old patient who presented with a hypersensitivity reaction following an infusion of rituximab (375mg/m(2)) in the context of a Castleman's syndrome. After a clinical flare (splenomegaly, adenopathies) despite treatment with tocilizumab, anakinra and valganciclovir, the reintroduction of rituximab was decided, according to the rapid desensitization protocol. Four full dose desensitizations were successfully performed allowing immediate clinical improvement (apyrexia, loss of sweating and lymphadenopathy, splenomegaly partial regression) and biological (negativation of HHV8 viral load, and disappearance of neutropenia, anemia and thrombocytopenia). Rapid desensitization is a promising method for the pursuit of rituximab therapy after a hypersensitivity reaction and should be considered in patients with no acceptable therapeutic alternative. Copyright © 2015 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

How was the UNAIDS drug access initiative implemented in Chile?

PubMed Central

Brousselle, Astrid; Champagne, François

2012-01-01

In 1997, UNAIDS decided to implement Drug Access Initiatives (DAI) in four different pilot-countries. We studied the implementation of the DAI in Chile as part of the evaluation program conducted by the ‘Agence Nationale de Recherche sur le SIDA’ (ANRS/France). The objective was to understand how the politico-organizational dynamic influenced the implementation process of the DAI. Approximately 50 semi-directed interviews and observation activities were conducted with the actors who participated in the implementation of the DAI or who played a role in the HIV/AIDS context. The program theory models were established and their evolution analyzed. This article offers an original analysis of an international HIV/AIDS drug access program that was put in place at a time when such programs were seen as a priority by international and governmental institutions. It also offers some insights for the creation of international projects that will be locally implemented. PMID:23230344

[A Listeria breast abscess in a man].

PubMed

Marsaudon, E; Berthy, J; Mamoune, S; Deniel, A; Ksiyer, S; Tiuca, D

2018-03-01

Listeriosis is a food-borne illness leading to bacteriemia or central nervous system infection especially in pregnant women or high-risk patients. It is rarely a localized infection. Breast contamination has rarely been reported in lactating women. We report a breast abscess in man. A 80 year old man, hypertensive and arrhythmic, was explored for weakness and dehydration. Type 2 diabetes and chronic lymphocytic leukemia were diagnosed. Clinical examination disclosed a breast abcess related to L monocytogenes infection. Histopathological study also revealed a breast subcutaneous infiltration by chronic lymphocytic leukemia. Listeriosis sometimes uncover an unknown immunosuppression, especially in the elderly. Breast is a non-sterile tissue containing a stable microbiome partly from digestive origin. It can thereby be contaminated by Listeria. The specific cutaneous infiltrate of chronic lymphocytic leukemia can create the conditions for a local infection. Copyright © 2017 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

High oxygen affinity hemoglobins.

PubMed

Mangin, O

2017-02-01

High oxygen affinity hemoglobins are responsible for rare and heterogeneous autosomic dominant genetic diseases. They cause pure erythrocytosis, sometimes accountable for hyperviscosity and thrombosis, or hemolysis. Differential diagnoses must be first ruled out. The diagnosis is based on the identification of a decreased P50, and their possible characterization by cation exchange-high performance liquid chromatography and capillary electrophoresis. Finally, genetic studies of the responsible globin chain gene will confirm the mutation. The prognosis mainly relies on the P50 decrease rate and on the hemoglobin cooperativity impairment. Disease management should be personalized, and it should primarily depend on smoking cessation and physical activity. Phlebotomy and platelet aggregation inhibitors' prescriptions can be discussed. There is no contraindication to flights, high-altitude conditions, or pregnancy. Nevertheless, blood donation must be prohibited. Copyright © 2016 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

[Opportunistic infections and sarcoidosis].

PubMed

Jamilloux, Y; Bernard, C; Lortholary, O; Kerever, S; Lelièvre, L; Gerfaud-Valentin, M; Broussolle, C; Valeyre, D; Sève, P

2017-05-01

Opportunistic infections (OI) are uncommon in sarcoidosis (1 to 10%) and mostly occur in patients with previously diagnosed disease or can rarely be the presenting manifestation. The most common OIs are, in descending order: aspergillosis, cryptococcosis, and mycobacterial infections. Treatment with corticosteroids is the most frequent risk factor for OI occurrence during sarcoidosis but immunosuppressive drugs and therapy with anti-TNFα are also risk factors. Overall, clinical presentation, treatment, and outcome are identical to that occur in other conditions complicated with the occurrence of OIs. However, some atypical presentations of OIs can mimic sarcoidosis exacerbation and misdiagnosis may lead clinicians to increase immunosuppression, causing worsening of the OI. The meticulous collection of patient's history along with factors differentiating OI from sarcoidosis exacerbation is key factor to optimally manage these patients. Copyright © 2016 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

X-ray crystallography, an essential tool for the determination of thermodynamic relationships between crystalline polymorphs.

PubMed

Céolin, R; Rietveld, I-B

2016-01-01

After a short review of the controversies surrounding the discovery of crystalline polymorphism in relation to our present day understanding, the methods of how to solve the stability hierarchy of different polymorphs will be briefly discussed. They involve either theoretical calculations, or, more commonly, experimental methods based on classical thermodynamics. The experimental approach is mainly carried out using heat-exchange data associated to the transition of one form into another. It will be demonstrated that work-related data associated to the phase transition should be taken into account and the role of X-ray crystallography therein will be discussed. X-ray crystallography has become increasingly precise and can nowadays provide specific volumes and their differences as a function of temperature, and also as a function of pressure, humidity, and time. Copyright © 2015 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

[An atypical form of neurosarcoidosis].

PubMed

Quenardelle, V; Benmekhbi, M; Aupy, J; Dalvit, C; Hirsch, E; Benoilid, A

2013-12-01

Nervous system involvement occurs in 5 to 15% of the patients with sarcoidosis. Neurosarcoidosis remains very difficult to diagnose because clinical presentation and imaging characteristics lack specificity. We report a 26-year-old man who gradually developed headaches, memory disturbance and epilepsy. CT-scan and MRI showed a temporal-parietal cystic mass, secondary to a rare and focal form of hydrocephalus, called "trapped temporal horn" revealing neurosarcoidosis. The "entrapped temporal horn" is due to an obstacle on the cerebrospinal fluid pathway at the trigone of the lateral ventricle that seals off the temporal horn and the choroid plexus from the rest of the ventricular system. The obstacle is related to the granulomatous tissue of sarcoidosis. Therefore, the "trapped temporal horn" acts as a space occupying process, causing headaches, memory pain, hemiparesis, homonymous hemianopsia, and requires medico-surgical management. Copyright © 2013 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

(Low-level waste disposal facility siting and site characterization)

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

Mezga, L.J.; Ketelle, R.H.; Pin, F.G.

A US team consisting of representatives of Oak Ridge National Laboratory (ORNL), Savannah River Plant (SRP), Savannah river Laboratory (SRL), and the Department of Energy Office of Defense Waste and Byproducts Management participated in the fourth meeting held under the US/French Radioactive Waste Management Agreement between the US Department of Energy and the Commissariat a l'Energie Atomique. This meeting, held at Agence Nationale pour les Gestion des Dechets Radioactifs' (ANDRA's) Headquarters in Paris, was a detailed, technical topical workshop focusing on Low-Level Waste Disposal Facility Siting and Site Characterization.'' The meeting also included a visit to the Centre de lamore » Manche waste management facility operated by ANDRA to discuss and observe the French approach to low-level waste management. The final day of the meeting was spent at the offices of Societe Generale pour les Techniques Nouvelles (SGN) discussing potential areas of future cooperation and exchange. 20 figs.« less

[Systemic sclerosis: Efficacy of intravenous immunoglobulins in severe cardiac involvement?

PubMed

Cacciatore, C; Riviere, S; Cohen, A; Gatfosse, M; Ederhy, S; Fain, O; Mekinian, A

2018-07-01

The heart involvement in systemic sclerosis is frequent and can touch various sites. The prognosis in the presence of heart disease is poor, but few data are available about its management. We report the case of 48 years old woman with systemic sclerosis which presented severe heart involvement. She has severe heart failure, supraventricular arrhythmias and symptomatic pericarditis, which required surgical intervention and immunosuppressive drugs (steroids with rituximab). Despite this treatment, she has persistent severe heart impaired function and intravenous immunoglobulins have been initiated. She experienced progressively the improvement of dyspnea, of heart systolic ejection fraction and decrease of Rodnan scale. Our case illustrates a severe heart involvement in systemic sclerosis which have been improved by intravenous immunoglobulins. Copyright © 2018 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier Masson SAS. All rights reserved.

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.

[Levels of trace elements in the fruits and vegetables from the so-called Land of fires in Campania Region (Southern Italy)].

PubMed

Esposito, Mauro; Cavallo, Stefania; Rosato, Guido; Chiaravalle, Eugenio; Miedico, Oto; Pellicanò, Roberta; Soprano, Vittorio; Baldi, Loredana

2016-01-01

INTRODUZIONE: una vasta area compresa tra le province di Napoli e Caserta nella regione Campania ha negli ultimi anni attirato l'attenzione dei mass media a causa degli interramenti illeciti di rifiuti di varia origine nei campi o del loro abbandono lungo le strade. A tali pratiche illecite si aggiunge il fenomeno dei roghi incontrollati di questo materiale, motivo per il quale la zona è stata soprannominata "Terra dei fuochi". OBIETTIVI: ricerca di elementi in tracce presenti nei prodotti alimentari di origine vegetale prodotti nella Terra dei fuochi. DISEGNO E SETTING: piano di monitoraggio per il rilevamento dei livelli di alcuni metalli tossici ed essenziali nei vegetali coltivati in Campania nella Terra dei fuochi. La determinazione dei microelementi è stata effettuata dopo mineralizzazione della sostanza organica mediante microonde, utilizzando la spettrometria di massa a plasma induttivamente accoppiato (ICP-MS). RISULTATI: durante l'attività di monitoraggio sono stati raccolti 65 campioni di ortaggi e 49 campioni di frutta in 43 comuni rientranti nella Terra dei fuochi. Il contenuto medio di metalli tossici, cadmio e piombo nei prodotti ortofrutticoli è risultato ben lontano dai limiti massimi fissati dalla normativa europea. I valori delle concentrazioni sono significativamente inferiori rispetto a quanto riscontrato in zone ad alto impatto ambientale a causa della presenza di impianti industriali. CONCLUSIONI: la presenza di elementi tossici o potenzialmente tali nei campioni vegetali prodotti nella Terra dei fuochi è attribuibile a una varietà di fattori ambientali rilevanti (caratteristiche geologiche dell'area, inquinamento del suolo, dell'atmosfera e delle acque di irrigazione, pratiche illecite di smaltimento dei rifiuti industriali); non sembra, tuttavia, sussistere un rischio per la salute dei consumatori. Resta comunque l'allerta per la loro presenza nell'ambiente e la necessità che le attività di monitoraggio continuino.

Analyse de la prise en charge du nouveau-né dans le cadre de la stratégie nationale de subvention des accouchements et des soins obstétricaux et néonatals d'urgence au Centre Hospitalier Universitaire Pédiatrique Charles de Gaulle, Ouagadougou (Burkina Faso)

PubMed Central

Ouédraogo, Solange Odile Yugbaré; Yougbaré, Nestor; Kouéta, Fla; Dao; Ouédraogo, Moussa; Lougué, Claudine; Ludovic, Kam; Traoré, Ramata Ouédraogo; Yé, Diarra

2015-01-01

Introduction Il s'agit d'analyser la prise en charge du nouveau-né dans le cadre de la stratégie na-tionale de subvention des accouchements et des soins obstétricaux et néonatals d'urgence mis en place par le gouvernement du Burkina Faso en 2006. Méthodes Nous avons menée une étude à visée descriptive et analytique comportant un volet ré-trospectif du 01 janvier 2006 au 31 décembre 2010 portant sur les paramètres épidémiologiques, cliniques des nouveau-nés hospitalisés et un volet prospectif du 3 octobre 2011 au 29 février 2012 par une entrevue des accompagnateurs des nouveau-nés et des prestataires des services de santé. Résultats Les hospitalisations ont augmenté de 43,65% entre 2006 à 2010 Le taux de mortalité néo-natale hospitalière qui était de 11,04% a connu une réduction moyenne annuelle de 3,95%. L'entrevue a porté sur 110 accompagnateurs et 76 prestataires. La majorité des prestataires (97,44%) et des ac-compagnateurs (88,18%) étaient informés de la stratégie mais n'avait pas une connaissance exacte de sa définition. Les prestataires (94,74%) ont signalé des ruptures de médicaments, consommables médicaux et des pannes d’ appareils de laboratoire et d'imagerie. Parmi les accompagnateurs (89%) disaient être satisfaits des services offerts et (72,89%) trouvaient les coûts abordables mais évoquaient les difficultés du transport. Conclusion: La subvention a amélioré la prise en charge du nou-veau-né mais son optimisation nécessiterait une meilleur information et implication de tous les acteurs. Conclusion La subvention a amélioré la prise en charge du nouveau-né mais son optimisation nécessiterait une meilleur information et implication de tous les acteurs. PMID:26161166

Calculations of dose distributions using a neural network model

NASA Astrophysics Data System (ADS)

Mathieu, R.; Martin, E.; Gschwind, R.; Makovicka, L.; Contassot-Vivier, S.; Bahi, J.

2005-03-01

The main goal of external beam radiotherapy is the treatment of tumours, while sparing, as much as possible, surrounding healthy tissues. In order to master and optimize the dose distribution within the patient, dosimetric planning has to be carried out. Thus, for determining the most accurate dose distribution during treatment planning, a compromise must be found between the precision and the speed of calculation. Current techniques, using analytic methods, models and databases, are rapid but lack precision. Enhanced precision can be achieved by using calculation codes based, for example, on Monte Carlo methods. However, in spite of all efforts to optimize speed (methods and computer improvements), Monte Carlo based methods remain painfully slow. A newer way to handle all of these problems is to use a new approach in dosimetric calculation by employing neural networks. Neural networks (Wu and Zhu 2000 Phys. Med. Biol. 45 913-22) provide the advantages of those various approaches while avoiding their main inconveniences, i.e., time-consumption calculations. This permits us to obtain quick and accurate results during clinical treatment planning. Currently, results obtained for a single depth-dose calculation using a Monte Carlo based code (such as BEAM (Rogers et al 2003 NRCC Report PIRS-0509(A) rev G)) require hours of computing. By contrast, the practical use of neural networks (Mathieu et al 2003 Proceedings Journées Scientifiques Francophones, SFRP) provides almost instant results and quite low errors (less than 2%) for a two-dimensional dosimetric map.

Impact of a surgical site infection (SSI) surveillance program in orthopedics and traumatology.

PubMed

Mabit, C; Marcheix, P S; Mounier, M; Dijoux, P; Pestourie, N; Bonnevialle, P; Bonnomet, F

2012-10-01

Surveillance of surgical site infections (SSI) is a priority. One of the fundamental principles for the surveillance of SSI is based on receiving effective field feedback (retro-information). The aim of this study was to report the results of a program of SSI surveillance and validate the hypothesis that there is a correlation between creating a SSI surveillance program and a reduction in SSI. The protocol was based on the weekly collection of surveillance data obtained directly from the different information systems in different departments. A delay of 3 months was established before extraction and analysis of data and information from the surgical teams. The NNIS index (National Nosocomial Infections Surveillance System) developed by the American surveillance system and the reduction of length of hospital stay index Journées d'hospitalisation évitées (JHE). Since the end of 2009, 7156 surgical procedures were evaluated (rate of inclusion 97.3%), and 84 SSI were registered with a significant decrease over time from 1.86% to 0.66%. A total of 418 days of hospitalization have been saved since the beginning of the surveillance system. Our surveillance system has three strong points: follow-up is continuous, specifically adapted to orthopedic traumatology and nearly exhaustive. The extraction of data directly from hospital information systems effectively improves the collection of data on surgical procedures. The implementation of a SSI surveillance protocol reduces SSI. Level III. Prospective study. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

Local responses to French medical imperialism in late nineteenth-century Algeria.

PubMed

Gallois, William

2007-08-01

This article offers the first account of the lives of Algerian-born doctors working in the French colonial medical service between 1870 and 1900. Their stories reveal the manner in which the idea of medical imperialism had collapsed in Algeria, as a result of maladministration, racial policies, competition between civil and military authorities, budgetary constraints and the rise of the colons. The article also indicates the way in which medicine became a locus of opposition to French rule. It shows how the first decades of the Third Republic were critical in terms of a shift from the earlier idea of medicine serving as an emblem of the mission civilisatrice to the ideological potential of medicine being seen in much more nuanced terms by both French settlers and Algerian locals. It is argued that the notion of cultural resistance to imperialism through medicine emerges in the 1870s and 1880s, thereby prefiguring the work of Fanon and the Front de Liberation Nationale's later analysis of the 'sickness' of colonial Algerian society.

Remote entanglement stabilization for modular quantum computing

NASA Astrophysics Data System (ADS)

Didier, Nicolas; Shankar, S.; Mirrahimi, M.

Quantum information processing in a modular architecture requires to distribute and stabilize entanglement in a qubit network. We present autonomous entanglement stabilization protocols between two qubits that are coupled to distant cavities. The cavities coupling is mediated and controlled via a three-wave mixing device that generates either a delocalized mode or a two-mode squeezed state between the remote cavities depending on the pump frequency. Local drives on the qubits and the cavities steer and maintain the system to the desired qubit Bell state. We show that these reservoir-engineering based protocols stabilize entanglement in presence of qubit-cavity asymmetries and losses. Most spectacularly, even a weakly-squeezed state can stabilize a maximally entangled Bell state of two distant qubits through entanglement accumulation. This research was supported by the Agence Nationale de la Recherche under Grant ANR-14-CE26-0018, by Inria's DPEI under the TAQUILLA associated team and by ARO under Grant No. W911NF-14-1-0011.

[Syphilis].

PubMed

Dupin, N

2016-11-01

Syphilis is back since the beginning of this century. The epidemic affects mainly men having sex with men with a high proportion of HIV-infected patients. The classification of syphilis distinguishes early syphilis where patients are contagious (primary, secondary and early latent of less than one year) and late syphilis where patients are not (or less) contagious (late latent of more than one year and tertiary). The clinical presentation of syphilis has not changed. However, we must insist on the early forms of neurosyphilis, notably ophthalmic syphilis often under-diagnosed, as it affects the treatment. Serologic tests may be improved but are very helpful for the positive diagnosis and the follow-up after treatment. Treatment of early syphilis is based on one injection of benzathine benzyl penicillin G. Patients who have had syphilis must be regularly followed-up after treatment, as re-infections are common and are often asymptomatic. Copyright © 2016 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

[Adult-onset opsoclonus-myoclonus-ataxia syndrome revealing rubella meningoencephalitis].

PubMed

Nasri, A; Mansour, M; Messelmani, M; Riahi, A; Derbali, H; Bedoui, I; Zaouali, J; Mrissa, R

2016-12-01

Opsoclonus-myoclonus-ataxia (OMS) is a rare clinical syndrome, of paraneoplastic infectious, post-infectious, post-vaccinal or idiopathic origin. We report a 24-year-old young man who presented with gait disorder preceded by a febrile rash and retroauricular lymph nodes. Three days before admission, he had headache, vertigo, nausea and vomiting followed by gait unsteadiness and movement disorders of limbs and eyes. On examination, he had OMS syndrome. Brain MRI, total body scan, MIBG scintigraphy, tumor markers and onconeural antibodies were normal. Cerebro-spinal fluid (CSF) analysis showed lymphocytic meningitis. Positive serum and CSF immunoglobulin M antibody against rubella virus was demonstrated. He received acyclovir with full recovery within two weeks. We discuss the peculiarities of this association with a literature review. This observation enlarges the spectrum of neurological manifestations of rubella as well as that of OMS etiologies. Copyright © 2016 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

[Enzymes for disrupting bacterial communication, an alternative to antibiotics?

PubMed

Rémy, B; Plener, L; Elias, M; Daudé, D; Chabrière, E

2016-11-01

Quorum sensing (QS) is used by bacteria to communicate and synchronize their actions according to the cell density. In this way, they produce and secrete in the surrounding environment small molecules dubbed autoinducers (AIs) that regulate the expression of certain genes. The phenotypic traits regulated by QS are diverse and include pathogenicity, biofilm formation or resistance to anti-microbial treatments. The strategy, aiming at disrupting QS, known as quorum quenching (QQ), has emerged to counteract bacterial virulence and involves QS-inhibitors (QSI) or QQ-enzymes degrading AIs. Differently from antibiotics, QQ aims at blocking cell signaling and does not alter bacterial survival. This considerably decreases the selection pressure as compared to bactericide treatments and may reduce the occurrence of resistance mechanisms. QQ-enzymes are particularly appealing as they may disrupt molecular QS-signal without entering the cell and in a catalytic way. This review covers several aspects of QQ-based medical applications and the potential subsequent emergence of resistance is discussed. Copyright © 2016 Académie Nationale de Pharmacie. All rights reserved.

[3D printed medical devices and anatomical models: What kind of distribution and which uses in French hospitals?

PubMed

Pierreville, J; Serrano, C; van den Brink, H; Prognon, P; Pineau, J; Martelli, N

2018-03-01

3D printing plays an increasingly important role in the medical sector and particularly in surgery. Nowadays, numerous manufacturers benefit from this technology to produce their medical devices and some hospitals have also purchased 3D printers. In this context, the aim of the present study was to study the distribution and the use of 3D printing in French hospitals in order to its main features in surgery. By conducting a national survey, we targeted hospitals equipped with 3D printers and those using external providers to benefit from this technology. Forty-seven hospitals were identified as using 3D printing including eight equipped with in-house 3D printers. This work gives us a first picture of 3D printing for hospital use in France and it raises questions about hospital pharmacists' involvement in 3D printed medical device production. Copyright © 2017 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

Combining bioinformatics, chemoinformatics and experimental approaches to design chemical probes: Applications in the field of blood coagulation.

PubMed

Villoutreix, B O

2016-07-01

Bioinformatics and chemoinformatics approaches contribute to the discovery of novel targets, chemical probes, hits, leads and medicinal drugs. A vast repertoire of computational methods has indeed been reported over the years and in this review, I will briefly introduce some concepts and approaches, namely the analysis of potential therapeutic target binding pockets, the preparation of compound collections and virtual screening. An example of application is provided for two proteins acting in the blood coagulation system. Overall, in silico methods have been shown to improve R and D productivity in both, academic settings and in the private sector, if they are integrated in a rational manner with experimental approaches. However, integration of tools and pluridisciplinarity are seldom achieved. Efforts should be done in this direction as pluridisciplinarity and a true acknowledgment of all the contributing actors along the value chain could enhance innovation and reduce skyrocketing costs. Copyright © 2016 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

[Acute pancreatitis as the presenting feature of an IgA vasculitis: An unusual presentation].

PubMed

Fertitta, L; Noel, N; Ackermann, F; Lerolle, N; Benoist, S; Rocher, L; Lambotte, O

2017-10-01

IgA vasculitis is a systemic small vessel leukocytoclastic vasculitis characterized by skin purpura, arthritis, abdominal pain and nephritis. Most of the abdominal complications are due to edema and hemorrhage in the small bowel wall, but rarely to acute secondary pancreatitis. Here, we report a 53-year-old woman who presented with acute pancreatitis and, secondarily, developed skin purpura and arthritis at the seventh day of the clinical onset. Biological tests and computed tomographic scan allowed to rule out another cause of pancreatitis and IgA vasculitis was diagnosed as its etiology. The outcome was favorable without any relapse on glucocorticoids. Despite its rarity, pancreatitis is a potential life-threatening complication of IgA vasculitis in which the role of glucocorticoids and immunosuppressive drugs remains uncertain. A prompt elimination of other usual pancreatitis etiologies is mandatory to improve the management of the patients. Copyright © 2017 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

[Irritable bowel syndrome: New pathophysiological hypotheses and practical issues].

PubMed

Duboc, H; Dior, M; Coffin, B

2016-08-01

In 2015, besides the fact that it still fills the gastroenterologists' offices and impairs patient's quality of life, the irritable bowel syndrome has considerably evolved on several points. The pathophysiology is now organized around a consensual hypothesis called the "brain-gut axis", which gather all the influences of peripheral factors as gut microbiota or local serotonin secretion, on the central pain perception, contributing to visceral hypersensitivity and transit modifications. About the diagnosis, the key message is "avoid over-prescription" of additional tests, and reminds that a positive clinical diagnosis based on Rome III criteria is possible after the elimination of simple clinical warning signs. Finally, the food component, a neglected and historical claim of patients, finally finds a strong scientific rational, with a diet low in fermentable sugar and polyols, that gives positive and reproducible results. Copyright © 2016 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

[Acetaminophen induced 5-oxoproline acidosis: An uncommon case of high anion gap metabolic acidosis].

PubMed

Lanot, A; Henri, P; Nowoczyn, M; Read, M H; Maucorps, C; Sassier, M; Lobbedez, T

2018-02-01

The most common causes of high anion gap metabolic acidosis (HAGMA) are lactic acidosis, ketoacidosis, and intoxications. Nevertheless, clinicians can be faced with unexplained HAGMA, with a need to look for less common etiologies. We describe a case of 5-oxoproline (pyroglutamate) acidosis due to chronic acetaminophen ingestion at therapeutic dose in a 79-year-old inpatient. The pathophysiology of this condition is detailed, with abnormalities in the gamma-glutamyl cycle due to acetaminophen ingestion and severe chronic morbidities, resulting in glutathione and cysteine deficiency and then accumulation of 5-oxoproline. In HAGMA, when usual causes have been excluded, 5-oxoproline acidosis should be suspected in patients with chronic morbidities and acetaminophen ingestion. This diagnosis should be kept in mind because it generally resolves quickly with cessation of acetaminophen and administration of intravenous fluids. Copyright © 2017 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

[Reactivation of parvovirus B19 infection in an HIV-infected woman].

PubMed

Sterpu, R; Ichou, H; Mahé, I; Mortier, E

2014-06-01

Infection by human parvovirus B19 (erythrovirus B19) is common and usually asymptomatic during childhood conferring lasting protection against a new infection. Parvovirus B19 infection may cause erythema infectiosum (5th disease) and aplastic crisis. Secondary symptomatic parvovirus B19 infection in the same patient is rare and its physiopathology is not always clear. A 48-year-old HIV-infected female patient presented within 5 years two acute episodes of parvovirus B19 infection although her CD4 cells count was above 500/mm(3). Absence of specific antibodies production after the first episode and persisting parvovirus viremia suggested viral reactivation rather than re-infection. During the second episode, specific antibodies were produced. Similarly to most DNA viruses, parvovirus B19 reactivation is possible in HIV-infected patients while effectively treated by antiretroviral therapy. Copyright © 2013 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

[Cardiac sarcoidosis: Diagnosis and therapeutic challenges].

PubMed

Cohen Aubart, F; Nunes, H; Mathian, A; Haroche, J; Hié, M; Le-Thi Huong Boutin, D; Cluzel, P; Soussan, M; Waintraub, X; Fouret, P; Valeyre, D; Amoura, Z

2017-01-01

Sarcoidosis is a granulomatous disorder of unknown cause characterized by non-caseating granuloma in young adults. Cardiac involvement is rare and range from 2 to 75% depending on diagnostic criteria. Cardiac involvement in sarcoidosis may be asymptomatic or may manifest as rhythm/conduction troubles or congestive heart failure. The diagnosis and treatment of cardiac sarcoidosis may be challenging. However, advances have come in recent years from the use of cardiac MRI and 18 FDG-TEP scanner, as well as from the stratification of the risk of ventricular tachycardia/fibrillation. Due to the rarity of the disease, there is no reliable prospective large study to guide therapeutic strategy for cardiac sarcoidosis. Corticosteroids are probably efficacious, in particular in case of atrio-ventricular block or moderate heart failure. Immunosuppressive drugs have not been largely studied but methotrexate could be helpful. In refractory forms, TNF-α antagonists have been used with success. Copyright © 2016 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

[Posterior reversible encephalopathy syndrome induced by a cough and cold drug containing pseudoephedrine].

PubMed

Ebbo, M; Benarous, L; Thomas, G; Jourde, N; Genot, S; Bernit, E; Veit, V; Harlé, J-R; Schleinitz, N

2010-06-01

Posterior reversible encephalopathy syndrome is a clinico-radiological entity characterized by neurologic symptoms in association with usually reversible bilateral posterior hemispheric oedema on neuroimaging. Many pathological conditions and treatments have been associated with this syndrome. We report a 19-year-old woman, followed-up for hypocomplementemic urticarial vasculitis, who presented with a posterior reversible encephalopathy syndrome induced by the intake of an over-the-counter cold remedy containing pseudoephedrine. Clinical manifestations and radiological abnormalities resolved after anti-hypertensive therapy and withdrawal of sympathomimetic drug. The diagnosis of posterior reversible encephalopathy syndrome should be considered in patients with compatible clinical and radiological presentation because of its potential reversibility with an appropriate management. Intake of drugs, including over-the-counter cough and cold drugs, should be looked for in the history as well as autoimmune disorders. Copyright 2010 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

The European "clinical trial" regulation; relationship with the Jardé Act: a Giens workshop.

PubMed

Lemaire, François; Marchenay, Brigitte; Chassany, Olivier; Barthélémy, Philippe; Bouzzagou, Mohamed; Comet, Denis; Delval, Cécile; Dubray, Claude; Fouret, Cécile; Frija-Orvoen, Elisabeth; Gambotti, Laetitia; Lamarque, Véronique; d'Orsay, Geneviève; Plattner, Valérie; Sibenaler, Claire; Roux, Jacques; Thoby, Frédérique

2015-01-01

In May 2014, the European Union Parliament and Council published a new regulation on clinical trials on medicinal products for human use, which is designed to replace Directive 2001/20/EC. It will not come into effect until 2016. Nevertheless, it is essential to examine its relationship with national legislation, i.e. the Jardé Act, whose implementation has been delayed pending publication of the European regulation. The Giens workshop identified and examined the various issues that this relationship is bound to raise. In particular, it looked at trial methodology assessment procedures, the working relationship between the French National Agency of Drug Safety and Health Products (Agence Nationale de Sécurité du Médicament et des Produits de Santé, ANSM) and ethics committees during the authorization application evaluation phase, review of post-authorization/registration studies on medicinal products and medical devices, and data transparency. © 2015 Société Française de Pharmacologie et de Thérapeutique.

[Retinal vasculitis and systemic diseases].

PubMed

Gascon, P; Jarrot, P-A; Matonti, F; Kaplanski, G

2018-06-19

Retinal vasculitis (RV) is an inflammation of retinal blood vessels that can be associated with uveitis or be isolated, and can induce vascular occlusion and retinal ischemia. Visual acuity can be severely affected in case of macular involvement or neovessel formation. The diagnosis relies on fundoscopy and fluorescein angiography. Systemic diseases may be associated with RV, the most frequently encountered are Behçet's disease, sarcoidosis or multiple sclerosis, all predominantly associated with venous involvement, whereas systemic lupus erythematosus and necrotizing vasculitis are less frequently observed and predominantly associated with arterial or mixed vasculitis. Treatments are usually aggressive in order to preserve a good visual acuity and to reduce retinal inflammation and chronic ischemia. Steroids, immunosuppressive drugs, retinal laser photocoagulation, intravitreal anti-VEGF injections are usual treatments and more recently, anti-TNFalpha monoclonal therapeutic antibodies have been shown to be very successful. Copyright © 2018 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier Masson SAS. All rights reserved.

French government to trim direct stake in Total

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

Not Available

This paper reports that the French government has decided to slash its direct stake in partly state owned oil company Total to 5% from 31.7%, a surprise move expected to raise 10 billion francs ($1.8 billion). At the same time, other state owned entities will be asked to boost their combined 2.2% stake in Total to 10%, leaving the government with a net 15% interest in Total vs. the current 34%. Initially, state owned insurance companies Groupe des Assurances Nationales and Assurances Generale de France will be asked to hike their stakes in Total, but others could be asked tomore » join if needed to meet the 10% target. The government the its phase-down of participation in Total, established in 1924 to manage French interests in Iraq Petroleum Co., was prompted by the evolution of the oil context, which differs greatly from what had prompted a significant stake of the state in Total's capital.« less

[Vertebral sarcoidosis. Spontaneous favorable outcome: A case report and literature review].

PubMed

Salmon, J-H; Perotin, J-M; Direz, G; Brochot, P; Laredo, J-D; Eschard, J-P

2013-01-01

The prevalence of vertebral sarcoidosis is highly variable (1 to 36% of reported case series). Because of limited clinical expression, its frequency is probably underestimated. Its proper management is not clearly defined. A 42-year-old woman who had a past medical history of cutaneous and pulmonary sarcoidosis presented with low back pain that was refractory to usual medical treatment. A diagnosis of vertebral localisation of sarcoidosis was considered on the history of proven sarcoidosis, radiological features, and the absence of evidence of an alternative diagnosis. In the absence of other clinical or biological evidence of active sarcoidosis, a simple follow-up was planned. MRI control at 1 year showed the resolution of vertebral sarcoidosis lesions. Spontaneous regression is a possible outcome of vertebral sarcoidosis. Initiation of a specific treatment should be discussed in the absence of other visceral involvement. Copyright © 2012 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

[Catheter fracture and pulmonary embolization of the distal fragment: a rare complication of the totally implantable venous access port].

PubMed

Rebahi, H; El Adib, A G; Mouaffak, Y; El Hattaoui, M; Chaara, A; Sadek, H; Khouchani, M; Mahmal, L; Younous, S

2015-01-01

Totally implantable venous access port plays a crucial role in the treatment of patients in oncology. However, its use can result sporadically in catheter fracture with catheter tip embolization into pulmonary arteries. We report this unusual but potentially serious complication in four patients. In these patients, the port had been inserted percutaneously into the subclavian vein using the infra-clavicular approach. This side effect occurred late in three patients. In all patients, the catheter fracture was asymptomatic or pauci-symptomatic and was caused by the pinch-off syndrome. The retrieval of the embolized fragments was successfully performed by transcatheter procedure in the cardiac catheterisation laboratory. We reviewed the literature and the newest guidelines and recommendations to detail the clinico-radiological features, the possible causes of this complication and discussed means to recognize, manage and prevent it. Copyright © 2013 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

[Enterobacteriaceae producing extended spectrum beta-lactamase: epidemiology, risk factors, and prevention].

PubMed

Vodovar, D; Marcadé, G; Raskine, L; Malissin, I; Mégarbane, B

2013-11-01

Multidrug-resistant bacteria are a major worldwide health public concern. It results from the growing increase in antibiotic prescriptions, which are responsible for selection pressure on bacteria. In France like in other countries, enterobacteriaceae producing extended spectrum beta-lactamase (EESBL) are the predominant multidrug-resistant bacteria. EESBL may be responsible for severe infections and require prescription of broad-spectrum antibacterial agents. The current EESBL outbreak is different from methicillin-resistant Staphylococcus aureus outbreak that occurred in the early 1980. Consistently, EESBL are isolated both in hospital and community. Moreover, standard hygiene measures appear ineffective since EESBL prevalence is still increasing. The current inability to contain EESBL outbreak is due to several factors, including the existence of a wide community- and hospital-acquired tank of EESBL, failure to follow strict rules for hygiene, and the current irrational prescription of antibiotics. Copyright © 2012 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

A 2016 Ganymede stellar occultation event

NASA Astrophysics Data System (ADS)

D'Aversa, Emiliano; Oliva, Fabrizio; Sindoni, Giuseppe; Hinse, Tobias Cornelius; Plainaki, Christina; Aoki, Shohei; Person, Michael J.; Carlson, Robert W.; Orton, Glenn S.

2017-04-01

On 2016 April,13th the Jovian satellite Ganymede occulted a 7th magnitude star. The predicted occultation track crossed the Northern Pacific Ocean, Japan, and South Korea. Hence, it was a very favorable event due to the star brightness and to the visibility from the large aperture telescopes at Hawaii. While no other similar event is expected for the next 10 years, only two occultation events are reported in literature in the past, from Earth in 1972 [1] and from Voyager [2], in large disagreement in respect to the atmosphere detection. However, evidence of an exosphere around Ganymede was inferred by [3], through H Lyman alpha emission detected by Galileo UVS, and by [4], through HST/GHRS detection of far-UV atomic O airglow emissions, signature of dissociated molecular oxygen ([5],[6]). Later, the HST/STIS observations by [7] provided further evidence for exospheric neutral hydrogen. Since Ganymede is known to have an intrinsic magnetic field ([8]) reconnecting with the Jovian magnetic field and (partially) shielding the surface equatorial latitudes from the electron impact, the UV emissions have been so far attributed to auroral processes ([6]). Nevertheless, the physical mechanisms governing these processes are not known with certainty (e.g. whether the emissions morphology is determined by the spatial distribution of magnetospheric electrons or by an uneven O2 exosphere or both, see e.g.[9]). We took advantage of this event in order to search for a signature of Ganymede's exosphere in the occultation light curve, by using facilities on Mauna Kea at Hawaii (NASA-IRTF observatory) and at Sobaeksan Optical Astronomy Observatory (SOAO) in South Korea. At IRTF, both MORIS [10] and SpeX [11] instruments have been used, fed by the same optical entrance through a dichroic beam splitter at 0.95 micron. MORIS acquired a high-rate sequence of images about 0.25 sec apart in the visible range, while SpeX acquired a sequence of spectra at a bit lower rate, covering the 0.9-2.5 micron range. Unfortunately, a planned MORIS movie-mode sequence at higher rate failed in starting acquisition. The field of view of the instruments was not large enough to include a reference unocculted body, hence sky fluctuations are the major noise source. At SOAO, a CCD camera in clear filter was used to obtain a shorter sequence of images at a lower rate (about 1 Hz). However, since the larger field of view allowed to observe simultaneously Ganymede and Callisto, we can use the latter as a reference unocculted body in order to cancel out telluric fluctuations. Results from the occultation light curve analysis on the three datasets will be discussed. Acknowledgments - The Infrared Telescope Facility is operated by the University of Hawaii under contract NNH14CK55B with the National Aeronautics and Space Administration. We express special thanks to Bobby Bus as support astronomer for both MORIS and SpeX observations. SOAO is managed by the Korean Astronomy and Space Science Istitute (KASI). References - [1] Carlson et al.,1973,Science,182,4107. [2] Broadfoot et al.,1981,Journ.of Geophys.Res.,86,8259. [3] Barth et al.,1996,EOS Suppl.77,F430. [4] Hall et al.,1998,ApJ,499,475. [5] McGrath et al.,2004,Cambridge Univ.Press,ISBN 0-521-81808-7,2004,p.457-483. [6] McGrath et al.,2013,Journ.of Geophys.Res.,118,2043. [7] Feldman et al.,2000,ApJ,535,1085. [8] Kivelson et al.,1996,Nature,384,537. [9] Plainaki et al.,2015,Icarus,245,306. [10] Gulbis et al.,2011,PASP,123,461. [11] Rayner et al.2003,PASP,115,362.

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)

A model for evaluating radiological impacts on organisms other than man for use in post-closure assessments of geological repositories for radioactive wastes.

PubMed

Thorn, M C; Kelly, M; Rees, J H; Sánchez-Friera, P; Calvez, M

2002-09-01

Bioaccumulation and dosimetric models have been developed that allow the computation of dose rates to a wide variety of plants and animals in the context of the deep geological disposal of solid radioactive wastes. These dose rates can be compared with the threshold dose rates at which significant deleterious effects have been observed in field and laboratory observations. This provides a general indication of whether effects on ecosystems could be observable, but does not quantify the level of those effects. To address this latter issue, two indicator organisms were identified and exposure-response relationships were developed for endpoints of potential interest (mortality in conifers and the induction of skeletal malformations in rodents irradiated in utero). The bioaccumulation, dosimetry and exposure-response models were implemented and used to evaluate the potential significance of radionuclide releases from a proposed deep geological repository for radioactive wastes in France. This evaluation was undertaken in the context of a programme of assessment studies being performed by the Agence nationale pour la gestion des déchets radioactifs (ANDRA).

Vigi4Med Scraper: A Framework for Web Forum Structured Data Extraction and Semantic Representation

PubMed Central

Audeh, Bissan; Beigbeder, Michel; Zimmermann, Antoine; Jaillon, Philippe; Bousquet, Cédric

2017-01-01

The extraction of information from social media is an essential yet complicated step for data analysis in multiple domains. In this paper, we present Vigi4Med Scraper, a generic open source framework for extracting structured data from web forums. Our framework is highly configurable; using a configuration file, the user can freely choose the data to extract from any web forum. The extracted data are anonymized and represented in a semantic structure using Resource Description Framework (RDF) graphs. This representation enables efficient manipulation by data analysis algorithms and allows the collected data to be directly linked to any existing semantic resource. To avoid server overload, an integrated proxy with caching functionality imposes a minimal delay between sequential requests. Vigi4Med Scraper represents the first step of Vigi4Med, a project to detect adverse drug reactions (ADRs) from social networks founded by the French drug safety agency Agence Nationale de Sécurité du Médicament (ANSM). Vigi4Med Scraper has successfully extracted greater than 200 gigabytes of data from the web forums of over 20 different websites. PMID:28122056

[Ocular tuberculosis : A case series].

PubMed

Koubaa, M; Smaoui, F; Gargouri, S; Ben Ayed, H; Rekik, K; Abid, I; Maaloul, I; Feki, J; Marrakchi, C; Ben Jemaa, M

2018-05-01

Ocular tuberculosis is a rare form of extra pulmonary tuberculosis. It represents 1-2% of all clinical forms. The aim of this work was to focus on diagnostic and therapeutic characteristics of ocular tuberculosis. We report a case series of 14 patients with ocular tuberculosis seen in an infectious diseases department between 2006 and 2015. The diagnosis was retained on clinical data and a positive tuberculin skin test or interferon-gamma release assay. The patient's mean age was 40.7±9years. The most common clinical presentation was uveitis (11 patients and 16 eyes). An extra ocular involvement was associated in three patients. The mean duration of antitubercular therapy was 10±2.5 months. Corticosteroid therapy was associated in 11 cases. The outcome was favorable in all cases. Two patients had maintained visual sequelae. Ocular tuberculosis is a rare disease but still remains a diagnostic problem. It should be considered in case of any chronic ocular symptoms, especially in endemic countries. Early management can improve the visual prognosis. Copyright © 2018 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

[Pulmonary intravascular talcosis: A case report].

PubMed

Reverso-Meinietti, J; Vandenbos, F; Risso, K; Coyne, J; Leroy, S; Padovani, B; Burel-Vandenbos, F

2018-04-09

Pulmonary intravascular talcosis is a rare condition occurring in intravenous drug users injecting oral medications. Talc results in a foreign-body granulomatous reaction giving a radiological haematogenic miliary appearance mimicking miliary tuberculosis. Drug users represent a population at risk for both these conditions and their distinction may be challenging. We reported the case of a man, 33 year-old, intravenous drug addict, detected by the health services because he was the partner of a person who died of contagious and multi-resistant tuberculosis. Chest X-ray and CT scan showed a typical miliary appearance. Despite negative microbiology, clinical diagnosis of miliary tuberculosis was retained. Due to the lack of radiological improvement despite appropriate antibiotic treatment, re-evaluation and trans-bronchial biopsy were undertaken. The presence of granulomas centered by birefringent foreign bodies in polarized light led to a diagnosis of pulmonary intravascular talcosis. In the presence of pulmonary miliary in an intravenous drug addict, intravascular talcosis should be suspected. Copyright © 2018 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

[Diagnostic issues of lymphogranuloma venereum: A case series of 5 patients].

PubMed

Fabre-Baudouin, A; Roux, A L; Marin, C; Lachatre, M; De Laroche, M; Ponsoye, M; Hanslik, T; Trad, S

2017-12-01

Lymphogranuloma venereum (LG) is a sexually transmitted infection (STI) caused by Chlamydia trachomatis L serovar. These five consecutive cases aim to highlight the risk of LG misdiagnosis, in case of initial presentation with isolated inguinal adenitis. Five men (mean age: 30±7 years) were seen in an internal medicine department, for inguinal adenopathy. One patient had clinical signs of urethritis. None presented an associated rectitis. Three patients had a history of STI, and two had a discovery of related HIV disease. Urinary polymerase chain reaction (PCR) was positive for the symptomatic patient and negative for the others. Lymph node PCR was positive in all patients within a L2b serotype (searched in 4 out of 5 cases). LG should be evoked in any patient with inguinal adenomegaly, particularly in case of STI history or risk factors. Negativity of urinary PCR should lead to further investigations, essentially a lymph node cytopuncture to evidence C. trachomatis. Copyright © 2017 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

[Langerhans cell histiocytosis in adults].

PubMed

Néel, A; Artifoni, M; Donadieu, J; Lorillon, G; Hamidou, M; Tazi, A

2015-10-01

Langerhans cell histiocytosis (LCH) is a rare disease characterized by the infiltration of one or more organs by Langerhans cell-like dendritic cells, most often organized in granulomas. The disease has been initially described in children. The clinical picture of LCH is highly variable. Bone, skin, pituitary gland, lung, central nervous system, lymphoid organs are the main organs involved whereas liver and intestinal tract localizations are less frequently encountered. LCH course ranges from a fulminant multisystem disease to spontaneous resolution. Several randomized controlled trials have enable pediatricians to refine the management of children with LCH. Adult LCH has some specific features and poses distinct therapeutic challenges, knowing that data on these patients are limited. Herein, we will provide an overview of current knowledge regarding adult LCH and its management. We will also discuss recent advances in the understanding of the disease, (i.e. the role of BRAF oncogene) that opens the way toward targeted therapies. Copyright © 2015 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Rapport sur l'état du patrimoine astronomique dans les observatoires français de la fin du XIXè siècle

NASA Astrophysics Data System (ADS)

Damm, E.; Pécontal, E.

2012-12-01

Suite au colloque sur la sauvegarde du patrimoine astronomique organisé par le MAEE et la SAF, sous l'égide de l'UNESCO, qui a conduit à l'adoption de la Déclaration de Paris, les directeurs d'observatoires institutionnels qui étaient absents du colloque ont ressenti le besoin de discuter de ces conclusions prises en leur nom. L'initiative d'organiser une réunion des directeurs des Observatoires des Sciences de l'Univers (OSU) à ce sujet le 30 janvier 2012 a été prise par François Vernotte, directeur de l'Observatoire de Besançon. Le présent compte-rendu de visite résulte d'une initiative spontanée d'Emmanuel Pécontal, astronome responsable du Patrimoine à l'observatoire de Lyon, et d'Evelyne Damm, membre de la Commission Nationale de classement des Monuments Historiques (CNMH) et élue à la communauté d'agglomération des Portes de l'Essonne oû est sis l'observatoire de Camille Flammarion.

[Carbapenemase-producing enterobacteriae: epidemiology, strategies to control their spread and issues].

PubMed

Lepelletier, D; Batard, E; Berthelot, P; Zahar, J-R; Lucet, J-C; Fournier, S; Jarlier, V; Grandbastien, B

2015-07-01

The increasing bacterial resistance to antibiotics has become a major public health concern bringing the threat of therapeutic impasses. In this context, control of the spread of highly-resistant bacteria emerging antibiotics (BHRe), such as glycopeptide-resistant enterococci (VRE) and Enterobacteriaceae producing carbapenemases (CPE), is based on a dual strategy of reducing the prescription of antibiotics to limit the pressure selection and preventing the spread from carriers. Prevention strategy is based on three different levels such as standard precautions for all patients with a particular focus on the management of excreta, and additional precautions for BHRe carriers. What makes it difficult is that carriage is usually completely asymptomatic, enterobacteria and enterococci are normal commensal of gut microbiota. Explosive dissemination of Enterobacteriaceae producing extended spectrum beta-lactamases in hospital and community heralds the emergence of CPE whose import by patients with a history of hospitalization in abroad may be the main source of spread in France. Copyright © 2015 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Five cases of acute Zika virus infection in French women of reproductive age returning from Central and South America.

PubMed

Penot, P; Balavoine, S; Leplatois, A; Brichler, S; Leparc-Goffart, I; Alloui, A-C; Flusin, O; Guilleminot, J; Amellou, M; Molina, J-M

2017-08-01

The favorable season for Aedes albopictus circulation has started in Europe and may lead to autochthonous transmission of Zika virus. Health care providers should be familiar with evocative clinical presentations and able to give updated information to women of reproductive age infected by Zika virus. We report five laboratory-confirmed Zika virus infections imported to metropolitan France from Central and South America between January and April, 2016. The five young women were not connected and not pregnant; common presentation combined a rash with persistent arthralgia. Zika virus was identified by RT-PCR from serum or urines, between two and eight days after the onset of the symptoms. As the duration of potential materno-foetal infectivity is still unknown, we were unable to answer with certitude to the patients' questions about the time interval to respect before attempting a pregnancy: one of them became pregnant one month after the diagnosis. Copyright © 2016 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

[Splenic abscesses: From diagnosis to therapy].

PubMed

Davido, B; Dinh, A; Rouveix, E; Crenn, P; Hanslik, T; Salomon, J

2017-09-01

Splenic abscess is septic collection which occurs after haematogenous spread or local dissemination. Splenic abscess is an uncommon and rare condition, more frequently affecting male and immunocompromised patients. There are no guidelines regarding its diagnosis and management. Computed tomography (CT) scan is highly sensitive and specific (95% and 92%, respectively) in the diagnosis of splenic abscess. Diagnosis is based on blood cultures which are positive in 24 to 80% of cases. Bacterial growth culture of abscess after drainage is more efficient (50-80%) and can be performed after surgery or percutaneous drainage under imaging, including CT scan. Microorganisms involved are frequently enterobacteriaceae, gram-positive cocci and anaerobes. This particular ecology leads to an empiric broad-spectrum antibiotic therapy, with a variable duration, from 10days to more than one month. Management remains very close to the one applied in case of liver abscesses. The role of splenectomy in the prevention of recurrence remains controversial. We reviewed the literature regarding splenic abscesses, from diagnosis to therapy. Copyright © 2017 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

The New Microbiology: a conference at the Institut de France.

PubMed

Radoshevich, Lilliana; Bierne, Hélène; Ribet, David; Cossart, Pascale

2012-08-01

In May 2012, three European Academies held a conference on the present and future of microbiology. The conference, entitled "The New Microbiology", was a joint effort of the French Académie des sciences, of the German National Academy of Sciences Leopoldina and of the British Royal Society. The organizers - Pascale Cossart and Philippe Sansonetti from the "Académie des sciences", David Holden and Richard Moxon from the "Royal Society", and Jörg Hacker and Jürgen Hesseman from the "Leopoldina Nationale Akademie der Wissenschaften" - wanted to highlight the current renaissance in the field of microbiology mostly due to the advent of technological developments and allowing for single-cell analysis, rapid and inexpensive genome-wide comparisons, sophisticated microscopy and quantitative large-scale studies of RNA regulation and proteomics. The conference took place in the historical Palais de l'Institut de France in Paris with the strong support of Jean-François Bach, Secrétaire Perpétuel of the Académie des sciences. Copyright © 2012 Académie des sciences. Published by Elsevier SAS. All rights reserved.

[Treatment of Behçet's disease].

PubMed

Comarmond, C; Wechsler, B; Cacoub, P; Saadoun, D

2014-02-01

Behçet's disease (BD) is a systemic large-vessel vasculitis characterized by a wide clinical spectrum including recurrent oral and genital ulcerations, uveitis, vascular, neurological, articular, and gastrointestinal manifestations. Therapeutic management of BD depends on the clinical presentation and organ involved. Although colchicine, non-steroidal anti-inflammatory agents and topical treatments with corticosteroids are often sufficient for mucocutaneous and joint involvement, a more aggressive approach with immunosuppressive agents is warranted for severe manifestations such as posterior uveitis, retinal vasculitis, vascular, neurological and gastrointestinal involvement. However, some patients still have refractory disease, relapses, sight threatening eye disease, or irreversible organ damage. Recent improvements in the understanding of the pathogenic mechanisms have led to the identification of potential targets and future therapies for BD. In contrast to current non-specific immunosuppressive agents, the emergence of immunomodulatory drugs provides the possibility of interfering with specific pathogenic pathways. Novel targeted immunosuppressive therapies might be used in the future for BD. Copyright © 2013 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

[Ischemic strokes in young adults and illegal drugs].

PubMed

Barbieux, M; Véran, O; Detante, O

2012-01-01

One out of four ischemic strokes in France occurs in adults under 65 years old. About a third of them remain unexplained even after an extensive etiological assessment. A large part of these unexplained strokes could be linked to illegal drug abuse, and 10 % are estimated to be directly linked to illegal drugs in some international studies. The most frequently incriminated recreational drug remains cocaine, via several mechanisms. However, several other illegal drugs, some very commonly used such as cannabis, are suspected to have an important role in neurovascular diseases. In this article, we reviewed the epidemiological, pathophysiological and clinical studies, published in the international literature over the past 30 years. The drug-caused stroke epidemiology needs to be more precisely studied, as well as the underlying mechanisms depending on each drug. This is a public health issue that affects an economically active population, as stroke is the first cause of acquired handicap in adults. Copyright © 2011 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

[Alzheimer's disease cerebro-spinal fluid biomarkers: A clinical research tool sometimes useful in daily clinical practice of memory clinics for the diagnosis of complex cases].

PubMed

Magnin, E; Dumurgier, J; Bouaziz-Amar, E; Bombois, S; Wallon, D; Gabelle, A; Lehmann, S; Blanc, F; Bousiges, O; Hannequin, D; Jung, B; Miguet-Alfonsi, C; Quillard, M; Pasquier, F; Peoc'h, K; Laplanche, J-L; Hugon, J; Paquet, C

2017-04-01

The role of biomarkers in clinical research was recently highlighted in the new criteria for the diagnosis of Alzheimer's disease. Cerebro-spinal fluid (CSF) biomarkers (total Tau protein, threonine 181 phosphorylated Tau protein and amyloid Aβ1-42 peptide) are associated with cerebral neuropathological lesions observed in Alzheimer's disease (neuronal death, neurofibrillary tangle with abnormal Tau deposits and amyloid plaque). Aβ1-40 amyloid peptide dosage helps to interpret Aβ1-42 results. As suggested in the latest international criteria and the French HAS (Haute Autorité de santé) recommendations, using theses CSF biomarkers should not be systematic but sometimes could be performed to improve confidence about the diagnostic of Alzheimer's disease in young subjects or in complex clinical situations. Future biomarkers actually in development will additionally help in diagnostic process (differential diagnosis) and in prognostic evaluation of neurodegenerative diseases. Copyright © 2016 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Technical and design update in the AUBE French low-level radioactive waste disposal facility

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

Marque, Y.

1989-01-01

Long-term industrial management of radioactive waste in France is carried out by the Agence Nationale pour la Gestion des Dechets Radioactifs (ANDRA). ANDRA is in charge of design, siting, construction, and operation of disposal centers. The solution selected in France for the disposal of low- and medium-level, short-lived radioactive waste is near-surface disposal in the earth using the principle of multiple barriers, in accordance with national safety rules and regulations, and based on operating experience from the Centre de Stockage de la Manche. Since the center's start-up in 1969, 400,000 m{sup 3} of waste have been disposed of. The Frenchmore » national program for waste management is proceeding with the construction of a second near-surface disposal, which is expected to be operational in 1991. It is located in the department of AUBE (from which its name derives), 100 miles southeast of Paris. The paper describes the criteria for siting and design of the AUBE disposal facility, design of the AUBE facility disposal module, and comparison with North Carolina and Pennsylvania disposal facility designs.« less

[Telemedicine in thrombotic microangiopathies: A way forward in rare diseases requiring emergency care].

PubMed

Coppo, P; Corre, E; Rondeau, E; Benhamou, Y; Bachet, A; Stépanian, A; Veyradier, A

2016-08-01

Thrombotic microangiopathies (TMA) represent rare diseases requiring a high skill for their management that deserved in France the identification of a dedicated National reference center. TMA are short-term life-threatening diseases; however, with an adapted management, their prognosis can be excellent. It is therefore mandatory to recognize and treat them rapidly according to standard guidelines. Telemedicine is a specialized hub consisting of highly skilled staff trained in a specific domain of medicine. The telemedicine activity of a reference center is an important representative indicator of its expertise and recourse ability. It requires to be accurately evaluated and promoted. In this work, we report the French reference center for TMA telemedicine activity since its setting-up. TMA represent an interesting model of diseases that required a specific organization of telemedicine activity to adapt to clinicians demand, which includes particularly the need to answer resorts in real time 24/7. Copyright © 2015 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

[Security of the medicinal therapy: Cartography of risks a priori within service of orthopaedic surgery].

PubMed

Razurel, A; Bertrand, É; Deranlot, J; Benhamou, F; Tritz, T; Le Mercier, F; Hardy, P

2015-11-01

Security and quality of the Medicinal Therapy are one of the most important objectives of the April 6th, 2011 order. The objective is to realize this study of the risks incurred by patients related to management and security of medicinal therapy in order to establish a plan to reduce the risks of drug's dispensation. The method of the Preliminary Risk Analysis (PRA) has been implemented by a multidisciplinary group in a hospital service of orthopaedic surgery. The study focused on the dispensation phase of medicinal circuit. This analysis revealed 148 scenarii, 35 were criticality unacceptable. Fifty-four initial risk control actions were proposed and their stress levels to put them in place were evaluated. The main measures of risk management are: training, information, communication, computerization, automation, dual control, updating the documentation system, drug reconciliation and respect for Best Practices Hospitallers (BPH). Risk management requires a significant human and financial investment as well as, material resources and multidisciplinary expertise in order to offer the best solutions. Copyright © 2015 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

Jean Francheteau (1943-2010)

NASA Astrophysics Data System (ADS)

Sclater, John; Le Pichon, Xavier

2010-12-01

Jean Francheteau, pioneering marine geologist and geophysicist, AGU Fellow, and emeritus professor at the University of Brest (Université de Bretagne Occidentale), died on 21 July in St-Renan, Brittany, France, at the age of 67 after a long illness. With his passing, the field of Earth sciences lost a major contributor to the development of a definitive theory of plate tectonics and one of the first to make visual geological observations on the deep seafloor. Such scientific accomplishments, coupled with his personal charm and the ability to collaborate with researchers from many institutions, ensured that he had a huge influence not only on the world of research but also on teaching and the application of ethics to science. Jean arrived at Scripps Institution of Oceanography in La Jolla, Calif., in 1966 after obtaining a diploma in mining engineering at the prestigious Éole Nationale Supérieure de la Métallurgie et de l'Industrie des Mines in Nancy, France. He chose Victor Vacquier as his thesis supervisor and began working in Vic's lab with John Sclater, ostensibly on heat flow measurements.

[A complex case of diabetes due to LMNA mutation].

PubMed

Ambonville, C; Bouldouyre, M-A; Laforêt, P; Richard, P; Benveniste, O; Vigouroux, C

2017-10-01

Laminopathies (diseases related to A/C mutations of lamines) are rare genetic diseases with an extensive phenotypic spectrum, including lipodystrophic syndromes-characterized by a selective loss of adipose tissue-of which the partial Dunnigan family type is the most frequent. We report on a 55-year-old woman with diabetes and long-term disabling myalgia. Her cushingoid morphotype, associated with cutaneous lipo-atrophy and muscle hypertrophy in addition to a genetic heritage, led us to the diagnosis of complex partial familial lipodystrophy heterozygous LMNA_c.82C>T, p.Arg28Trp mutation. Familial partial lipodystrophic syndromes may have varied phenotypes, mainly cardio-metabolic, which could mimic a particularly severe type 2 diabetes. The diagnostic work-up of this disease has to include a careful investigation of gait troubles and paroxysmal conduction that could lead to sudden death, as well as a genetic examination. In some cases, recombinant leptin can be proposed. Copyright © 2017 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Mode de révélation particulier d'une tumeur brune chez une patiente hémodialysée chronique

PubMed Central

El Harraqui, Ryme; Karimi, Ilham; Chemlal, Abdeljalil; Ismaili, Fatiha Alaoui; Haddiya, Intissar

2014-01-01

Les tumeurs brunes constituent une complication rare mais sévère de la dialyse, le plus souvent asymptomatique. Nous rapportons le cas d'une patiente dont le mode de révélation de la tumeur brune fut atypique. Observation médicale: Madame F. est une patiente hémodialysée chronique depuis 14 ans suite à une néphropathie indéterminée. Sur le plan phosphocalcique, elle présente une ostéoporose depuis plus de 10 ans, ainsi qu'une hyperparathyroïdie secondaire. A la date du 24 octobre 2013, elle rapporte qu'elle a constaté la présence d'une petite « bosse » pariétale, apparue de façon spontanée la veille, sans notion de traumatisme. A l'examen clinique, nous trouvons une petite tuméfaction de 2cm de diamètre environs, de consistance dure, indolore, mobile par rapport au cuir chevelu. L’échographie a conclu à un lipome. Le lendemain matin, la patiente entre dans un état de coma profond. Le scanner cérébral a révélé la présence d'un hématome extradural associé à un hématome superficiel extra-crânien en regard d'une lyse de l'os pariétal, qui est en fait une tumeur brune. La patiente est transférée en réanimation où elle décède dans la journée. PMID:25422698

[Typology of the French medical learned societies. Survey of 129 organizations].

PubMed

Maisonneuve, Hervé; Moreau, Nicolas; Steudler, François; Guérot, Claude; Durocher, Alain

2004-07-10

A study on the relationship between the ANDEM--Agence Nationale pour le Développement de l'Evaluation Médicale (French agency for the development of health technology assessment) and the learned societies showed that a definition of the role of these organisations and criteria to define learned societies were lacking. We conducted a survey among the learned societies in the field of medicine so as to elaborate a definition. We used the files of the learned societies of the Anaes--Agence Nationale d'Accréditation et d'Evaluation en Santé (French Agency for accreditation and evaluation in health) in 1998, which included 225 organisations. We sent a letter together with a single-page questionnaire and copies of the 2 publications on the relationship between the ANDEM and the learned societies. To analyse the suggestions for a definition, having read the replies, a segmentation of the population, the means and modalities of action and the aims and fields of action were used. A proposal for a definition was discussed during 2002/2003 with the board of the Fédération des Spécialités Médicales (FSM) (Federation of medical specialties) regrouping 33 medical and 12 surgical societies. Three meetings between a representative of the Anaes and the board of the FSM resulted in the proposition of so-called "validation" criteria for learned societies. A search on the French Internet listing such societies was made using a research motor (March 20, 2004). Out of the 225 organisations contacted, 129 (57%) replied. Among the latter, 115 considered themselves as a learned society and 14 did not. Among the 115 organisations defining themselves as a learned society, 97 proposed a definition, 16 made use of the definitions proposed in the questionnaire and 81 proposed their own definition. The analysis identified 6 important elements (reporting, knowledge, education, research, diffusion, promotion). The data analysed permitted the elaboration of a definition based on the proposals of the learned societies: "An organised group, within the framework of a given discipline, the members' aim of which is to report on their work, to improve knowledge on their discipline, to ensure education and research, to diffuse information on their work and research and to support and promote their discipline". Thirty-two of the 45 societies of the FSM accepted the 11 validation criteria proposed, some of which were commented on. Only one society abstained and 12 did not reply. No French Internet web site listing the learned societies specified a definition of criteria for inclusion in the lists. A definition of the learned societies and validation criteria, obtained through the participation of the principle actors, could serve as a basis for the recognition and identification of such societies.

Relaxation diélectrique de solutions aqueuses d'éthylène glycol aux micro-ondes

NASA Astrophysics Data System (ADS)

Vicq, G.; Delbos, G.; Forniés Marquina, J. M.; Lamkaouchi, K.

1999-09-01

The study of dielectric properties of aqueous solutions of ethylene glycol in the frequency range 10 MHz - 20 GHz is reported as a function of water concentration at 20 circC. Some complex permittivity measurements were carried out using a precise reflectrometric method at 1.20, 3.26 and 9.45 GHz and some others using HP 8510 B network analyser from 45 MHz to 20 GHz and measurements by time domain reflectometry (T.D.R.). The dielectric relaxation analysis shows two domains of “Debye" dispersion for pure ethylene glycol and his aqueous solutions. Using a spectral decomposition, the static and high frequency dielectric constant and the relaxation time have been determined. The dielectric behaviour is interpreted by using the concept of Schallamach, concerning the mixtures of associated-associated liquids. Les auteurs présentent des séries de résultats de mesures en hyperfréquences concernant les permittivités diélectriques de l'éthylène-glycol et de ses solutions aqueuses à 20 circC, pour diverses concentrations, entre 100 MHz et 20 GHz. Ils ont utilisé trois techniques différentes : des mesures précises à trois fréquences fixes parfaitement stabilisées en guides d'ondes 1,20 ; 3,26 et 9,45 GHz par une méthode réflectométrique ; des mesures utilisant l'analyseur de réseau vectoriel HP 8510 B fonctionnant entre 45 MHz et 20 GHz ; et des mesures par réflectométrie en domaine de temps (R.D.T.). Ils montrent que l'analyse de la relaxation peut être représentée par la superposition de deux domaines de dispersion de type “Debye" pour l'éthylène glycol et ses solutions aqueuses. Par décomposition spectrales, ils déduisent la permittivité statique, les temps de relaxation et la permittivité à fréquence infinie à 20 circC? Ils proposent que ces mélanges soient de type associé-associé suivant le concept de Schallamach, qui montre que pour des mélanges de ce type, il existe des relaxations d'agrégats contenant les deux types de molécules plutôt que des relaxations de molécules individuelles.

Ensemble Classifiers for Predicting HIV-1 Resistance from Three Rule-Based Genotypic Resistance Interpretation Systems.

PubMed

Raposo, Letícia M; Nobre, Flavio F

2017-08-30

Resistance to antiretrovirals (ARVs) is a major problem faced by HIV-infected individuals. Different rule-based algorithms were developed to infer HIV-1 susceptibility to antiretrovirals from genotypic data. However, there is discordance between them, resulting in difficulties for clinical decisions about which treatment to use. Here, we developed ensemble classifiers integrating three interpretation algorithms: Agence Nationale de Recherche sur le SIDA (ANRS), Rega, and the genotypic resistance interpretation system from Stanford HIV Drug Resistance Database (HIVdb). Three approaches were applied to develop a classifier with a single resistance profile: stacked generalization, a simple plurality vote scheme and the selection of the interpretation system with the best performance. The strategies were compared with the Friedman's test and the performance of the classifiers was evaluated using the F-measure, sensitivity and specificity values. We found that the three strategies had similar performances for the selected antiretrovirals. For some cases, the stacking technique with naïve Bayes as the learning algorithm showed a statistically superior F-measure. This study demonstrates that ensemble classifiers can be an alternative tool for clinical decision-making since they provide a single resistance profile from the most commonly used resistance interpretation systems.

[Management of neuropathic pain].

PubMed

Lozeron, P; Kubis, N

2015-07-01

Neuropathic pain is often underestimated and not adequately treated. The DN4 scale is very useful for its identification since it will benefit from pharmacological and non-pharmacological specific alternative care. The pathophysiological mechanisms involve the hyperexcitability of nociceptive pathways or decreased inhibitory descending controls that will be the target of pharmacological treatments. Frontline molecules are antidepressants (tricyclics and mixed serotonin and norepinephrine reuptake inhibitors) and antiepileptics (α2δ calcium channel inhibitors). However, these drugs will only have a partial efficacy on pain. The therapeutic strategy is based on reasonable goals, starting with a monotherapy adapted to the patient's symptoms and comorbidities and increased step by step. Patient compliance to contract is essential and requires clear and complete information. The impact on profession, social and family integration should rapidly be taken into account. In case of inefficiency, a change of the first-line treatment or an association could be considered. Some indications justify a specific therapy. Patients with resistant chronic pain should be sent to a specialized centre. New drugs are being studied and non-pharmacological support must be evaluated. Copyright © 2015 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

[The French medecine pricing committee].

PubMed

Giorgi, D

2017-09-01

The French medicine pricing committee (CEPS) has to reconcile several major constraints, including optimal patient access to medicines and a good control of expenditures on reimbursable medicines. From 2013 to 2015, drug price decreases and discounts obtained by CEPS contributed more than € 5 billion to the balance of the health insurance accounts. As for price setting, there is a significant drop in the prices of medicines in France once they are registered for reimbursement. France is affected by a limited, but costly, flow of innovative medicines, whose prices are higher than those of previous generations, a reflection of an international gradient to which France is obviously subject, despite prices that remain at the low end of the range in Western Europe. The provision of innovative medicines for all patients who need them has been ensured in France over the last fifteen years at a controlled cost. But with the arrival of new expensive products, a resolute policy of control of expenditures must take over from the fall in prices, and original financing channels will have to be explored. Copyright © 2017 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

[Repetitive transcranial magnetic stimulation: A potential therapy for cognitive disorders?

PubMed

Nouhaud, C; Sherrard, R M; Belmin, J

2017-03-01

Considering the limited effectiveness of drugs treatments in cognitive disorders, the emergence of noninvasive techniques to modify brain function is very interesting. Among these techniques, repetitive transcranial magnetic stimulation (rTMS) can modulate cortical excitability and have potential therapeutic effects on cognition and behaviour. These effects are due to physiological modifications in the stimulated cortical tissue and their associated circuits, which depend on the parameters of stimulation. The objective of this article is to specify current knowledge and efficacy of rTMS in cognitive disorders. Previous studies found very encouraging results with significant improvement of higher brain functions. Nevertheless, these few studies have limits: a few patients were enrolled, the lack of control of the mechanisms of action by brain imaging, insufficiently formalized technique and variability of cognitive tests. It is therefore necessary to perform more studies, which identify statistical significant improvement and to specify underlying mechanisms of action and the parameters of use of the rTMS to offer rTMS as a routine therapy for cognitive dysfunction. Copyright © 2016 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

[Issues and difficulties in the relationship between patients and caregivers in painful sickle cell vaso-occlusive crisis].

PubMed

Dzierzynski, N; Stankovic Stojanovic, K; Georgin-Lavialle, S; Lionnet, F

2016-02-01

Sickle cell patients in acute pain situation experiment cognitive, behavioral and emotional changes that can accentuate their pain and disrupt communication with caregivers. On the other hand, caregivers have to face pain assessment difficulties and their own psychological reactions to their patient's pain. The gap between the patient's experience and caregiver's evaluation can lead to conflict and non-adherence treatment, and have a direct impact on the sickle cell disease prognosis. There is nothing inevitable about these phenomena, whose knowledge allows the action and opens up prospects for improving the management of sickle cell disease pain. This article is a narrative review updating the interactions between acute pain and some configurations, such as the inability to discern emotions, catastrophizing, post-traumatic stress or feeling ostracized. The overestimation of patient's addiction by caregivers also influences the pain itself. Open communication, as well as some treatments, medicated or not, a consistent institutional organization and a multidisciplinary approach altogether have an analgesic role by acting on pain cognitive and emotional components. Copyright © 2015 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Implementation of flu vaccination in community pharmacies: Understanding the barriers and enablers.

PubMed

Kirkdale, C L; Nebout, G; Taitel, M; Rubin, J; Jacinto, I; Horta, R; Megerlin, F; Thornley, T

2017-01-01

Improving influenza vaccination coverage has been, and still remains a challenge internationally. There are now many examples where countries have pursued a pharmacist-led influenza vaccination service in order to enhance vaccination coverage of at-risk populations. England, Portugal and the United States are successful examples where their experience implementing this service can now be explored retrospectively and learnt from. This review aims to provide evidence to help overcome barriers to commissioning and implementation of such services in countries new to the experience. Implementation is influenced by differing regulatory frameworks underpinning the provision of pharmacist-led influenza vaccination, methods of remuneration, training, and operating procedures. Practical aspects such as the facilities required, how patient records are maintained and how patients and other healthcare professionals are engaged also have an impact. These examples illustrate how community pharmacists can be trained to deliver influenza vaccinations safely, and coupled with their accessibility and convenience, can provide a complementary service to that already provided by family doctors and nurses to deliver influenza vaccinations for the benefit of patients. Copyright © 2016 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

[Current treatment and epidemiology of Clostridium difficile infections].

PubMed

Dinh, A; Bouchand, F; Le Monnier, A

2015-09-01

During the past 10years, Clostridium difficile infections (CDI) have become a major public health challenge. Their epidemiology has changed with a rise in the number of cases and an increase in severe episodes. Recurrence and failure of conventional treatments have become more common. Furthermore, a spread of CDI has been observed in the general population-involving subjects without the usual risk factors (unexposed to antibiotic treatment, young people, pregnant women, etc.). All these change are partially due to the emergence of the hypervirulent and hyperepidemic clone NAP1/B1/027. New therapeutic strategies (antimicrobial treatment, immunoglobulins, toxin chelation, fecal microbiota transplantation) are now available and conventional treatments (metronidazole and vancomycin) have been reevaluated with new recommendations. Recent studies show a better efficacy of vancomycin compared to metronidazole for severe episodes. Fidaxomicin is a novel antibiotic drug with interesting features, including an efficacy not inferior to vancomycin and a lower risk of recurrence. Finally, for multi-recurrent forms, fecal microbiota transplantation seems to be the best option. We present the available data in this review. Copyright © 2015 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Children and screens: Groupe de Pédiatrie Générale (Société française de pédiatrie) guidelines for pediatricians and families.

PubMed

Picherot, G; Cheymol, J; Assathiany, R; Barthet-Derrien, M-S; Bidet-Emeriau, M; Blocquaux, S; Carbajal, R; Caron, F-M; Gerard, O; Hinterman, M; Houde, O; Jollivet, C; Le Heuzey, M-F; Mielle, A; Ogrizek, M; Rocher, B; Samson, B; Ronziere, V; Foucaud, P

2018-02-01

The Groupe de Pédiatrie Générale (General Pediatrics Group), a member of the Société française de pédiatrie (French Pediatrics Society), has proposed guidelines for families and doctors regarding children's use of digital screens. A number of guidelines have already been published, in particular by the French Academy of Sciences in 2013 and the American Academy of Pediatrics in 2016. These new guidelines were preceded by an investigation into the location of digital screen use by young children in France, a survey of medical concerns on the misuse of digital devices, and a review of their documented benefits. The Conseil Supérieur de l'Audiovisuel (Higher Council on Audiovisual Technology) and the Union Nationale de Associations Familiales (National Union of Family Associations) have taken part in the preparation of this document. Five simple messages are proposed: understanding without demonizing; screen use in common living areas, but not in bedrooms; preserve time with no digital devices (morning, meals, sleep, etc.); provide parental guidance for screen use; and prevent social isolation. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

[HPV (Human Papilloma Virus) implication in other cancers than gynaecological].

PubMed

Badoual, C; Tartour, E; Roussel, H; Bats, A S; Pavie, J; Pernot, S; Weiss, L; Mohamed, A Si; Thariat, J; Hoffmann, C; Péré, H

2015-08-01

Worldwide, approximately 5 to 10% of the population is infected by a Human Papilloma Virus (HPV). Some of these viruses, with a high oncogenic risk (HPV HR), are responsible for about 5% of cancer. It is now accepted that almost all carcinomas of the cervix and the vulva are due to an HPV HR (HPV16 and 18) infection. However, these viruses are known to be involved in the carcinogenesis of many other cancers (head and neck [SCCHN], penis, anus). For head and neck cancer, HPV infection is considered as a good prognostic factor. The role of HPV HR in anal cancer is also extensively studied in high-risk patient's population. The role of HPV infection in the carcinogenesis of esophageal, bladder, lung, breast or skin cancers is still debated. Given the multiple possible locations of HPV HR infection, the question of optimizing the management of patients with a HPV+ cancer arises in the implementation of a comprehensive clinical and biological monitoring. It is the same in therapeutics with the existence of a preventive vaccination, for example. Copyright © 2015 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

[Ocular manifestations of Behçet's disease].

PubMed

Saadoun, D; Cassoux, N; Wechsler, B; Boutin, D; Terrada, C; Lehoang, P; Bodaghi, B; Cacoub, P

2010-08-01

Eye involvement in Behçet's disease (BD) is frequent and an important cause of morbidity. The mean age at onset of uveitis is between 20 and 30 years in male and 30 years in female patients. Ocular involvement includes anterior, posterior or panuveitis. Uveitis may be the presenting manifestation of the disease in 20% of cases or may appear 2 or 3 years after the disease onset. The estimated risk of blindness at 5 years ranges from 15 to 25%. The main goals in the management of patients with BD uveitis are the rapid control of intraocular inflammation, the prevention of recurrent attacks, the achievement of complete remission, and preservation of vision. The medical treatment of patients with severe uveitis relies on the use of systemically administered drugs, including corticosteroids and cytotoxic agents. Anti-TNF agents and interferon-alpha seem to be efficient and well-tolerated alternative therapeutic options. Controlled clinical trials are mandatory to define the place of these new immunomodulatory agents in the therapeutic strategy, and especially their use as first-line therapy. Copyright (c) 2010 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

[Henoch-Schönlein purpura in the adult].

PubMed

Pillebout, E; Verine, J

2014-06-01

Henoch-Schönlein purpura is a systemic vasculitis of the small vessels characterized by perivascular leucocyte infiltrates. It is an immunoglobulin A-related immune complex-mediated disease involving the skin, the joints and the gastrointestinal system. Renal disease may sometimes be associated to these clinical manifestations. Prevalence of the nephritis is highly variable, depending on the series. More rarely, other organs such as the lungs, the heart or the nervous system may be involved. The clinical diagnosis is confirmed by histopathology of the skin (leukocytoclastic vasculitis) and kidney (endo-capillary proliferative glomerulonephritis), showing IgA deposits in these tissues. Short-term prognosis depends on the severity of digestive involvement, but long-term prognosis depends on the renal disease. Recent publications of pediatric and adult series show that the chronic renal failure may progress, sometimes more than ten years after the initial flare. Treatment is usually supportive. The benefit of more specific treatments (corticosteroids or immunosuppressive drugs) in severe visceral forms (usually abdominal or kidney) has not yet been established. Copyright © 2013 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

FOREWORD: International Conference on Heavy Ion Collisions in the LHC Era

NASA Astrophysics Data System (ADS)

Arleo, Francois; Salgado, Carlos A.; Tran Thanh Van, Jean

2013-03-01

The International Conference on Heavy Ion Collisions in the LHC Era was held in Quy Nhon, Vietnam, on 16-20 July 2012. The series Rencontres du Vietnam, created by Jean Tran Thanh Van in 1993, consists of international meetings aimed to stimulate the development of advanced research in Vietnam and more generally in South East Asia, and to establish collaborative research networks with Western scientific communities. This conference, as the whole series, also supports the International Center for Interdisciplinary Science Education being built in Quy Nhon. The articles published in this volume present the latest results from the heavy-ion collision programs of RHIC and LHC as well as the corresponding theoretical interpretation and future perspectives. Lower energy nuclear programs were also reviewed, providing a rather complete picture of the state-of-the-art in the field. We wish to thank the sponsors of the Conference on Heavy Ion Collisions in the LHC Era: the European Research Council; Xunta de Galicia (Spain); EMMI (Germany) and Agence Nationale de la Recherche (France) François Arleo (Laboratoire d'Annecy-le-Vieux de Physique Théorique, France) Francois Arleo, Carlos A Salgado and Jean Tran Thanh Van Conference photograph

Stability studies on florfenicol using developed derivative spectrophotometric methods.

PubMed

Elimam, M M; Shantier, S W; Gadkariem, E A; Mohamed, M A; Osman, Z

2017-01-01

This study aims to investigate the stability of florfenicol using previously developed derivative spectrophotometric methods (D 1 and D 2 ). The studied stability-indicating pararmeters included alkali (NaOH, 1M), acid (HCl, 1M), pH changes (buffer pH 2.2-11), temperature (80°C and 100°C at pH 10) and light. A constructed pH profile for the drug degradation rate revealed a significant effect of pH on the drug stability between pH ranges 8 and 11. The obtained profile indicated first order dependence of K obs on [OH - ]. Arrhenius plot at pH 10 was found linear at temperatures 80°C and 100°C with estimated activation energy of 19.35kcal/mol. The calculated rate constant (K obs ), t ½ and t 90 at 25°C were found to be 1.8×10 -3 h, 385h and 58.3h, respectively. The photostability of florfenicol was also studied by exposing the drug solution to direct sunlight during mid-day time. The obtained results reflected the instability of florfenicol under the study conditions. Copyright © 2016 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

FRIPON, the French fireball network

NASA Astrophysics Data System (ADS)

Colas, F.; Zanda, B.; Bouley, S.; Vaubaillon, J.; Marmo, C.; Audureau, Y.; Kwon, M. K.; Rault, J. L.; Caminade, S.; Vernazza, P.; Gattacceca, J.; Birlan, M.; Maquet, L.; Egal, A.; Rotaru, M.; Gruson-Daniel, Y.; Birnbaum, C.; Cochard, F.; Thizy, O.

2015-10-01

FRIPON (Fireball Recovery and InterPlanetary Observation Network) [4](Colas et al, 2014) was recently founded by ANR (Agence Nationale de la Recherche). Its aim is to connect meteoritical science with asteroidal and cometary science in order to better understand solar system formation and evolution. The main idea is to set up an observation network covering all the French territory to collect a large number of meteorites (one or two per year) with accurate orbits, allowing us to pinpoint possible parent bodies. 100 all-sky cameras will be installed at the end of 2015 forming a dense network with an average distance of 100km between stations. To maximize the accuracy of orbit determination, we will mix our optical data with radar data from the GRAVES beacon received by 25 stations [5](Rault et al, 2015). As both the setting up of the network and the creation of search teams for meteorites will need manpower beyond our small team of professionals, we are developing a citizen science network called Vigie-Ciel [6](Zanda et al, 2015). The public at large will thus be able to simply use our data, participate in search campaigns or even setup their own cameras.

Effect of the band structure in a rigorous two-body model with long-range interactions in 1D optical lattices

NASA Astrophysics Data System (ADS)

Kristensen, Tom; Simoni, Andrea; Launay, Jean-Michel

2016-05-01

We compute scattering and bound state properties for two ultracold molecules in a pure 1D optical lattice. We introduce reference functions with complex quasi-momentum that naturally account for the effect of excited energy bands. Our exact results for a short-range interaction are first compared with the simplest version of the standard Bose-Hubbard (BH) model. Such comparison allows us to highlight the effect of the excited bands, of the non-on-site interaction and of tunneling with distant neighbor, that are not taken into account in the BH model. The effective interaction can depend strongly on the particle quasi-momenta and can present a resonant behavior even in a deep lattice. As a second step, we study scattering of two polar particles in the optical lattice. Peculiar Wigner threshold laws stem from the interplay of the long range dipolar interaction and the presence of the energy bands. We finally assess the validity of an extended Bose-Hubbard model for dipolar gases based on our exact two-body calculations. This work was supported by the Agence Nationale de la Recherche (Contract No. ANR-12-BS04-0020-01).

[The roles and the impacts of pharmacists in the management of medical devices at the hospital: A literature review].

PubMed

Ferrand, É; Painchart, L; Grimandi, G; Décaudin, B; Bussières, J-F

2017-11-01

Identify the training profile and the published evidences about the roles and the impacts of hospital pharmacists in medical devices. A literature review was conducted using Google, Google Scholar and Pubmed for 1990-2016 associated with a manual search conducted in three non-indexed pharmaceutical journals for 2000-2016. The analysis of training programs available did not allow us to identify a specific training profile. A total of 72 articles related to the roles and the impacts of the pharmacist were identified, 52 of which came from non-indexed journals. Those articles did not deal specifically about the roles and the impacts of pharmacist; however, articles were analyses for three spheres including the referencing of medical devices (n=36), the evaluation (n=19) and the distribution system (n=13). French pharmacists have many theoretical and practical training opportunities. There are a few articles describing precisely the roles and the impacts of hospital pharmacists in medical device. It appears urgent to better document this activity in professional and indexed literature. Copyright © 2017 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

[Application of robustness test for assessment of the measurement uncertainty at the end of development phase of a chromatographic method for quantification of water-soluble vitamins].

PubMed

Ihssane, B; Bouchafra, H; El Karbane, M; Azougagh, M; Saffaj, T

2016-05-01

We propose in this work an efficient way to evaluate the measurement of uncertainty at the end of the development step of an analytical method, since this assessment provides an indication of the performance of the optimization process. The estimation of the uncertainty is done through a robustness test by applying a Placquett-Burman design, investigating six parameters influencing the simultaneous chromatographic assay of five water-soluble vitamins. The estimated effects of the variation of each parameter are translated into standard uncertainty value at each concentration level. The values obtained of the relative uncertainty do not exceed the acceptance limit of 5%, showing that the procedure development was well done. In addition, a statistical comparison conducted to compare standard uncertainty after the development stage and those of the validation step indicates that the estimated uncertainty are equivalent. The results obtained show clearly the performance and capacity of the chromatographic method to simultaneously assay the five vitamins and suitability for use in routine application. Copyright © 2015 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

[City-hospital network and quality control of officinal preparations].

PubMed

Curti, C; Gallice, S; Lamy, E; Rathelot, P; Vanelle, P

2018-05-01

In a hospital environment, the quality control of the hospital preparations allows to release homogeneous batches in a secure way. These controls are totally integrated into the process of production and can also, in certain cases, be realized for high-alert magistral preparations. In community pharmacy, these controls were not required, but the Agence régionale de santé (ARS) recently incited compounding community pharmacies to realize this type of analyses. This decision motivated the creation of a collaboration between the pharmacy department of a French teaching hospital and a society including around thirty community pharmacies having a preparatory. Twenty community pharmacies distributed on all the territory have submitted one of their pediatric preparation, capsules of captopril 2mg, to the pharmacopoeia controls usually realized in the industry or hospital. All the analyzed batches were in agreement with European Pharmacopeia specifications. We shall present the rational of this work, the results as well as the numerous perspectives offered by this new type of collaboration joining completely the logic of a network city-hospital allowing the improvement of security of the medication circuit in France. Copyright © 2017 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

Pillow lavas volcanic glasses (ancient and recent) and traces of life in them

NASA Astrophysics Data System (ADS)

Astafieva, Marina; Rozanov, Alexei; Eugene, Sharkov; Alexei, Chistyakov; Maria, Bogina

2010-05-01

Pillow lavas volcanic glasses (ancient and recent) and traces of life in them. Astafieva* M.M., Rozanov* A.Yu., Sharkov** E.V., Chistyakov** A.V., Bogina** M.M. * Paleontological Institute of Russian Academy of Sciences, 117997 Profsoyusnaya 123, Moscow, Russia; ** Institute of Geology of Ore deposits, Petrography, Mineralogy, and Geochemistry of Russian Academy of Sciences, 119017 Staromonetny 35, Moscow, Russia; Microbial complexes from volcanogenic rocks both ancient (Early Paleoproterozoic (2.41 GA) basalt pillow-lavas with inclusions of volcanic glass from Karelia) and recent (fresh volcanic glass from pillow-lavas of underwater Middle-Atlantic Ridge were revealed, studied and compared. Our studies confirmed that basaltic glass of the Early Precambrian submarine eruptions was inhabited by microbes in a similar way as it had been done for volcanic glass of modern eruptions. So, well preserved pillow-lavas, that are the main component of Arkhaean and Early Paleoproterozoic greenstone belts, could be the most perspective for searching of traces of ancient life on the Earth. Consequently, it is possible to say, that volcanogenic rocks are not the obstacle for finding traces of life in them. The assumption that volcanic rocks served as habitats for the early microbial life was not unexpected. Some of the most primitive organisms close to the base of the phylogenetic tree are thermophilic microbes. Some data indicates that early life could be restricted to the hydrothermal vents in volcanic settings1. For instance, filamentous bacteria described from the massive sulfide deposits (age ~3.235 Ga) are interpreted as formed under black smoker conditions2, which provide the temperature tolerant for the growth of thermophilic bacteria (about 70oC). It was additionally proposed that life can be present immediately after volcanic eruptions, when the temperature of rock surface decreases below 113oC3,4 and bacteria penetrate the glass-like material of pillow lavas together with seawater. Of interest also is the development of life at the igneous rock-water boundary5,6,7, when microbial colonization spans not only surface but also penetrates deep into the rock. As a result of bacterial-paleontological investigations diverse and numerous remains of microorganisms were found. Studying and comparison of them permitted us to speak about presence of rather diverse fossil microbial complex in basalt pillow-lavas and their glasses both in Early Paleoproterozoic and Recent. This notes that well preserved pillow lavas of the Archaean and Early Paleoproterozoic greenstone belts are promising for the discovery of traces of ancient life on Earth. It is necessary to note that in both complexes filament forms predominate and that presumably eukaryotic forms were met. The study was executed within the framework of the complex program of basic research of the Presidium of the Russian Academy of Sciences "Origin of Biosphere and Evolution of Geo-biological Systems" (subprogram II) and was supported by the Russian Foundation for Basic Research, projects 08-04-00484 and SS-4207.2008.5. REFERENCES 1. Furnes, H., Banerjee, N.R., Muehlenbachs, K, et al., "Early life recorded in Archean pillow lavas", Science, 304, 578-581 (2004). 2. Rasmussen, B., "Filamentous microfossils in a 3,235-million-year-old volcanogenic massive sulfide deposit", Nature, 405, 676-679 (2000). 3. Stetter, K.O., "Hyperthermofiles in the history of life", Phil. Trans. Roy. Soc. B 361, 1837-1843 (2006). 4. Stetter, K.O., Fiala, G., Huber, G., Segerer, A., "Hyperthermofilic microorganisms", FEMS Microbiol. Rev., 75, 117-124 (1990). 5. Fisk, M.R., Storrie-Lombardi, M.C., Josef, J.A., "Aqueous Biotic and Abiotic Alteration of Silicate Rock: Evaluation of Landing Sites on Mars for Their Potential of Revealing Evidence for Life", Proc. SPIE. 6309, 630903-1 - 630903-9 (2006). 6. Astafieva, M.M., Rozanov, A.Yu., Sadovnikov, G.N., Sapova, E.V., "Fossil Bacteria from the Permotriassic Trappean Strata of Siberia", Paleontol. Journ. 43(8), 46-54 (2009). 7. Rozanov, A. Yu., Astafieva, M. M., "The Evolution of the Early Precambrian Geobiological Systems", Paleontol. Journ., 43(8), 61-77 (2009).

The RHYTMME system: an operational real-time warning and mapping system for flash floods, debris flows, landslide and rock falls in Southeastern France.

NASA Astrophysics Data System (ADS)

Fouchier, Catherine; Mériaux, Patrice; Atger, Frédéric; Ecrepont, Stéphane; Liébault, Frédéric; Bertrand, Mélanie; Bel, Coraline; Batista, Dominique; Azemard, Pierre; Saint-Martin, Clotilde; Javelle, Pierre

2016-04-01

Almost all municipalities of Southeastern France are concerned by natural hazards triggered by heavy rainfalls such as floods, debris flows, landslides and rock falls. Although some tools exist to forecast and monitor heavy rains and floods in France, their spatial resolution sometimes does not meet the needs of local risk managers who have to monitor events at a small spatial scale. In order to improve the risk management in the mountainous and Mediterranean areas of Southeastern France, Irstea and Météo-France have led the RHYTMME project. The goal of this project is to improve the ability to forecast and localize high-risk rainfall-induced hazards in the Provence-Alpes-Côte d'Azur administrative area. This goal is currently under achievement thanks to the implementation of a real-time warning and mapping system for rainfall induced natural hazards, fed by radar data and whose outputs are made available via the Internet to operators in charge of risk management (local and regional authorities, emergency and rescue services, road and rail networks managers, ...). This system provides maps which display in real-time: - the radar estimations of rainfall for different rain durations and at the spatial resolution of 1 km² (Westrelin et al., 2013), - the estimation of the scarcity of these rainfall estimations, also at the spatial resolution of 1 km², thanks to a comparison with threshold values provided by a regionalized stochastic hourly point rainfall generator (Arnaud et al., 2007), - an anticipation of the rivers discharges, computed at the outlet of 1700 watersheds of Southeastern France thanks to the AIGA warning system which combines a rainfall runoff model and an estimation of the scarcity of the discharges thanks to a comparison with threshold values (Javelle et al., 2014). Maps of susceptibility to debris flow, landslide and rock falls can also be displayed in the RHYTMME warning system along with the real time maps of rainfall hazard (Batista, 2013a, 2013b; Bertrand, 2014). It enables to identify, during intense events, the reaches the more likely to generate and/or to spread debris flow and the areas the more likely to generate landslide and/or rock falls. The RHYTMME warning and mapping system is now fully operational. It is currently being provided to local authorities (City councils, River boards, …) as well as State authorities in charge of risk managements in the Provence-Alpes-Côte d'Azur administrative area. Training sessions are organized in order to help these end-users to handle the system. References Arnaud P., Fine J.-A. and Lavabre J. (2007). An hourly rainfall generation model applicable to all types of climate. Atmospheric Research 85(2): 230-242. Batista D., Azémard P., Boutry M. (2013). Prévision de l'aléa glissement de terrain et analyse statistique des facteurs de prédisposition par l'outil SIG, sur la région Provence-Alpes-Côte d'Azur. Journées Aléas Gravitaires, 17 et 18/9/2013 - Grenoble, 11 p. Batista D., Azémard P., Rougé A.C., Dumalin M., Rault C. (2013). Prévision de l'aléa chute de blocs, analyse statistique des facteurs de prédisposition et des critères de déclenchement sur la région Provence-Alpes-Côte d'Azur. Journées Aléas Gravitaires, 17 et 18/9/2013 - Grenoble, 11 p. Bertrand M. (2014). Approches régionales de la susceptibilité torrentielle dans les Alpes du Sud. Thèse de Doctorat, École Normale Supérieure de Lyon, 162 pp. Javelle P., Demargne J., Defrance D., Pansu J., Arnaud P. (2014). Evaluating flash-flood warnings at ungauged locations using post-event surveys: A case study with the AIGA warning system. Hydrological Sciences Journal 59 (7): 1390-1402. Westrelin S., Mériaux P., Dalle S., Fradon B., Jamet G. (2013). Déploiement d'un réseau de radars pour anticiper les risques hydro-météorologiques, La Météorologie 8 (83): 69-79.

Patient journey following lumbar spinal fusion surgery (LSFS): protocol for a multicentre qualitative analysis of the patient rehabilitation experience (FuJourn)

PubMed Central

Staal, J Bart; Verra, Martin; Emms, Andrew; Cole, Ashley; Willems, Paul; Benneker, Lorin; Masson, Annabel

2018-01-01

Introduction There has been a 65% increase in lumbar spinal fusion surgery (LSFS) worldwide over the last 13 years, with costs of £26 million to the UK National Health Service annually. Patient dissatisfaction with outcome and persistent pain and disability incurs further costs. Three trials provide low-quality evidence for the role of physiotherapy. Our UK surveys investigating physiotherapy/surgeon practice concluded rehabilitation should be tailored to the individual patient owing to considerable clinical heterogeneity. This study will explore the perceptions of patients who undergo LSFS to inform precision rehabilitation. Methods and analysis A qualitative study, using interpretive phenomenological analysis, will recruit a purposive sample (n=40) to ensure patterns of similarity and difference in their journeys can be explored. In-depth semistructured interviews will be undertaken following discharge from hospital and at 12 months postsurgery. Patients’ preoperative and postoperative experiences, underlying attitudes and beliefs towards the surgical intervention, facilitators and barriers to recovery, adherence to advice and physiotherapy, experiences of rehabilitation and return to normal function/activity/work will be explored. A 12-month patient diary will provide real time access to patient data, capturing a weekly record of life as lived, including symptoms, medication, experiences of stages of recovery, rehabilitation adherence, healthcare professional appointments, attitudes, their feelings and experiences throughout their journey. Data will be analysed in a number of stages in accordance with interpretive phenomenological analysis, supported using NVivo software. Analysis of the first interviews and patient diaries will afford a rich density of data to build an overall understanding of the patients’ lived experiences, informing the 12-month interview. Strategies (eg, reflexivity) will ensure trustworthiness. Ethics and dissemination The study has ethical approval (IRAS 223283). Findings will ensure that patient-driven data inform precision rehabilitation by understanding the patient journey. Findings will be disseminated through peer-reviewed journals and conferences. PMID:29301765

[Clinical overview of auto-inflammatory diseases].

PubMed

Georgin-Lavialle, S; Rodrigues, F; Hentgen, V; Fayand, A; Quartier, P; Bader-Meunier, B; Bachmeyer, C; Savey, L; Louvrier, C; Sarrabay, G; Melki, I; Belot, A; Koné-Paut, I; Grateau, G

2018-04-01

Monogenic auto-inflammatory diseases are characterized by genetic abnormalities coding for proteins involved in innate immunity. They were initially described in mirror with auto-immune diseases because of the absence of circulating autoantibodies. Their main feature is the presence of peripheral blood inflammation in crisis without infection. The best-known auto-inflammatory diseases are mediated by interleukines that consisted in the 4 following diseases familial Mediterranean fever, cryopyrinopathies, TNFRSF1A-related intermittent fever, and mevalonate kinase deficiency. Since 10 years, many other diseases have been discovered, especially thanks to the progress in genetics. In this review, we propose the actual panorama of the main known auto-inflammatory diseases. Some of them are recurrent fevers with crisis and remission; some others evaluate more chronically; some are associated with immunodeficiency. From a physiopathological point of view, we can separate diseases mediated by interleukine-1 and diseases mediated by interferon. Then some polygenic inflammatory diseases will be shortly described: Still disease, Schnitzler syndrome, aseptic abscesses syndrome. The diagnosis of auto-inflammatory disease is largely based on anamnesis, the presence of peripheral inflammation during attacks and genetic analysis, which are more and more performant. Copyright © 2018 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Costless Platform for High Resolution Stereoscopic Images of a High Gothic Facade

NASA Astrophysics Data System (ADS)

Héno, R.; Chandelier, L.; Schelstraete, D.

2012-07-01

In October 2011, the PPMD specialized master's degree students (Photogrammetry, Positionning and Deformation Measurement) of the French ENSG (IGN's School of Geomatics, the Ecole Nationale des Sciences Géographiques) were asked to come and survey the main facade of the cathedral of Amiens, which is very complex as far as size and decoration are concerned. Although it was first planned to use a lift truck for the image survey, budget considerations and taste for experimentation led the project to other perspectives: images shot from the ground level with a long focal camera will be combined to complementary images shot from what higher galleries are available on the main facade with a wide angle camera fixed on a horizontal 2.5 meter long pole. This heteroclite image survey is being processed by the PPMD master's degree students during this academic year. Among other type of products, 3D point clouds will be calculated on specific parts of the facade with both sources of images. If the proposed device and methodology to get full image coverage of the main facade happen to be fruitful, the image acquisition phase will be completed later by another team. This article focuses on the production of 3D point clouds with wide angle images on the rose of the main facade.

[Hyper-reactive malarial splenomegaly].

PubMed

Maazoun, F; Deschamps, O; Barros-Kogel, E; Ngwem, E; Fauchet, N; Buffet, P; Froissart, A

2015-11-01

Hyper-reactive malarial splenomegaly is a rare and severe form of chronic malaria. This condition is a common cause of splenomegaly in endemic areas. The pathophysiology of hyper-reactive malarial splenomegaly involves an intense immune reaction (predominantly B cell-driven) to repeated/chronic infections with Plasmodium sp. The diagnosis may be difficult, due to a poorly specific clinical presentation (splenomegaly, fatigue, cytopenias), a long delay between residence in a malaria-endemic area and onset of symptoms, and a frequent absence of parasites on conventional thin and thick blood smears. A strongly contributive laboratory parameter is the presence of high levels of total immunoglobulin M. When the diagnostic of hyper-reactive malarial splenomegaly is considered, search for anti-Plasmodium antibodies and Plasmodium nucleic acids (genus and species) by PCR is useful. Diagnosis of hyper-reactive malarial splenomegaly relies on the simultaneous presence of epidemiological, clinical, biological and follow-up findings. Regression of both splenomegaly and hypersplenism following antimalarial therapy allows the differential diagnosis with splenic lymphoma, a common complication of hyper-reactive malarial splenomegaly. Although rare in Western countries, hyper-reactive malarial splenomegaly deserves increased medical awareness to reduce the incidence of incorrect diagnosis, to prevent progression to splenic lymphoma and to avoid splenectomy. Copyright © 2015 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

[Primary intestinal lymphangiectasia (Waldmann's disease)].

PubMed

Vignes, S; Bellanger, J

2017-08-31

Primary intestinal lymphangiectasia (PIL), Waldmann's disease, is a rare disorder of unknown etiology characterized by dilated intestinal lacteals leading to lymph leakage into the small-bowel lumen and responsible for protein-losing enteropathy leading to lymphopenia, hypoalbuminemia and hypogammaglobulinemia. PIL is generally diagnosed before 3 years of age but may be diagnosed in older patients. The main symptom is bilateral lower limb edema. Edema may be moderate to severe including pleural effusion, pericarditis or ascites. Protein-losing enteropathy is confirmed by the elevated 24-h stool α1-antitrypsin clearance and diagnosis by endoscopic observation of intestinal lymphangiectasia with the corresponding histology of biopsies. Videocapsule endoscopy may be useful when endoscopic findings are not contributive. Several B-cell lymphomas of the gastrointestinal tract or with extra-intestinal localizations were reported in PIL patients. A long-term strictly low-fat diet associated with medium-chain triglyceride and liposoluble vitamin supplementation is the cornerstone of PIL medical management. Octreotide, a somatostatin analog, have been proposed with an inconsistent efficacy in association with diet. Surgical small-bowel resection is useful in the rare cases with segmental and localized intestinal lymphangiectasia. A prolonged clinical and biological follow-up is recommended. Copyright © 2017 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

3D Model of Surfactant Replacement Therapy

NASA Astrophysics Data System (ADS)

Grotberg, James; Tai, Cheng-Feng; Filoche, Marcel

2015-11-01

Surfactant Replacement Therapy (SRT) involves instillation of a liquid-surfactant mixture directly into the lung airway tree. Though successful in neonatal applications, its use in adults had early success followed by failure. We present the first mathematical model of 3D SRT where a liquid plug propagates through the tree from forced inspiration. In two separate modeling steps, the plug first deposits a coating film on the airway wall which subtracts from its volume, a ``coating cost''. Then the plug splits unevenly at the airway bifurcation due to gravity. The steps are repeated until a plug ruptures or reaches the tree endpoint alveoli/acinus. The model generates 3D images of the resulting acinar distribution and calculates two global indexes, efficiency and homogeneity. Simulating published literature, the earlier successful adult SRT studies show comparatively good index values, while the later failed studies do not. Those unsuccessful studies used smaller dose volumes with higher concentration mixtures, apparently assuming a well mixed compartment. The model shows that adult lungs are not well mixed in SRT due to the coating cost and gravity effects. Returning to the higher dose volume protocols could save many thousands of lives annually in the US. Supported by NIH Grants HL85156, HL84370 and Agence Nationale de la Recherche, ANR no. 2010-BLAN-1119-05.

[Management of mesenteric ischemia in the era of intestinal stroke centers: The gut and lifesaving strategy].

PubMed

Nuzzo, A; Corcos, O

2017-09-01

Mesenteric ischemia is a gut and life-threatening, medical and surgical, digestive and vascular emergency. Mesenteric ischemia is the result of an arterial or venous occlusion, a vasospasm secondary to low-flow states in intensive care patients, aortic clamping during vascular surgery or intestinal transplantation. Progression towards mesenteric infarction and its complications is unpredictable and correlates with high rates of mortality or a high risk of short bowel syndrome in case of survival. Thus, mesenteric ischemia should be diagnosed and treated at an early stage, when gut injury is still reversible. Diagnostic workup lacks sensitive and specific clinical and biological marker. Consequently, diagnosis and effective therapy can be achieved by a high clinical suspicion and a specific multimodal management: the gut and lifesaving strategy. Based on the model of ischemic stroke centers, the need for a multidisciplinary and expert 24/24 emergency care has led, in 2016, to the inauguration of the first Intestinal Stroke Center (Structure d'urgences vasculaires intestinales [SURVI]) in France. This review highlights the pathophysiological features of chronic and acute mesenteric ischemia, as well as the diagnosis workup and the therapeutic management developed in this Intestinal Stroke Center. Copyright © 2017 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

[Impact of an automated dispensing system for medical devices in cardiac surgery department].

PubMed

Clou, E; Dompnier, M; Kably, B; Leplay, C; Poupon, E; Archer, V; Paul, M

2018-01-01

To secure medical devices' management, the implementation of automated dispensing system in surgical service has been realized. The objective of this study was to evaluate security, organizational and economic impact of installing automated dispensing system for medical devices (ASDM). The implementation took place in a cardiac surgery department. Security impact was assessed by comparing traceability rate of implantable medical devices one year before and one year after installation. Questionnaire on nurses' perception and satisfaction completed this survey. Resupplying costs, stocks' evolution and investments for the implementation of ASDM were the subject of cost-benefit study. After one year, traceability rate is excellent (100%). Nursing staffs were satisfied with 87.5% by this new system. The introduction of ASDM allowed a qualitative and quantitative decrease in stocks, with a reduction of 30% for purchased medical devices and 15% for implantable medical devices in deposit-consignment. Cost-benefit analysis shows a rapid return on investment. Real stock decrease (purchased medical devices) is equivalent to 46.6% of investment. Implementation of ASDM allows to secure storage and dispensing of medical devices. This system has also an important economic impact and appreciated by users. Copyright © 2017 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

[Lung is also involved in juvenile dermatomyositis].

PubMed

Pouessel, G; Thumerelle, C; Nève, V; Santangelo, T; Flammarion, S; Pruvot, I; Tillie-Leblond, I; Deschildre, A

2014-07-01

Juvenile dermatomyositis is the leading cause of chronic idiopathic inflammatory myopathy of auto-immune origin in children. Lung involvement in inflammatory myopathies is well described in adults, involving mostly interstitial lung disease, aspiration pneumonia and alveolar hypoventilation. We propose to describe its specificities in children. Pulmonary involvement may be asymptomatic and therefore must be systematically screened for. In case of clinical or functional respiratory abnormality, a chest computed tomographic (CT) scan is necessary. In children, a decrease of respiratory muscle strength seems common and should be systematically and specifically searched for by non-invasive and reproducible tests (sniff test). Interstitial lung disease usually associates restrictive functional defect, impairment of carbon monoxide diffusion and interstitial lung disease on CT scan. As in adults, the first-line treatment of juvenile dermatomyositis is based on corticosteroids. Corticosteroid resistant forms require corticosteroid bolus or adjuvant immunosuppressive drugs (methotrexate or cyclosporine). There is no consensus in pediatrics for the treatment of diffuse interstitial lung disease. Complications of treatment, including prolonged steroid therapy, are frequent and therefore a careful assessment of the treatments risk-benefit ratio is necessary, especially in growing children. Copyright © 2014 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

[Physical activity and cancer: Update and literature review].

PubMed

Desnoyers, A; Riesco, E; Fülöp, T; Pavic, M

2016-06-01

Physical activity is a key determinant of public health and contributes to decreasing the prevalence of many diseases. Cancer is the leading cause of death worldwide. Physical activity, accessible to the entire population, could prevent up to 25% of cancers, in addition to improving survival rates and quality of life in cancer patients. Physical activity acts via various mechanisms to slow or decrease tumor growth, including the production and bioavailability of sex hormones, insulin resistance and insulin secretion, and inflammation. In primary prevention, physical activity reduces breast cancer risk by 15-20% and colorectal cancer risk by 24%. All-cause mortality is reduced by 33% in cancer survivors who exercise. Health-related quality of life, fatigue and depression are enhanced by the practice of physical activity in cancer patients. In the general population, the global recommendations on physical activity for health, published by the World Health Organisation, are suggested as a means of primary prevention of cancer. In cancer patients, an adapted physical activity routine is promoted from the very beginning of patient care to decrease fatigue as well as improve tolerance and benefits of treatments. Copyright © 2015 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Biosimilars: from technical to pharmacoeconomic considerations. 30th Rencontres Nationales de Pharmacologie et Recherche clinique pour l'Innovation et l'Evaluation des Technologies de Santé. Tables rondes.

PubMed

Girault, Danièle; Trouvin, Jean-Hugues; Blachier-Poisson, Corinne; Gary, François; Laloye, Didier; Bergmann, Jean-François; Casadevall, Nicole; Delval, Cécile; De Sahb Berkovitch, Rima; Fagon, Jean-Yves; Gersberg, Marta; Lassale, Catherine; Lechat, Philippe; Le Jeunne, Claire; Montastruc, Jean-Louis; Prugnaud, Jean-Louis; Ratignier-Carbonneil, Christelle; Rey-Coquais, Cécile

2015-01-01

A biosimilar is a biological medicinal product claimed to be similar to a reference biological medicinal product. Its development plan includes studies comparing it with the reference product in order to confirm its similarity in terms of quality, preclinical safety, clinical efficacy, and clinical safety, including immunogenicity. Biosimilars differ from generics both in their molecular complexity and in the specific requirements that apply to them. Since patents on many biological medicinal products will expire within the next 5 years in major therapeutic areas such as oncology, rheumatology and gastroenterology and as those products are so costly to the French national health insurance system, the availability of biosimilars would have a considerable economic impact. The round table has issued a number of recommendations intended to ensure that the upcoming arrival of biosimilars on the market is a success, in which prescribing physicians would have a central role in informing and reassuring patients, an efficient monitoring of the patients treated with biologicals would be set up and time to market for biosimilars would be speeded up. © 2015 Société Française de Pharmacologie et de Thérapeutique.

[The permanence of access to health care: a tradition of hospitality and innovative organizational model].

PubMed

Georges-Tarragano, C

2015-01-01

The PASS ("Permanence d'Accès aux Soins de Santé") are hospital-based units providing primary care services to patients who lack health care coverage. Using a "whole person" approach and providing a combination of health and social care, the PASS offer an appropriately adapted response to complex health problems within a context of marked social vulnerability and contribute to reducing health inequalities. The PASS are an example of an interdisciplinary approach to health care which contrasts with the segmentary approach typical of conventional hospital departments. Operating at the interface between primary and secondary care, the PASS have the potential to become key players in developing models of patient pathways. Their presence reduces inappropriate emergency attendances and hospitalisation by offering medical care in a timely fashion, in an outpatient-type setting. The PASS can provide a resource for research into optimum models of health care, where the social context of health needs are fully recognized and inform medical treatment appropriately. According to their potential development, PASS are living labs of an innovative organizational model of care. Copyright © 2014 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Representation-based user interfaces for the audiovisual library of the year 2000

NASA Astrophysics Data System (ADS)

Aigrain, Philippe; Joly, Philippe; Lepain, Philippe; Longueville, Veronique

1995-03-01

The audiovisual library of the future will be based on computerized access to digitized documents. In this communication, we address the user interface issues which will arise from this new situation. One cannot simply transfer a user interface designed for the piece by piece production of some audiovisual presentation and make it a tool for accessing full-length movies in an electronic library. One cannot take a digital sound editing tool and propose it as a means to listen to a musical recording. In our opinion, when computers are used as mediations to existing contents, document representation-based user interfaces are needed. With such user interfaces, a structured visual representation of the document contents is presented to the user, who can then manipulate it to control perception and analysis of these contents. In order to build such manipulable visual representations of audiovisual documents, one needs to automatically extract structural information from the documents contents. In this communication, we describe possible visual interfaces for various temporal media, and we propose methods for the economically feasible large scale processing of documents. The work presented is sponsored by the Bibliotheque Nationale de France: it is part of the program aiming at developing for image and sound documents an experimental counterpart to the digitized text reading workstation of this library.

HPLC & NMR-based forced degradation studies of ifosfamide: The potential of NMR in stability studies.

PubMed

Salman, D; Peron, J-M R; Goronga, T; Barton, S; Swinden, J; Nabhani-Gebara, S

2016-03-01

The aim of this study is to conduct a forced degradation study on ifosfamide under several stress conditions to investigate the robustness of the developed HPLC method. It also aims to provide further insight into the stability of ifosfamide and its degradation profile using both HPLC and NMR. Ifosfamide solutions (20mg/mL; n=15, 20mL) were stressed in triplicate by heating (70°C), under acidic (pH 1 & 4) and alkaline (pH 10 & 12) conditions. Samples were analysed periodically using HPLC and FT-NMR. Ifosfamide was most stable under weakly acidic conditions (pH 4). NMR results suggested that the mechanism of ifosfamide degradation involves the cleavage of the PN bond. For all stress conditions, HPLC was not able to detect ifosfamide degradation products that were detected by NMR. These results suggest that the developed HPLC method for ifosfamide did not detect the degradation products shown by NMR. It is possible that degradation products co-elute with ifosfamide, do not elute altogether or are not amenable to the detection method employed. Therefore, investigation of ifosfamide stability requires additional techniques that do not suffer from the aforementioned shortcomings. Copyright © 2015 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

[Particulate contamination associated with the manipulation of drugs in glass ampules: A literature review].

PubMed

Painchart, L; Odou, P; Bussières, J-F

2018-01-01

The manipulation of drugs from glass ampules can generate particles when the ampule is broken. Several authors recommend the use of filter needle to withdraw the drug content. The aim of this study is to make an assessment of the presence of particles during the manipulation of glass ampules and to discuss the current practices. Literature review based on a search strategy (Pubmed, Google Scholar) and a summary table of available data. Analysis to evaluate the efficacy of the filtration when data are available. Eighteen articles have been included. Most of study shows the presence of particles in glass ampules. Important discrepancies reported regarding the number of particles per ampule. Analysis of data from seven studies: decrease of 83% of the total number of particles (>10μm) identified when drugs are removed with filter needle. All studies but two confirm the efficacy of filter needles. Studies show the presence of particles when drugs are removed from glass ampules. They do not allow to make a conclusion on human clinical consequences associated with the presence of particles. It is necessary to evaluate in human the risks associated with particle contamination to determine the optimal use of filter needle. Copyright © 2017 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

[Staff accreditation in parenteral nutrition production in hospital pharmacy].

PubMed

Vrignaud, S; Le Pêcheur, V; Jouan, G; Valy, S; Clerc, M-A

2016-09-01

This work aims to provide staff accreditation methodology to harmonize and secure practices for parenteral nutrition bags preparation. The methodology used in the present study is inspired from project management and quality approach. Existing training supports were used to produce accreditation procedure and evaluation supports. We first defined abilities levels, from level 1, corresponding to accredited learning agent to level 3, corresponding to expert accredited agent. Elements assessed for accreditation are: clothing assessment either by practices audit or by microbiologic test, test bags preparation and handling assessment, bag production to assess aseptic filling for both manual or automatized method, practices audit, number of days of production, and non-conformity following. At Angers Hospital, in 2014, production staff is composed of 12 agents. Staff accreditation reveals that 2 agents achieve level 3, 8 agents achieve level 2 and 2 agents are level 1. We noted that non-conformity decreased as accreditation took place from 81 in 2009 to 0 in 2014. To date, there is no incident due to parenteral bag produced by Angers hospital for neonatal resuscitation children. Such a consistent study is essential to insure a secured nutrition parenteral production. This also provides a satisfying quality care for patients. Copyright © 2016 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

[Prevention of infections in adults and adolescents with systemic lupus erythematosus: Guidelines for the clinical practice based on the literature and expert opinion].

PubMed

Mathian, A; Arnaud, L; Adoue, D; Agard, C; Bader-Meunier, B; Baudouin, V; Belizna, C; Bonnotte, B; Boumedine, F; Chaib, A; Chauchard, M; Chiche, L; Daugas, E; Ghali, A; Gobert, P; Gondran, G; Guettrot-Imbert, G; Hachulla, E; Hamidou, M; Haroche, J; Hervier, B; Hummel, A; Jourde-Chiche, N; Korganow, A-S; Kwon, T; Le Guern, V; Le Quellec, A; Limal, N; Magy-Bertrand, N; Marianetti-Guingel, P; Martin, T; Martin Silva, N; Meyer, O; Miyara, M; Morell-Dubois, S; Ninet, J; Pennaforte, J-L; Polomat, K; Pourrat, J; Queyrel, V; Raymond, I; Remy, P; Sacre, K; Sibilia, J; Viallard, J-F; Viau Brabant, A; Hanslik, T; Amoura, Z

2016-05-01

To develop French recommendations about the management of vaccinations, the screening of cervical cancer and the prevention of pneumocystis pneumonia in systemic lupus erythematosus (SLE). Thirty-seven experts qualified in internal medicine, rheumatology, dermatology, nephrology and pediatrics have selected recommendations from a list of proposition based on available data from the literature. For each recommendation, the level of evidence and the level of agreement among the experts were specified. Inactivated vaccines do not cause significant harm in SLE patients. Experts recommend that lupus patient should receive vaccinations accordingly to the recommendations and the schedules for the general public. Pneumococcal vaccination is recommended for all SLE patients. Influenza vaccination is recommended for immunosuppressed SLE patients. Live attenuated vaccines should be avoided in immunosuppressed patients. Yet, recent works suggest that they can be considered in mildly immunosuppressed patients. Experts have recommended a cervical cytology every year for immunosuppressed patients. No consensus was obtained for the prevention of pneumocystis pneumonia. These recommendations can be expected to improve clinical practice uniformity and, in the longer term, to optimize the management of SLE patients. Copyright © 2016 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Associations among body size across the life course, adult height and endometriosis.

PubMed

Farland, L V; Missmer, S A; Bijon, A; Gusto, G; Gelot, A; Clavel-Chapelon, F; Mesrine, S; Boutron-Ruault, M C; Kvaskoff, M

2017-08-01

Are body size across the life course and adult height associated with endometriosis? Endometriosis is associated with lean body size during childhood, adolescence and adulthood; tall total adult height; and tall sitting height. The literature suggests that both adult body size and height are associated with endometriosis risk, but few studies have investigated the role of body size across the life course. Additionally, no study has investigated the relationships between components of height and endometriosis. We used a nested case-control design within E3N (Etude Epidémiologique auprès de femmes de l'Education Nationale), a prospective cohort of French women. Data were updated every 2-3 years through self-administered questionnaires. Odds ratios (ORs) and 95% CIs were computed using logistic regression models adjusted for a priori confounding factors. A total of 2416 endometriosis cases were reported as surgically ascertained among the 61 208 included women. The odds of endometriosis were lower among women who reported having a large versus lean body size at 8 years (P for trend = 0.003), at menarche (P for trend < 0.0001) and at ages 20-25 years (P for trend < 0.0001). Women in the highest quartiles of height had statistically significantly increased odds of endometriosis compared to those in the lowest (<158 cm) (162-164 cm: OR = 1.28, 95% CI = 1.12-1.46; ≥165 cm: OR = 1.33, 95% CI = 1.18-1.49, P for trend < 0.0001). Statistically significantly increased odds were also observed among women with a taller sitting height (OR = 1.24, 95% CI = 1.05-1.47, P for trend = 0.01). Leg length was not statistically significantly associated with endometriosis. Endometriosis cases may be prone to misclassification; however, we restricted our case definition to surgically-confirmed cases, which showed a high validation rate. Body size is based on retrospective self-report, which may be subject to recall bias. The results of this study suggest that endometriosis is positively associated with lean body size across the life course and total adult height. They also suggest that components of height are associated with endometriosis, which should be investigated further. The Mutuelle Générale de l'Education Nationale (MGEN); the European Community; the French League against Cancer (LNCC); Gustave Roussy; the French Institute of Health and Medical Research (Inserm). L.V.F. was supported by a T32 grant (#HD060454) in reproductive, perinatal and pediatric epidemiology from the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the National Cancer Institute (3R25CA057711) National Institutes of Health. M.K. was supported by a Marie Curie Fellowship within the seventh European Community Framework Programme (#PIOF-GA-2011-302078). The authors have no conflicts of interest to declare. © The Author 2017. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

[Medico-economic evaluation of therapeutic strategies at hospital: A systematic review of French studies].

PubMed

Baudouin, A; Armoiry, X; Dussart, C

2017-05-01

Therapeutic innovation contributes to the increase of health care expenditures in France. Medico-economic evaluation has still a minor role in the decision-making for the registration of drugs and medical devices in hospitals. This study aimed to systematically review published works on medico-economic studies conducted within French hospitals. A literature review was carried out to search for medico-economic studies conducted by hospital teams on therapeutic or diagnostic strategies employed within French hospitals and published from 2010 to 2014. Quality assessment of selected studies was performed according to Drummond et al.'s checklist, which is also used within French guidelines. Of the 44 analyzed articles, methods for identification and measure of costs and results complied with guidelines in 95 % of cases. For results interpretation, compliance was 91 %. Costs discounting (29 %) and the use of sensitivity analysis to account for results uncertainty (70 %) were the parameters with the lowest compliance to guidelines. A good training of health professionals in using economic and statistic tools, and the transferability of results of medico-economic studies are essential and should be optimized to enable a broader use of medico-economic evaluation within the scope of decision-making in French hospitals. Copyright © 2016 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

[Multiple facets of ADA2 deficiency: Vasculitis, auto-inflammatory disease and immunodeficiency: A literature review of 135 cases from literature].

PubMed

Fayand, A; Sarrabay, G; Belot, A; Hentgen, V; Kone-Paut, I; Grateau, G; Melki, I; Georgin-Lavialle, S

2018-04-01

Deficiency of adenosine deaminase 2 (DADA2) is a recently described auto-inflammatory disorder. It is an autosomal recessive inherited disease, caused by mutations in the ADA2 gene (formerly known as CECR1) encoding ADA2 enzyme. Besides its role in the purine metabolism, it has been postulated that ADA2 may act as a growth factor for endothelial cells and in the differenciation of monocytes. Thus, deficiency of ADA2 would lead to endothelial damage and a skewing of monocytes into M1 pro-inflammatory macrophage, causing DADA2 manifestations. Three core clinical features have been described: inflammatory-vascular signs, hematologic abnormalities and immunodeficiency. Clinically, patients display intermittent fever, cutaneous vascular manifestations, such as livedo, ischemic strokes, arthralgia and abdominal pain crisis. Corticosteroids and immunosuppressive agents (i.e. cyclophosphamide, azathioprine, ciclosporin, methotrexate) appear to be poorly effective. Although the mechanism has not been elucidated, anti-TNF agents have been proven efficient in DADA2 and should therefore be used as first line therapy for vasculitis. Role of anti-platelet and anticoagulant therapies in stroke-prophylaxis remains to be discussed, as those patients display a high risk of intracranial bleeding. Copyright © 2017 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

[Refusal of care faced by case manager from elderly persons in complex situation: cross perspectives].

PubMed

Corvol, A; Balard, F; Moutel, G; Somme, D

2014-01-01

Case management is a new professional field in France. It is addressed to elderly persons living in community whose situation is regarded as particularly complex. Case managers have to assess needs and coordinate necessary services. One common criteria of complexity is refusal of care. The objective of this study is to compare the words of users with those of case managers about refusal of care, in order to understand its meaning, professionals' attitudes and ethical challenges. Two researchers have cooperated on this qualitative research: the first one, anthropologist, interviewed 19 individuals, and 11 of their caregivers. The second one, geriatrician and researcher in medical ethics, lead four focus groups gathering a total of 18 case managers. Refusal of care often is the result of the will of preserving one's identity, compromised by illness. Individuals seek control on their life. Facing this behaviour, case managers try to secure the individual, by establishing a personal relationship that respects their choices, even if care has to be delayed. Refusal of care may sometimes disclose a desire to vanish, in front of which professionals meet their own limits. To recognise an elderly person that refuses care as a unique individual who can make choices secure his identity, and allow him to change. Copyright © 2013 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

[Cryopyrine-associated periodic syndrome: CAPS seen from adulthood].

PubMed

Koné-Paut, I

2015-04-01

Cryopyrin-associated periodic syndrome is a rare hereditary periodic fever syndrome for which, the genetic mechanism, mutation in the NLRP3 gene, has allowed to gather 3 clinical phenotypes (familial cold urticaria [FCAS], Muckle-Wells syndrome [MWS], and chronic infantile neurological cutaneous and articular syndrome [CINCA]) initially described independently, and to discover the NLRP3 inflammasome, a key receptor of the innate immunity, which regulates the interleukine-1β secretion into the mononuclear cells. The clinical manifestation of CAPS : urticaria-like skin rash, eyes redness, myalgia and sensory deafness are not specific, if considered separately, and that often leads to a wandering diagnosis through a complex medical journey including various specialists. The diagnostic delay is deleterious to patients compromising their quality of life and exposing them to neurosensory complications and renal failure by secondary amyloidosis. The paediatric onset of disease, the family history, the trigger of symptoms by the cold, and the recognition of the skin rash as neutrophilic are important clues before diagnostic confirmation by genetic testing. Interleukine-1 blockade is the only effective treatment of CAPS symptoms which often may stabilize (rarely regression) the sensory involvement and in some cases may allow the regression of secondary amyloidosis. Copyright © 2014 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Machine Learning to Improve the Effectiveness of ANRS in Predicting HIV Drug Resistance.

PubMed

Singh, Yashik

2017-10-01

Human immunodeficiency virus infection and acquired immune deficiency syndrome (HIV/AIDS) is one of the major burdens of disease in developing countries, and the standard-of-care treatment includes prescribing antiretroviral drugs. However, antiretroviral drug resistance is inevitable due to selective pressure associated with the high mutation rate of HIV. Determining antiretroviral resistance can be done by phenotypic laboratory tests or by computer-based interpretation algorithms. Computer-based algorithms have been shown to have many advantages over laboratory tests. The ANRS (Agence Nationale de Recherches sur le SIDA) is regarded as a gold standard in interpreting HIV drug resistance using mutations in genomes. The aim of this study was to improve the prediction of the ANRS gold standard in predicting HIV drug resistance. A genome sequence and HIV drug resistance measures were obtained from the Stanford HIV database (http://hivdb.stanford.edu/). Feature selection was used to determine the most important mutations associated with resistance prediction. These mutations were added to the ANRS rules, and the difference in the prediction ability was measured. This study uncovered important mutations that were not associated with the original ANRS rules. On average, the ANRS algorithm was improved by 79% ± 6.6%. The positive predictive value improved by 28%, and the negative predicative value improved by 10%. The study shows that there is a significant improvement in the prediction ability of ANRS gold standard.

[Patients' intervention in a therapeutic education program dedicated to systemic lupus: definitions, setting and benefits].

PubMed

Hervier, B; Magar, Y; Allab, F; Richard, K; Neves, Y; Danjou, S; Amoura, Z; Ayçaguer, S

2015-10-01

Though recommended, participation of patients with specific expertise in therapeutic education programs (TEP) is rare. This work reports the experience of a national reference centre for rare systemic diseases. Involvement of "expert patients" (EP) has been planned from the development of a TEP dedicated to systemic lupus: patients' roles and required expertise have been defined and linked to the pedagogical tools. Such patients have been recruited during individual interviews and called to participate to specific pedagogical training. EP intervention have been evaluated by questionnaire to EP and health care providers. Three EP's functions have been identified: sharing experiences, giving "tips and tricks" and promoting dialogue. EP's interventions has been organised into a hierarchy (from sharing to co-animation). Among 298 patients enrolled in the TEP, 25 (8.4%) have been identified as possible EP. Eight of them (32%) benefited from a specific training of 12 hours. Among these patients, two (25%) regularly participate to the education sessions. For EP as well as for health care providers, EP's intervention seems beneficial (visual scale scores of 7.5 and 9.5, respectively). Though difficult to organise, EP's intervention in TEP dedicated to rare systemic diseases seems useful and would earn to be increase. Copyright © 2015 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

[Unexplicated neuropsychiatric disorders: Do not ignore dysimmune encephalitis. A case report of a dysimmune encephalitis with anti-leucine rich glioma inactivated 1 (LGI-1) antibodies].

PubMed

Le Dault, E; Lagarde, S; Guedj, E; Dufournet, B; Rey, C; Kaphan, E; Tanguy, G; Bregigeon, M; Sagui, E; Brosset, C

2016-02-01

Anti-leucine rich glioma inactivated 1 encephalitis is a common and a treatable etiology of autoimmune encephalitis. Its diagnosis is a challenge because the initial diagnostic work-up is often normal. A 48-year-old man experienced cognitive and behavioral troubles, facio-brachial dystonic seizures and a syndrome of inappropriate antidiuretic hormone secretion. First line tests excluded infectious, neoplastic, systemic inflammatory, endrocrine or toxic etiologies. Cerebral (18)Fluoro-desoxy-glucose (FDG) position emission tomography and research of specific antibodies in cerebro-spinal fluid and serum led to diagnose an anti-leucine rich glioma inactivated 1 encephalitis. Intravenous immunoglobulins and corticosteroids were partially effective. Cyclophosphamid permitted a good recovery. In the presence of acute neuropsychiatric disorders with a negative etiologic research, physician should think about dysimmune encephalitis. Facio-brachial dystonic seizures and syndrome of inappropriate antidiuretic hormone secretion are highly evocative of anti-leucine rich glioma inactivated 1 encephalitis. The diagnosis needs specific diagnostic tests (cerebral (18)FDG position emission tomography and antibodies research in cerebro-spinal fluid and in serum), after the exclusion of alternative diagnoses. Extensive and repeated diagnostic work-up for neoplasia is required. Immunosupressive therapies are effective in most cases. Copyright © 2015 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

["Placebo effect", from personal convictions to collective representations: A psychosocial reading of a pharmacodynamic phenomenon].

PubMed

Balez, R; Couturaud, F; Touffet, L

2015-11-01

After starting with a brief historical account of the placebo effect organized around the elaboration of clinical trials and around sham therapy as a method, we will offer a psychosocial point of view on the placebo phenomenon. The placebo effect is at the heart of medicine and particularly of therapeutic trials from theoretical research on a drug to its acceptance and its use in every-day clinical practice. The placebo effect intermingles biology, relationships and the context of therapeutic interactions. This type of phenomenon originates as much from biology as from human psychology. Our article puts more precisely into question the part that psychology has in the placebo phenomenon and suggests a chart to address it. This chart refers both to the pharmacodynamic effect given to drugs in a subjective way, and to the collective representations and social interactions depending on them. What can we say about the psychosociological dimensions of the placebo effect? How is it possible to organize the scope of these dimensions to base systematic studies on them in the field of clinical trials? We try to give elements of response to these questions by suggesting the study of the placebo effect as an original field of study by necessarily mobilizing both health sciences and the human and social sciences. Copyright © 2015 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

[The plague: An overview and hot topics].

PubMed

Galy, A; Loubet, P; Peiffer-Smadja, N; Yazdanpanah, Y

2018-04-05

Plague is a bacterial zoonosis caused by Yersinia pestis, usually found in fleas and small rodents that constitute the reservoir of the disease. It is transmitted to humans by flea bite, contact with rodents or inhalation of infected droplets. There are three clinical forms: bubonic plague, pulmonary plague and septicemic plague. The usual presentation is a flu-like syndrome possibly accompanied by an inflammatory lymphadenopathy which appears after 1 to 7days of incubation. Bubonic plague has a case fatality rate of about 50% while other forms of plague are almost always fatal without treatment. Diagnosis can be confirmed by usual bacteriological techniques (Gram examination, culture) but also by serological examination, use of rapid diagnostic tests or PCR. Although aminoglycosides are traditionally regarded as the most effective treatment, fluoroquinolones or cyclins are currently recommended in France. Plague is one of the re-emerging diseases according to the WHO and Madagascar suffered in 2017 the most important plague epidemic of the 21st century with more than 2000 cases and 200 deaths. Peru and the Democratic Republic of Congo are also considered endemic areas. Public health measures and a relentless fight against poverty are the cornerstone of the control of the disease. Vaccine improvement in endemic areas may also play an important role. Copyright © 2018 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

[Electronic cigarettes: A therapeutic tool, a social phenomenon or a business?].

PubMed

Berlin, I

2015-06-01

Smoking is the first avoidable cause of morbidity and mortality. It is estimated that there were around 14 million smokers in France in 2012 and that smoking results in 70,000 deaths per year. All types of interventions reducing with efficacy the incidence and prevalence of smoking are to consider in prolonging life expectancy. Electronic cigarettes (e.cig.) are a social phenomenon but they also are a system delivering pharmacologically active substances; their use concerns today several millions of individuals in France. By this fact, it became important for clinical practitioners to acquire some knowledge about e. cig. Most of the e.cig. contains nicotine, thus, e.cig. are now called in the medical literature as electronic nicotine delivery system (ENDS). It is highly plausible that ENDS, which are, as of today, consumer products and not health products, deliver nicotine with a good bioavailability and could, if largely used, help to reduce smoking prevalence. However, because of current lack of regulations, as of today, the risk/benefit ratio of ENDS as an aid to help smokers quit and their adverse effect profile cannot be established. It is of public health responsibility to promote evidence based knowledge about e.cig. to know with confidence their risk/benefit ratio. Copyright © 2014 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

[Medication errors with concentrated potassium intravenous solutions: Data of the literature, context and prevention].

PubMed

Charpiat, B; Magdinier, C; Leboucher, G; Aubrun, F

2016-01-01

Accidental direct intravenous injection of a concentrated solution of potassium often leads to patient death. In France, recommendations of healthcare agencies to prevent such accidents cover only preparation and intravenous infusion conditions. Accidents continue to occur in French hospitals. These facts demonstrate that these recommendations are insufficient and ineffective to prevent such deaths, especially those occurring during a catheter flushing. This article reviews the measures able to reduce the number of accidents. Countries which removed concentrated ampoules from ward stocks observed a decrease of the number of accidental deaths. This withdrawal, recommended by the World Health Organization, is now part of standards in studies aimed at determining the safety of care in hospitals. However, removal alone is insufficient to eliminate the risk. The combination with other measures should be considered. These measures are the provision of a combination of diluted intravenous ready to use solutions, the promotion of the oral route with tablets and oral solutions for potassium replenishment and to make available products with safeguards to prevent single shot intravenous injection. Studies aimed at determining the consequences on preventing concentrated potassium accidents of a widespread distribution of isotonic sodium chloride pre-filled ready-to-use syringes for catheter flushing should be performed. Copyright © 2015 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

A French-speaking speech-language pathology program in West Africa: transfer of training between Minority and Majority World countries.

PubMed

Topouzkhanian, Sylvia; Mijiyawa, Moustafa

2013-02-01

In West Africa, as in Majority World countries, people with a communication disability are generally cut-off from the normal development process. A long-term involvement of two partners (Orthophonistes du Monde and Handicap International) allowed the implementation in 2003 of the first speech-language pathology qualifying course in West Africa, within the Ecole Nationale des Auxiliaires Medicaux (ENAM, National School for Medical Auxiliaries) in Lome, Togo. It is a 3-year basic training (after the baccalaureate) in the only academic training centre for medical assistants in Togo. This department has a regional purpose and aims at training French-speaking African students. French speech-language pathology lecturers had to adapt their courses to the local realities they discovered in Togo. It was important to introduce and develop knowledge and skills in the students' system of reference. African speech-language pathologists have to face many challenges: creating an African speech and language therapy, introducing language disorders and their possible cure by means other than traditional therapies, and adapting all the evaluation tests and tools for speech-language pathology to each country, each culture, and each language. Creating an African speech-language pathology profession (according to its own standards) with a real influence in West Africa opens great opportunities for schooling and social and occupational integration of people with communication disabilities.

Benefits of pharmacist-led flu vaccination services in community pharmacy.

PubMed

Kirkdale, C L; Nebout, G; Megerlin, F; Thornley, T

2017-01-01

Seasonal influenza is a major cause of excess winter deaths and increased hospital admissions. There is a high level of economic burden associated with the infection. Although vaccination targets have been set to tackle this international issue, many countries struggle to reach these coverage targets for their at-risk populations using traditional delivery methods. Traditional providers include family doctors and nurses; however, pharmacist-led influenza vaccination has become a more commonly utilised aid to support vaccination targets. Community pharmacies are convenient and widely accessible and evaluations consistently demonstrate that patients are satisfied with pharmacist-led vaccinations. Allowing community pharmacists to administer influenza vaccination as an alternative option for delivery helps to increase the coverage rate of vaccination. In addition, commissioning community pharmacists to provide this service has been shown to contribute to achieving targets for those at-risk. Pharmacist-led influenza vaccination services can create value for payors and reduce pressure on health systems. This review aims to demonstrate the success of pharmacy-led influenza vaccinations, and the impact it has had in driving up immunisation rates within other countries. Experiences of countries such as England, Portugal and the United States provide evidence to demonstrate the benefit to both the patient and the health system. Copyright © 2016 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

[Tetanus risk assessment in the older outpatients: Usefulness of the "Tétanos Quick Stick ®"?].

PubMed

Nicolaï, D; Farcet, A; Molines, C; Delalande, G; Retornaz, F

2015-05-01

Tetanus is a serious disease, which could be potentially lethal. All cases are observed in patients inadequately immunized. The immunochromatographic tests (including Tetanos quick Stick(®) [TQS]) have demonstrated their efficiency in emergency setting. The aim of our study was to assess the usefulness of these tests in elderly outpatients seen in ambulatory settings. This prospective study included patients aged 65 years and over who presented to the outpatients' clinic of the Gerontologic Departmental Center (Marseille). A TQS and a self-administered questionnaire to assess risk factors for tetanus were performed. One hundred and twenty-two patients were studied. The prevalence of positive TQS was 66%. Patients have an average of 2.5 risk factors for tetanus. Negative TQS was observed in 35% of patients who had seen their general practitioner for a wound during the previous year. Elderly patients accumulate several risk factors regardless of age and lifestyle. While physicians are familiar with the vaccine recommendations, they are often faced with the difficulty of assessing patient's status based only on the patient's interview, which is frequently not reliable. The implementation of immunochromatographic tests in general practice could help physicians in the management of patients at risk for tetanus. Copyright © 2014 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

[Glass ceiling for women in academic medicine in France].

PubMed

Rosso, C; Leger, A; Steichen, O

2018-06-03

To determine whether career development in academic medicine is more difficult for women than for men, and, if any, the nature and level of barriers to this progression. Extraction of full-time medical staff in a Parisian hospital group, through the SIGAPS platform; an online questionnaire survey of career choices and barriers experienced by full-time male and female physicians. The study population comprises 181 hospital practitioners and 141 academic physicians (49 associate professors and 92 full professors). Women represent 49% of the medical staff but 15% of full professors. This underrepresentation of women is more important among intensivists/anesthesiologists than technique-based specialists (such as radiologists, biologists…). There is no difference in scientific output, marital status and parenthood between women and men. On the other hand, there is a difference in attitudes highlighted by the EVAR risk-taking scale as well as in the burden of familial involvement and the prejudices felt by women during the academic selection process. The glass ceiling exists in one of the largest French hospital group. Career development principles promote merit, but should decrease the benefit of "masculine" attitudes in the competition for academic positions. Academic selection criteria should evolve to limit the disadvantage of women related to deeper familial involvement and less competitive strategies and risk-taking attitudes. Copyright © 2018 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

[Description of the mental processes occurring during clinical reasoning].

PubMed

Pottier, P; Planchon, B

2011-06-01

Clinical reasoning is a highly complex system with multiple inter-dependent mental activities. Gaining a better understanding of those cognitive processes has two practical implications: for physicians, being able to analyse their own reasoning method may prove to be helpful in diagnostic dead end; for medical teachers, identifying problem-solving strategies used by medical students may foster an appropriate individual feed-back aiming at improving their clinical reasoning skills. On the basis of a detailed literature review, the main diagnostic strategies and their related pattern of mental processes are described and illustrated with a concrete example, going from the patient's complaint to the chosen solution. Inductive, abductive and deductive diagnostic approaches are detailed. Different strategies for collecting data (exhaustive or oriented) and for problem-building are described. The place of problem solving strategies such as pattern-recognition, scheme inductive process, using of clinical script, syndrome grouping and mental hypotheses test is considered. This work aims at breaking up mental activities in process within clinical reasoning reminding that expert reasoning is characterised by the ability to use and structure the whole of these activities in a coherent system, using combined strategies in order to guarantee a better accuracy of their diagnosis. Copyright © 2010 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Forensic entomology: implementing quality assurance for expertise work.

PubMed

Gaudry, Emmanuel; Dourel, Laurent

2013-09-01

The Department of Forensic Entomology (Institut de Recherche Criminelle de la Gendarmerie Nationale, France) was accredited by the French Committee of Accreditation (Cofrac's Healthcare section) in October 2007 on the basis of NF EN ISO/CEI 17025 standard. It was the first accreditation in this specific field of forensic sciences in France and in Europe. The present paper introduces the accreditation process in forensic entomology (FE) through the experience of the Department of Forensic Entomology. Based upon the identification of necrophagous insects and the study of their biology, FE must, as any other expertise work in forensic sciences, demonstrate integrity and good working practice to satisfy both the courts and the scientific community. FE does not, strictly speaking, follow an analytical method. This could explain why, to make up for a lack of appropriate quality reference, a specific documentation was drafted and written by the staff of the Department of Forensic Entomology in order to define working methods complying with quality standards (testing methods). A quality assurance system is laborious to set up and maintain and can be perceived as complex, time-consuming and never-ending. However, a survey performed in 2011 revealed that the accreditation process in the frame of expertise work has led to new well-defined working habits, based on an effort at transparency. It also requires constant questioning and a proactive approach, both profitable for customers (magistrates, investigators) and analysts (forensic entomologists).

Parallel assessment of the effects of bisphenol A and several of its analogs on the adult human testis.

PubMed

Desdoits-Lethimonier, C; Lesné, L; Gaudriault, P; Zalko, D; Antignac, J P; Deceuninck, Y; Platel, C; Dejucq-Rainsford, N; Mazaud-Guittot, S; Jégou, B

2017-07-01

Are bisphenol A (BPA) and BPA analogs (BPA-A) safe for male human reproductive function? The endocrine function of human testes explants [assessed by measuring testosterone and insulin-like factor 3 (INSL3)] was impacted by exposure of the human adult testis explants to BPA/BPA-A. The few epidemiologic studies performed suggest that bisphenols have potential endocrine disruptive properties, but they did not identify clear and direct patterns of endocrine disruption. Adult human testis explants in culture were exposed to BPA and the analogs bisphenol F (BPF), bisphenol S (BPS), bisphenol E (BPE), bisphenol B (BPB) and bisphenol A diglycidyl ether (BADGE) at 10-9-10-5 M for 24 or 48 h. Human adult testes were obtained from prostate cancer patients who had no hormone therapy, or from multiorgan donors. After ex vivo exposure to the investigated bisphenols, the measured outcomes were related to histopathology (gross morphology and germ cell viability determined by anti-caspase three immunohistochemistry), and the levels of testosterone, INSL3 and inhibin B were measured using immunoassays. The levels of mRNA encoding key enzymes of bisphenol biotransformation were investigated by quantitative PCR: UGT2B15 UDP (glucuronosyltransferase two family, polypeptide B15), GUSB (glucuronidase beta), SULT1A1 and 3 (sulfotransferase family 1 A member 1 and 3) and STS (steroid sulfatase). A significant dose-dependent inhibition was found between testosterone levels measured in the culture medium and concentrations of BPA (P = 0.00778 at 24 h and P = 0.0291 at 48 h), BPE (P = 0.039) and BPF (P = 0.00663). The observed BPA and BPA-A-induced inhibition of testosterone production varied according to duration of exposure and BPA/BPA-A concentrations. BPA (10-9 M; P < 0.05), BPB (10-9 M; P < 0.05), BPS (10-9 and 10-8 M; P < 0.05) and BADGE (10-5 M; P < 0.05) increased Leydig cell INSL3 production. By contrast, BPE dose dependently inhibited INSL3 (P = 0.0372). Conversely, Sertoli cell function (inhibin B) and germ cell viability were not significantly affected by either bisphenols. N/A. Environmental compounds cannot be deliberately administered to men, justifying the use of an ex vivo approach. A relatively low number of testes samples were available for analysis (n = 3, except for testosterone secretion with n = 5). The active concentrations of BPA and BPA-A used in the study were higher than those found in human biological fluids. Under our experimental conditions, direct exposure to BPA or BPA-A can result in endocrine disturbance in the adult human testis. This study was funded by Inserm (Institut National de la Santé et de la Recherche Médicale), EHESP-School of Public Health, University of Rennes1, by grants from the Agence Nationale de la Recherche (ANR; grant#ANR-13-CESA-0012-03 NEWPLAST) and Agence Nationale de Sécurité Sanitaire de l'Alimentation, de l'Environnement et du Travail (ANSES; grant#EST-2010/2/046 (BPATESTIS)). All authors declare they have no current or potential competing financial interests. © The Author 2017. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

L’incidence des infections nosocomiales urinaires et des sites opératoires dans la maternité de l’Hôpital Général de Référence de Katuba à Lubumbashi en République Démocratique du Congo

PubMed Central

Lukuke, Hendrick Mbutshu; Kasamba, Eric; Mahuridi, Abdulu; Nlandu, Roger Ngatu; Narufumi, Suganuma; Mukengeshayi, Abel Ntambue; Malou, Vicky; Makoutode, Michel; Kaj, Françoise Malonga

2017-01-01

Introduction Les patients hospitalisés en Afrique intertropicale sont exposés à un risque des infections nosocomiales. La rareté des données publiées sur le sujet limite l’analyse descriptive de la situation. L’objectif de ce travail était de déterminer l’incidence, les germes en cause et les facteurs de risque des infections nosocomiales urinaires et des sites opératoires à la maternité de l’HGR Katuba de Lubumbashi en République Démocratique du Congo(DRC). Méthodes Nous avons réalisé une étude descriptive longitudinale de la période allant du 1er octobre 2014 au 1er Janvier 2015. Notre population d’étude était constituée de 207 femmes ayant séjourné dans cette maternité. La collecte de données était réalisée d’une manière exhaustive. Résultats L’incidence de ces infections nosocomiales était de 15,5%. Les parturientes ayant passé plus de trois jours à l'hôpital avaient trois fois plus de risque de développer une infection nosocomiale (p = 0,003) tandis que celles qui ont eu un accouchement avec complication avaient quatre fois plus de risque de contracter une infection nosocomiale (p = 0,000). Escherichia coli était l'agent causal le plus isole (38,1%), suivi de Citrobacter freundii (23,8%), Acinobacter baumannii (18, 2%), Staphylococcus aureus (18,2%), Enterococcus feacalis (14,3%) et Pseudomonas aeruginosa (9,1%). L'ampicilline était l'antibiotique le plus prescrit auquel tous les microbes isoles ont été résistants. Conclusion Il faut améliorer des conditions d’hygiène hospitalière; mais aussi une étude ultérieure pour étudier la ressemblance entre les souches des germes de l’environnement et celles trouvés dans les liquides biologiques. PMID:29230259

Coherent Sea Ice Variations in the Nordic Seas and Abrupt Greenland Climate Changes over Dansgaard-Oeschger Cycles

NASA Astrophysics Data System (ADS)

Sadatzki, H.; Berben, S.; Dokken, T.; Stein, R.; Fahl, K.; Jansen, E.

2016-12-01

Rapid changes in sea ice extent in the Nordic Seas may have played a crucial role in controlling the abruptness of ocean circulation and climate changes associated with Dansgaard-Oeschger (D-O) cycles during the last glacial (Li et al., 2010; Dokken et al., 2013). To investigate the role of sea ice for abrupt climate changes, we produced a sea ice record from the Norwegian Sea Core MD99-2284 at a temporal resolution approaching that of ice core records, covering four D-O cycles at ca. 32-41 ka. This record is based on the sea ice diatom biomarker IP25, open-water phytoplankton biomarker dinosterol and semi-quantitative phytoplankton-IP25 (PIP25) estimates. A detailed tephrochronology of MD99-2284 corroborates the tuning-based age model and independently constrains the GS9/GIS8 transition, allowing for direct comparison between our sediment and ice core records. For cold stadials we find extremely low fluxes of total organic carbon, dinosterol and IP25, which points to a general absence of open-water phytoplankton and ice algae production under a near-permanent sea ice cover. For the interstadials, in turn, all biomarker fluxes are strongly enhanced, reflecting a highly productive sea ice edge situation and implying largely open ocean conditions for the eastern Nordic Seas. As constrained by three tephra layers, we observe that the stadial-interstadial sea ice decline was rapid and may have induced a coeval abrupt northward shift in the Greenland precipitation moisture source as recorded in ice cores. The sea ice retreat also facilitated a massive heat release through deep convection in the previously stratified Nordic Seas, generating atmospheric warming of the D-O events. We thus conclude that rapid changes in sea ice extent in the Nordic Seas amplified oceanic reorganizations and were a key factor in controlling abrupt Greenland climate changes over D-O cycles. Dokken, T.M. et al., 2013. Paleoceanography 28, 491-502 Li, C. et al., 2010. Journ. Clim. 23, 5457-5475

[Simulation-based learning and internal medicine: Opportunities and current perspectives for a national harmonized program].

PubMed

Galland, J; Abbara, S; Terrier, B; Samson, M; Tesnières, A; Fournier, J P; Braun, M

2018-06-01

Simulation-based learning (SBL) is developing rapidly in France and the question of its use in the teaching of internal medicine (IM) is essential. While HAS encourages its integration into medical education, French Young Internists (AJI) set up a working group to reflect on the added-value of this tool in our specialty. Different sorts of SBL exist: human, synthetic and electronic. It enables student to acquire and evaluate technical skills (strengths, invasive procedures, etc.) and non-technical skills (relational, reasoning…). The debriefing that follows the simulation session is an essential time in pedagogical terms. It enables the acquisition of knowledge by encouraging the students' reflection to reshape their reasoning patterns by self-correcting. IM interns are supportive of its use. The simulation would allow young internists to acquire skills specific to our specialty such as certain gestures, complex consulting management, the synthesis of difficult clinical cases. SBL remains confronted with human and financial cost issues. The budgets allocated to the development and maintenance of simulation centres are uneven, making the supply of training unequal on the territory. Simulation sessions are time-consuming and require teacher training. Are faculties ready to train and invest their time in simulation, even though the studies do not allow us to conclude on its pedagogical validity? Copyright © 2018 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Microwave freeze-thaw technique of injectable drugs. A review from 1980 to 2014.

PubMed

Hecq, J-D; Godet, M; Jamart, J; Galanti, L

2015-11-01

Microwave freeze-thaw treatment (MFTT) of injectable drugs can support the development of centralized intravenous admixtures services (CIVAS). The aim of the review is to collect information and results about this method. A systematic review of the scientific literature about injectable drug stability studies was performed. The data are presented in a table and describe name of the drug, producer, final concentration, temperature and time of freezing storage, type of microwave oven, thawing power, method of dosage and results after treatment or final long-term storage at 5±3 °C. From 1980 to 2014, 59 drugs were studied by MFTT and the results were presented in 49 publications. Forty papers were presented by 8 teams (2 to 18 by team). The temperatures of freezing storage vary from -70 °C to -10 °C, the time storage from 4 hours to 12 months, the thaw from low to full power. Dosages are mainly made by high performance liquid chromatography. Most of the 59 drugs are stable during and after treatment. Only 3 teams have tested the long-term stability after MFTT, the first for ganciclovir after 7 days, the second for ceftizoxime after 30 days and the third for 19 drugs after 11 to 70 days. This review can help CIVAS to take in charge the productions of ready-to-use injectable drugs. Copyright © 2015 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

Changes in food and nutrient intake of 6- to 17-year-old Germans between the 1980s and 2006.

PubMed

Stahl, Anna; Vohmann, Claudia; Richter, Almut; Heseker, Helmut; Mensink, Gert B M

2009-10-01

To compare the food consumption and nutrient intakes of German children and adolescents in the 1980s with present dietary habits. Two cross-sectional representative surveys, the German National Food Consumption Study (Nationale Verzehrsstudie, NVS) from 1985-8 and the nutrition module 'EsKiMo' of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) from 2006, were analysed for differences in food and nutrient intakes stratified by age and sex groups. Secondary analyses of data from representative observational studies. Children and adolescents aged 6-17 years living in Germany in the 1980s (n 2265) and in 2006 (n 2506). Food consumption was characterised by higher amounts of vegetables/pulses, fruits/nuts and beverages and less meat products/sausages, butter, fats/oils, potatoes/potato products and bread/pastries in 2006 than in 1985-8. The overall changes in food intake were reflected in improvements of macronutrient composition, increased water intake and lower energy density of the diet. Intake of most vitamins and minerals increased in relation to energy intake, but the nutrient density of the diet for vitamins B12 and D decreased. The most critical nutrients observed in NVS and EsKiMo were folate, vitamin D, vitamin A, vitamin E, Ca and Fe. In addition, dietary fibre intake was relatively low and fatty acid and carbohydrate compositions were not favourable. Further efforts will be necessary to improve dietary habits among children and adolescents.

[Bell's palsy].

PubMed

Prud'hon, S; Kubis, N

2018-03-30

Idiopathic peripheral facial palsy, also named Bell's palsy, is the most common cause of peripheral facial palsy in adults. Although it is considered as a benign condition, its social and psychological impact can be dramatic, especially in the case of incomplete recovery. The main pathophysiological hypothesis is the reactivation of HSV 1 virus in the geniculate ganglia, leading to nerve edema and its compression through the petrosal bone. Patients experience an acute (less than 24 hours) motor deficit involving ipsilateral muscles of the upper and lower face and reaching its peak within the first three days. Frequently, symptoms are preceded or accompanied by retro-auricular pain and/or ipsilateral face numbness. Diagnosis is usually clinical but one should look for negative signs to eliminate central facial palsy or peripheral facial palsy secondary to infectious, neoplastic or autoimmune diseases. About 75% of the patients will experience spontaneous full recovery, this rate can be improved with oral corticotherapy when introduced within the first 72 hours. To date, no benefit has been demonstrated by adding an antiviral treatment. Hemifacial spasms (involuntary muscles contractions of the hemiface) or syncinesia (involuntary muscles contractions elicited by voluntary ones, due to aberrant reinnervation) may complicate the disease's course. Electroneuromyography can be useful at different stages: it can first reveal the early conduction bloc, then estimate the axonal loss, then bring evidence of the reinnervation process and, lastly, help for the diagnosis of complications. Copyright © 2018 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

[Problems encountered by hospital pharmacists with information systems: Analysis of exchanges within social networks].

PubMed

Charpiat, B; Mille, F; Fombeur, P; Machon, J; Zawadzki, E; Bobay-Madic, A

2018-05-21

The development of information systems in French hospitals is mandatory. The aim of this work was to analyze the content of exchanges carried out within social networks, dealing with problems encountered with hospital pharmacies information systems. Messages exchanged via the mailing list of the Association pour le Digital et l'Information en Pharmacie and abstracts of communications presented at hospital pharmacists trade union congresses were analyzed. Those referring to information systems used in hospital pharmacies were selected. From March 2015 to June 2016, 122 e-mails sent by 80 pharmacists concerned information systems. From 2002 to 2016, 45 abstracts dealt with this topic. Problems most often addressed in these 167 documents were "parameterization and/or functionalities" (n=116), interfaces and complexity of the hospital information systems (n=52), relationship with health information technologies vendors and poor reactivity (n=32), additional workload (n=32), ergonomics (n=30), insufficient user training (n=22). These problems are interdependent, lead to errors and in order to mitigate their consequences, they compel pharmacy professionals to divert a significant amount of working hours to the detriment of pharmaceutical care and dispensing and preparing drugs. Hospital pharmacists are faced with many problems of insecurity and inefficiency generated by information systems. Researches are warranted to determine their cost, specify their deleterious effects on care and identify the safest information systems. Copyright © 2018 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

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

[Gut microbiota: Description, role and pathophysiologic implications].

PubMed

Landman, C; Quévrain, E

2016-06-01

The human gut contains 10(14) bacteria and many other micro-organisms such as Archaea, viruses and fungi. Studying the gut microbiota showed how this entity participates to gut physiology and beyond this to human health, as a real "hidden organ". In this review, we aimed to bring information about gut microbiota, its structure, its roles and its implication in human pathology. After bacterial colonization in infant, intestinal microbial composition is unique for each individual although more than 95% can be assigned to four major phyla. The use of culture independent methods and more recently the development of high throughput sequencing allowed to depict precisely gut microbiota structure and diversity as well as its alteration in diseases. Gut microbiota is implicated in the maturation of the host immune system and in many fundamental metabolic pathways including sugars and proteins fermentation and metabolism of bile acids and xenobiotics. Imbalance of gut microbial populations or dysbiosis has important functional consequences and is implicated in many digestive diseases (inflammatory bowel diseases, colorectal cancer, etc.) but also in obesity and autism. These observations have led to a surge of studies exploring therapeutics which aims to restore gut microbiota equilibrium such as probiotics or fecal microbiota transplantation. But recent research also investigates biological activity of microbial products which could lead to interesting therapeutics leads. Copyright © 2015 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

[Pre-eclampsia prevention in 2018 in general population and in lupic women: At the dawn of a personalized medicine?

PubMed

de Moreuil, C; Fauchais, A-L; Merviel, P; Tremouilhac, C; Le Moigne, E; Pasquier, E; Pan-Petesch, B; Lacut, K

2018-06-19

Pre-eclampsia prevention represents a major public health issue, as this vasculo-placental disorder generates a great burden of foeto-maternal morbi-mortality. Aspirin has proved its efficacy in primary and secondary pre-eclampsia prevention, especially when it is given at 150mg per day bedtime before 15 weeks of gestation to high-risk women. In the English trial ASPRE, high-risk women were identified by an algorithm taking into account angiogenic biomarkers ascertained at the end of first trimester of pregnancy. This article focuses on physiopathological mechanisms and risk factors of pre-eclampsia and on the interest of early angiogenic biomarkers dosing during pregnancy, for the assessment of pre-eclampsia risk. Unlike Great Britain or Israel, cost-effectiveness of this algorithm in general population has not been assessed in France. Finally, systemic lupus erythematous is at high risk of vasculo-placental disorders. Although few studies of angiogenic biomarkers dosing during lupus pregnancies identified a correlation between high sFlt1 levels at the end of first trimester and subsequent onset of severe vasculo-placental disorders, with a very good negative predictive value of sFtl1. Angiogenic biomarkers ascertainment for screening of vasculo-placental disorders in pregnant women with systemic lupus erythematous could allow targeting at best women needing an aspirin treatment and a closer monitoring. Copyright © 2018 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier Masson SAS. All rights reserved.

Nutrient profiling can help identify foods of good nutritional quality for their price: a validation study with linear programming.

PubMed

Maillot, Matthieu; Ferguson, Elaine L; Drewnowski, Adam; Darmon, Nicole

2008-06-01

Nutrient profiling ranks foods based on their nutrient content. They may help identify foods with a good nutritional quality for their price. This hypothesis was tested using diet modeling with linear programming. Analyses were undertaken using food intake data from the nationally representative French INCA (enquête Individuelle et Nationale sur les Consommations Alimentaires) survey and its associated food composition and price database. For each food, a nutrient profile score was defined as the ratio between the previously published nutrient density score (NDS) and the limited nutrient score (LIM); a nutritional quality for price indicator was developed and calculated from the relationship between its NDS:LIM and energy cost (in euro/100 kcal). We developed linear programming models to design diets that fulfilled increasing levels of nutritional constraints at a minimal cost. The median NDS:LIM values of foods selected in modeled diets increased as the levels of nutritional constraints increased (P = 0.005). In addition, the proportion of foods with a good nutritional quality for price indicator was higher (P < 0.0001) among foods selected (81%) than among foods not selected (39%) in modeled diets. This agreement between the linear programming and the nutrient profiling approaches indicates that nutrient profiling can help identify foods of good nutritional quality for their price. Linear programming is a useful tool for testing nutrient profiling systems and validating the concept of nutrient profiling.

[Anti-pneumococcal vaccine coverage for hospitalized risk patients: Assessment and suggestions for improvements].

PubMed

Richard, C; Le Garlantezec, P; Lamand, V; Rasamijao, V; Rapp, C

2016-05-01

Streptococcus pneumoniae can cause invasive infections. Incidence and severity are linked to patients' risk factors. Due to the resistance to leading antibiotics, the anti-pneumococcal vaccination has become a major public health issue. The purpose of this survey was to evaluate the anti-pneumococcal vaccine coverage in a population of adults with risk factors. This was a prospective study that included patients with at least one recommendation for pneumococcal vaccination as indicated by the Weekly Epidemiological Bulletin (BEH), to which three further US recommendations were added (diabetes, obesity and age>65years). One hundred and thirty-four patients with an average age of 70 years were included. The physician could only confirm 68 % of the patients' vaccination status. Vaccination coverage as recommended by the BEH board was 30 % (n=54). All HIV patients were vaccinated (n=2) and the vaccination coverage was 75 % (n=8) for patients treated for autoimmune diseases and only 10 % (n=20) for patients treated with chemotherapy. Patients with no vaccination didn't know the existence of the vaccine or didn't know that vaccination was recommended to them. This study has highlighted a deficit in pneumococcal vaccination coverage and a high level of ignorance of the existence of recommended vaccination. In addition to awareness campaign for patients and caregiver training, the expansion of the vaccine e-book utilization could improve the vaccination status. Copyright © 2015 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

[Thrombotic thrombocytopenia purpura in Martinique: Retrospective study between 2008 and 2015].

PubMed

Patient, M; Fuseau, P; Deligny, C

2017-08-01

Some studies suggest that thrombotic thrombocytopenic purpura (TTP) occurs more often in African Americans. However there is low evidence for this in the literature. The aim of our study was to describe the clinical and biological characteristics of TTP in the Afro-Caribbean population of Martinique. We retrospectively analysed all patients with TTP diagnosed at the Fort-de-France hospital between 2008, January 1st and 2015, December 31st. Diagnosis was confirmed if ADAMTS-13 activity was<10 %. Ten patients were included, corresponding to an average annual incidence of 3.2 cases/year/million individuals. None of the patient presented with the association of the five characteristic features of TTP. Microangiopathic haemolytic anaemia and severe peripheral thrombocytopenia (median: 13G/L) was the main presentation leading to diagnosis. There was no kidney involvement in 90 % of all patients, but severe neurological manifestations occurred in 70 %. Classical management including corticosteroids and plasma exchanges allowed clinical remission in 6 out of the 10 cases. If necessary, rituximab or cyclophosphamide was used. The overall survival rate was 90 %. In Martinique, the incidence of TTP is twice that reported in similar studies in France. Clinical manifestations seem to differ by more common and more severe neurological involvement. Mortality is low, in part, due to optimal care. Copyright © 2017 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

[Study of parenteral iron use in a health facility and its impact in terms of hospital economics].

PubMed

Vonesch, M-A; Grangier, G; Girard, P; Dussart, C

2016-07-01

Administration of parenteral iron is a mainstay of iron deficiency treatment. Evaluation and control of this element is an issue for healthcare facilities. Study of parenteral iron use is thus to be evaluated in its impact in terms of hospital economics. Parenteral iron administrations that took place on 2014 in our healthcare facility were retrospectively identified by pharmacists. Following data were extracted from Pharma™ and Crossway™ softwares: indication, diagnostic coding and total dose of iron received. They were then compared to the summary of product characteristics. Of 198 analyzed prescriptions, iron deficiency was known or suspected for 97% of patients. However, the total dose of iron administered was not in compliance for three quarters of prescriptions. Sixty-eight percent of patients appear under-dosed. Administration's traceability was found for two-thirds. Eighty-five hospital discharges did not have the right coding and 34 stays were charged like an external act instead sessions. Financial loss for the hospital is estimated at 49,300 euros. As part of improving practice, close pharmaceutical monitoring of parenteral iron prescribed dosing regimen is essential. Effective communication with the medical information department and regular awareness raising of prescribers should also allow to give more value to this act. Hospital economics is a real tool to aid decision-making. Copyright © 2015 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

[Changes in olfaction during ageing and in certain neurodegenerative diseases: up-to-date].

PubMed

Bianchi, A-J; Guépet-Sordet, H; Manckoundia, P

2015-01-01

Olfaction is a complex sensory system, and increasing interest is being shown in the link between olfaction and cognition, notably in the elderly. In this literature review, we revisit the specific neurophysiological features of the olfactory system and odorants that lead to a durable olfactory memory and an emotional memory, for which the implicit component produces subconscious olfactory conditioning. Olfaction is known to affect cognitive abilities and mood. We also consider the impairment of olfactory function due to ageing and to neurodegenerative diseases, in particular Alzheimer's disease and Parkinson's disease, through anatomopathological changes in the peripheral and central olfactory structures. The high frequency of these olfactory disorders as well as their early occurrence in Alzheimer disease and Parkinson disease are in favour of their clinical detection in subjects suffering from these two neurodegenerative diseases. Finally, we analyse the impact of olfactory stimulation on cognitive performance and attention. Current observational data from studies in elderly patients with Alzheimer-type dementia are limited to multiple sensory stimulation methods, such as the Snoezelen method, and aromatherapy. These therapies have shown benefits for dementia-related mood and behaviour disorders in the short term, with few side effects. Since olfactory chemosensory stimulation may be beneficial, it may be proposed in patients with dementia, especially Alzheimer-type dementia, as a complementary or even alternative therapy to existing medical strategies. Copyright © 2014 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Radioactive waste management in France and international cooperation

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

Marque, Y.

1991-01-01

Long-term industrial management of radioactive waste in France is carried out by the Agence Nationale pour la gestion des Dechets Radioactifs. (ANDRA), which is a public body responsible mainly for siting, design, construction, and operation of the disposal facilities for every kind of radioactive waste produced in the country. Furthermore, ANDRA has to define and control the required quality of waste packages delivered for disposal. As far as disposal is concerned, it is customary in France to classify waste in two main categories. The first category includes all the so-called short-lived low-level waste (LLW) containing mainly radioactive substances have

Comparison of the Explantation Rate of Poly Implant Prothèse, Allergan, and Pérouse Silicone Breast Implants within the First Four Years after Reconstructive Surgery before the Poly Implant Prothèse Alert by the French Regulatory Authority.

PubMed

Leduey, Alexandre; Mazouni, Chafika; Leymarie, Nicolas; Alkhashnam, Heba; Sarfati, Benjamin; Garbay, Jean-Rémi; Gaudin, Amélie; Kolb, Frédéric; Rimareix, Françoise

2015-01-01

Background. In March 2010, ANSM (Agence Nationale de Sécurité du Medicament), the French Medical Regulatory Authority, withdrew Poly Implant Prothèse (PIP) breast implants from the market due to the use of non-medical-grade silicone gel. The aim of this study was to compare the removal rate (and reasons thereof) of breast implants produced by different manufacturers before the ANSM alert. Materials and Methods. From October 2006 to January 2010, 652 women received 944 implants after breast cancer surgery at the Gustave Roussy Comprehensive Cancer Center, Paris (France). The complications and removal rates of the different implant brands used (PIP, Allergan, and Pérouse) were evaluated and compared. Results. PIP implants represented 50.6% of the used implants, Allergan 33.4%, and Pérouse 16%. The main reasons for implant removal were patient dissatisfaction due to aesthetic problems (43.2%), infection (22.2%), and capsular contracture (13.6%). Two years after implantation, 82% of Pérouse implants, 79% of PIP, and 79% of Allergan were still in situ. There was no difference in removal rate among implant brands. Conclusion. Before the ANSM alert concerning the higher rupture rate of PIP breast implants, our implant removal rate did not predict PIP implant failure related to the use of nonapproved silicone gel.

Comparison of the Explantation Rate of Poly Implant Prothèse, Allergan, and Pérouse Silicone Breast Implants within the First Four Years after Reconstructive Surgery before the Poly Implant Prothèse Alert by the French Regulatory Authority

PubMed Central

Leduey, Alexandre; Mazouni, Chafika; Leymarie, Nicolas; Alkhashnam, Heba; Sarfati, Benjamin; Garbay, Jean-Rémi; Gaudin, Amélie; Kolb, Frédéric; Rimareix, Françoise

2015-01-01

Background. In March 2010, ANSM (Agence Nationale de Sécurité du Medicament), the French Medical Regulatory Authority, withdrew Poly Implant Prothèse (PIP) breast implants from the market due to the use of non-medical-grade silicone gel. The aim of this study was to compare the removal rate (and reasons thereof) of breast implants produced by different manufacturers before the ANSM alert. Materials and Methods. From October 2006 to January 2010, 652 women received 944 implants after breast cancer surgery at the Gustave Roussy Comprehensive Cancer Center, Paris (France). The complications and removal rates of the different implant brands used (PIP, Allergan, and Pérouse) were evaluated and compared. Results. PIP implants represented 50.6% of the used implants, Allergan 33.4%, and Pérouse 16%. The main reasons for implant removal were patient dissatisfaction due to aesthetic problems (43.2%), infection (22.2%), and capsular contracture (13.6%). Two years after implantation, 82% of Pérouse implants, 79% of PIP, and 79% of Allergan were still in situ. There was no difference in removal rate among implant brands. Conclusion. Before the ANSM alert concerning the higher rupture rate of PIP breast implants, our implant removal rate did not predict PIP implant failure related to the use of nonapproved silicone gel. PMID:26543648

[Drug-food interactions in internal medicine: What physicians should know?].

PubMed

Mouly, S; Morgand, M; Lopes, A; Lloret-Linares, C; Bergmann, J-F

2015-08-01

Orally administered medications may interact with various fruits, vegetables, herbal medicines, functional foods or dietary supplements. Drug-food interactions, which are mostly unknown from prescribers, including internists, may be responsible for changes in drug plasma concentrations, which may decrease efficacy or led to sometimes life-threatening toxicity. Aging, concomitant medications, transplant recipients, patients with cancer, malnutrition, HIV infection and those receiving enteral or parenteral feeding are at increased risk of drug-food interactions. This review focused on the most clinically relevant drug-food interactions, including those with grapefruit juice, Saint-John's Wort, enteral or parenteral nutrition, their respective consequences in the clinical setting in order to provide thoughtful information for internists in their routine clinical practice. Specific clinical settings are also detailed, such as the Ramadan or multiple medications especially in elderly patients. Drug-food interactions are also presented with respect to the main therapeutic families, including the non-steroidal anti-inflammatory drugs, analgesics, cardiovascular medications, warfarin as well as new oral anticoagulants, anticancer drugs and immunosuppressant medications. Considerable effort has been achieved to a better understanding of food-drug interactions and increase clinicians' ability to anticipate their occurrence and consequences in clinical practice. Describing the frequency of relevant food-drug interactions in internal medicine is paramount in order to optimize patient care and drug dosing on an individual basis as well as to increase patients and doctors information. Copyright © 2015 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

[Clinical pharmacist influence at hospital to prevent overdosed prescription of acetaminophen].

PubMed

Viguier, F; Roessle, C; Zerhouni, L; Rouleau, A; Benmelouka, C; Chevallier, A; Chast, F; Conort, O

2016-11-01

The recommended daily dose of acetaminophen is limited to 60mg/kg/day with a maximum of 3g daily dose in adults weighing less than 50kg or in patients undergoing certain risk factors. This study aimed at assessing the fulfillment of those recommendations and the possible impact on the liver dysfunction at supra-therapeutic doses of acetaminophen. This study was performed one day in 9 services. Patients characteristics, acetaminophen dose, daily dose administered, physiopathological aspects, markers of liver damage were collected. Among 542 prescriptions analyzed, 343 of them contained acetaminophen. The median age of patients studied was 81 years and one third weighed less than 50kg. The main risk factor of supra-therapeutic prescriptions was the lack of dose acetaminophen based on weight with 14% patients concerned and this risk raised at 17% when the pathophysiological conditions were included. The presence of pharmacists in medicals departments was more effective than the use of informatics programs limiting the dose systematically to 3g/day, or a distant pharmaceutical validation from care services to reduce the risk of acetaminophen overdose. According to the statement of administrations, only 4 of 49 patients received doses above 60mg/kg/day with a low impact on liver function tests. The continuous presence in pharmaceutical care services was the most effective measure to ensure effective implementation of acetaminophen recommendations. Copyright © 2016 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

[Pharmacist's interview with type 2 diabetes: Development of a follow-up form].

PubMed

Garcia Santos, P; Bernard, L; Bedhomme, S; Blum, S; Gravelin, M; Leonce, M F; McLeod, M L; Roche, B; Roche, M C; Van Lander, A; Sautou, V; Vennat, B

2017-09-01

Type 2 diabetes is a major public health concern because of its prevalence, the severity of complications and the financial implications. Compliance and patient's autonomy in medications intake play key roles in the success of treatment. Pharmacists' interviews ensure an optimized and individual follow-up. Type 2 diabetes is not one of the targeted diseases to perform pharmacists' interviews on under Health Insurance. We thus judged useful to contribute to their development. We applied a cross-disciplinary methodological process in order to define the specifications of the follow-up form useful to conduct the pharmacist's interview 1 by focusing on the identification of a non-compliance and its origins. A feasibility study was carried out in order to check its workability to the pharmacy practice. The follow-up form, associated with a pharmacist practical guide, includes 3 parts: (1) General informations, (2) Survey establishing patient's knowledge, (3) Summary including a level of knowledge assessment grid. Outcomes provide a long but appropriate-felt duration, few difficulties to conduct the interview and a proven usefulness in 90% of all cases that make the follow-up form suitable to the pharmacy practice. This tool could serve as a model for the pharmacist to conduct his future interviews for the type 2 diabetes patients, thus improving patient care, together with other health professionals. Copyright © 2017 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

Circular flow patterns induced by ciliary activity in reconstituted human bronchial epithelium

NASA Astrophysics Data System (ADS)

Viallat, Annie; Khelloufi, Kamel; Gras, Delphine; Chanez, Pascal; Aix Marseille Univ., CNRS, CINaM, Marseille, France Team; Aix Marseille Univ., CNRS, Inserm, LAI, Marseille, France Team

2016-11-01

Mucociliary clearance is the transport at the surface of airways of a complex fluid layer, the mucus, moved by the beats of microscopic cilia present on epithelial ciliated cells. We explored the coupling between the spatial organisation and the activity of cilia and the transport of surface fluids on reconstituted cultures of human bronchial epithelium at air-liquid interface, obtained by human biopsies. We reveal the existence of stable local circular surface flow patterns of mucus or Newtonian fluid at the epithelium surface. We find a power law over more than 3 orders of magnitude showing that the average ciliated cell density controls the size of these flow patterns, and, therefore the distance over which mucus can be transported. We show that these circular flow patterns result from the radial linear increase of the local propelling forces (due to ciliary beats) on each flow domain. This linear increase of local forces is induced by a fine self-regulation of both cilia density and orientation of ciliary beats. Local flow domains grow and merge during ciliogenesis to provide macroscopic mucus transport. This is possible only when the viscoelastic mucus continuously exerts a shear stress on beating cilia, revealing a mechanosensitive function of cilia. M. K. Khelloufi thanks the society MedBioMed for financial support. This work was supported by the ANR MUCOCIL project, Grant ANR-13-BSV5-0015 of the French Agence Nationale de la Recherche.

Nematic fluctuations and resonance in iron-based superconductors

NASA Astrophysics Data System (ADS)

Gallais, Yann

The spontaneous appearance of nematicity, a state of matter that breaks rotation but not translation symmetry, is ubiquitous in many iron based superconductors (Fe SC), and has relevance for the cuprates as well. Here I will review recent electronic Raman scattering experiments which report the presence of critical nematic fluctuations in the charge channel in the tetragonal phase of several Fe SC systems. In electron doped Co-BaFe2As2 (Co-Ba122), these fluctuations extend over most of the superconducting dome. Their associated nematic susceptibility shows Curie-Weiss behavior, and its doping dependence suggests the presence of a nematic quantum critical point near optimal TC Similar nematic fluctuations are also observed in FeSe despite the absence of magnetic order, raising the question of the link between nematicity and magnetism in Fe SC. In FeSe I will further contrast the evolution of nematic fluctuations under isoelectronic S substitution and hydrostatic pressures up to 8 GPa, with only the former showing evidence for a nematic quantum critical point. In the superconducting state of Co-Ba122, I will show that a resonance emerges in the Raman spectra near the nematic quantum critical point. This nematic resonance is a clear fingerprint of the coupling between nematic fluctuations and Bogoliubov quasiparticles, and can be thought as the nematic counterpart of the spin resonance observed in neutron scattering experiments. Support from Agence Nationale de la Recherche via ANR Grant ''Pnictides'' is acknowledged.

[How to promote the respect of good infusion practices by meeting health care professionals?].

PubMed

Le Reste, C; Fiedler, A; Dubois, S; Dewailly, A; Le Du, I; Cogulet, V

2016-05-01

Health care professionals often forget that there are risks associated with infusion therapy even if it is a common care. In order to assess this practice and to draw potential improvement actions, an audit of local gravity-flow intravenous infusion practices was conducted. The audit, based on a grid including 66 items from the medical prescription to the end of the infusion therapy administration, was conducted in the 6 units which use the most gravity-flow intravenous infusion devices. A multidisciplinary working group was created to decide and organize priority corrective measures in order to improve infusion practices and quality of healthcare. The audit enabled to observe 90hours of nurse's practices (96 infusions) and highlighted heterogeneity in infusion, in some cases inappropriate infusion practices and misuse of infusion devices. We found 4 main issues: labelling infusion therapy, training of health care professionals on good practices, support the purchase of infusion pumps and standardize perfusion line. An interactive educational program for nurses (workshops) was organized to enhance the respect of good practices: infusion identification at any time, respect of hygiene rules, flow rate regulation by counting drops, appropriate use of pumps and flow rate regulators. The audit drew up work priorities. The workshops made easier exchanges between professionals and had a warm welcome that's why it is essential to carry on such training. This collaborative approach between pharmacists, nurses, hygienists and biomedical technicians contribute to drug management improvement and promote optimal patient care. Copyright © 2015 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

Development and efficacy assessments of tea seed oil makeup remover.

PubMed

Parnsamut, N; Kanlayavattanakul, M; Lourith, N

2017-05-01

The efficacy of tea seed oil to clean foundation and eyeliner was evaluated. The safe and efficient tea seed oil makeup remover was developed. In vitro cleansing efficacy of makeup remover was UV-spectrophotometric validated. The stability evaluation by means of accelerated stability test was conducted. In vitro and in vivo cleansing efficacy of the removers was conducted in a comparison with benchmark majorly containing olive oil. Tea seed oil cleaned 90.64±4.56% of foundation and 87.62±8.35% of eyeliner. The stable with most appropriate textures base was incorporated with tea seed oil. Three tea seed oil removers (50, 55 and 60%) were stabled. The 60% tea seed oil remover significantly removed foundation better than others (94.48±3.37%; P<0.001) and the benchmark (92.32±1.33%), but insignificant removed eyeliner (87.50±5.15%; P=0.059). Tea seed oil remover caused none of skin irritation as examined in 20 human volunteers. A single-blind, randomized control exhibited that the tea seed oil remover gained a better preference over the benchmark (75.42±8.10 and 70.00±7.78%; P=0.974). The safe and efficient tea seed oil makeup removers had been developed. The consumers' choices towards the makeup remover containing the bio-oils are widen. In vitro cleansing efficacy during the course of makeup remover development using UV-spectrophotometric method feasible for pharmaceutic industries is encouraged. Copyright © 2016 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

[Computerized ranking test in three French universities: Staff experience and students' feedback].

PubMed

Roux, D; Meyer, G; Cymbalista, F; Bouaziz, J-D; Falgarone, G; Tesniere, A; Gervais, J; Cariou, A; Peffault de Latour, R; Marat, M; Moenaert, E; Guebli, T; Rodriguez, O; Lefort, A; Dreyfuss, D; Hajage, D; Ricard, J-D

2016-03-01

The year 2016 will be pivotal for the evaluation of French medical students with the introduction of the first computerized National Ranking Test (ECNi). The SIDES, online electronic system for medical student evaluation, was created for this purpose. All the universities have already organized faculty exams but few a joint computerized ranking test at several universities simultaneously. We report our experience on the organization of a mock ECNi by universities Paris Descartes, Paris Diderot and Paris 13. Docimological, administrative and technical working groups were created to organize this ECNi. Students in their fifth year of medical studies, who will be the first students to sit for the official ECNi in 2016, were invited to attend this mock exam that represented more than 50% of what will be proposed in 2016. A final electronic questionnaire allowed a docimological and organizational evaluation by students. An analysis of ratings and rankings and their distribution on a 1000-point scale were performed. Sixty-four percent of enrolled students (i.e., 654) attended the three half-day exams. No difference in total score and ranking between the three universities was observed. Students' feedback was extremely positive. Normalized over 1000 points, 99% of students were scored on 300 points only. Progressive clinical cases were the most discriminating test. The organization of a mock ECNi involving multiple universities was a docimological and technical success but required an important administrative, technical and teaching investment. Copyright © 2016 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Description and analysis of hospital pharmacies in Madagascar.

PubMed

Ratsimbazafimahefa, H R; Sadeghipour, F; Trouiller, P; Pannatier, A; Allenet, B

2018-05-01

Madagascar's health care system has operated without formal hospital pharmacies for more than two decades. The gradual integration of pharmacists in public hospitals since 2012 will allow the structuring of this field. This study was conducted to characterize the current situation regarding all aspects relating to the general functioning of hospital pharmacies and the services provided. This qualitative research used semi-structured interviews. Interviewees' perceptions about the general organization and functioning of hospital pharmacies and details on services provided were collected. The 16 interviewees were Ministry of Health staff members involved in hospital pharmacy, hospital directors, medical staff members and hospital pharmacy managers. Interviews were recorded, translated into French if conducted in Malagasy, and fully transcribed. Verbatim transcripts were coded according to the themes of hospital pharmacy and topical content analysis was performed. The principal issue perceived by interviewees was the heterogeneity of the system in terms of technical and financing management, with a main impact on the restocking of pharmaceutical products. The drug supply chain is not under control: no internal procedure has been established for the selection of pharmaceutical products, the quantification of needs is complex, stock management is difficult to supervise, a standard prescription protocol is lacking, dispensing is performed by unqualified staff, no pharmaceutical preparation is manufactured in the hospitals and administration occurs without pharmaceutical support. Progressive structuring of efficient hospital pharmacy services using the Basel statements for the future of hospital pharmacy is urgently needed to improve health care in Madagascar. Copyright © 2017 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

Immunoglobulin G particles manufacturing by spray drying process for pressurised metered dose inhaler formulations.

PubMed

Carli, V; Menu-Bouaouiche, L; Cardinael, P; Benissan, L; Coquerel, G

2018-07-01

The objective of this work is to show the feasibility of manufacturing from a spray drying process particles containing immunoglobulin G capable of being administered by inhalation via a pressurized metered dose inhaler. Spray drying were made from aqueous solutions containing IgG and two types of excipients, mannitol and trehalose, with two ratios: 25% w/w and 75%w/w. The physicochemical and aerodynamic properties of the powders obtained were characterized just after manufacturing and after 1 month of storage at 40°C/75% RH according to criteria defined as needed to satisfy an inhaled formulation with a pressurized metered dose inhaler. Maintain of the biological activity and the structure of IgG after atomization was also tested by slot blot and circular dichroism. All spray-dried powders presented a median diameter lower than 5μm. The powders atomized with trehalose showed a solid state more stable than those atomized with mannitol. All atomized powders were in the form of wrinkled particles regardless the nature and the ratios of excipients. The results showed that the aerosolisation properties were compliant with the target, independently of the excipient used at a ratio of 25% w/w IgG-excipient. Moreover, the addition of excipient during the atomization process the denaturation of IgG was limited. This study showed that the use of trehalose as excipient could satisfy the requirements of an inhaled formulation with a pressurized metered dose inhaler. Copyright © 2018 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

Deep dermatophytosis and inherited CARD9 deficiency.

PubMed

Lanternier, Fanny; Pathan, Saad; Vincent, Quentin B; Liu, Luyan; Cypowyj, Sophie; Prando, Carolina; Migaud, Mélanie; Taibi, Lynda; Ammar-Khodja, Aomar; Stambouli, Omar Boudghene; Guellil, Boumediene; Jacobs, Frederique; Goffard, Jean-Christophe; Schepers, Kinda; Del Marmol, Véronique; Boussofara, Lobna; Denguezli, Mohamed; Larif, Molka; Bachelez, Hervé; Michel, Laurence; Lefranc, Gérard; Hay, Rod; Jouvion, Gregory; Chretien, Fabrice; Fraitag, Sylvie; Bougnoux, Marie-Elisabeth; Boudia, Merad; Abel, Laurent; Lortholary, Olivier; Casanova, Jean-Laurent; Picard, Capucine; Grimbacher, Bodo; Puel, Anne

2013-10-31

Deep dermatophytosis is a severe and sometimes life-threatening fungal infection caused by dermatophytes. It is characterized by extensive dermal and subcutaneous tissue invasion and by frequent dissemination to the lymph nodes and, occasionally, the central nervous system. The condition is different from common superficial dermatophyte infection and has been reported in patients with no known immunodeficiency. Patients are mostly from North African, consanguineous, multiplex families, which strongly suggests a mendelian genetic cause. We studied the clinical features of deep dermatophytosis in 17 patients with no known immunodeficiency from eight unrelated Tunisian, Algerian, and Moroccan families. Because CARD9 (caspase recruitment domain-containing protein 9) deficiency has been reported in an Iranian family with invasive fungal infections, we also sequenced CARD9 in the patients. Four patients died, at 28, 29, 37, and 39 years of age, with clinically active deep dermatophytosis. No other severe infections, fungal or otherwise, were reported in the surviving patients, who ranged in age from 37 to 75 years. The 15 Algerian and Tunisian patients, from seven unrelated families, had a homozygous Q289X CARD9 allele, due to a founder effect. The 2 Moroccan siblings were homozygous for the R101C CARD9 allele. Both alleles are rare deleterious variants. The familial segregation of these alleles was consistent with autosomal recessive inheritance and complete clinical penetrance. All the patients with deep dermatophytosis had autosomal recessive CARD9 deficiency. Deep dermatophytosis appears to be an important clinical manifestation of CARD9 deficiency. (Funded by Agence Nationale pour la Recherche and others.).

Deep Dermatophytosis and Inherited CARD9 Deficiency

PubMed Central

Vincent, Quentin B.; Liu, Luyan; Cypowyj, Sophie; Prando, Carolina; Migaud, Mélanie; Taibi, Lynda; Ammar-Khodja, Aomar; Stambouli, Omar Boudghene; Guellil, Boumediene; Jacobs, Frederique; Goffard, Jean-Christophe; Schepers, Kinda; del Marmol, Véronique; Boussofara, Lobna; Denguezli, Mohamed; Larif, Molka; Bachelez, Hervé; Michel, Laurence; Lefranc, Gérard; Hay, Rod; Jouvion, Gregory; Chretien, Fabrice; Fraitag, Sylvie; Bougnoux, Marie-Elisabeth; Boudia, Merad

2014-01-01

BACKGROUND Deep dermatophytosis is a severe and sometimes life-threatening fungal infection caused by dermatophytes. It is characterized by extensive dermal and subcutaneous tissue invasion and by frequent dissemination to the lymph nodes and, occasionally, the central nervous system. The condition is different from common superficial dermatophyte infection and has been reported in patients with no known immunodeficiency. Patients are mostly from North African, consanguineous, multiplex families, which strongly suggests a mendelian genetic cause. METHODS We studied the clinical features of deep dermatophytosis in 17 patients with no known immunodeficiency from eight unrelated Tunisian, Algerian, and Moroccan families. Because CARD9 (caspase recruitment domain–containing protein 9) deficiency has been reported in an Iranian family with invasive fungal infections, we also sequenced CARD9 in the patients. RESULTS Four patients died, at 28, 29, 37, and 39 years of age, with clinically active deep dermatophytosis. No other severe infections, fungal or otherwise, were reported in the surviving patients, who ranged in age from 37 to 75 years. The 15 Algerian and Tunisian patients, from seven unrelated families, had a homozygous Q289X CARD9 allele, due to a founder effect. The 2 Moroccan siblings were homozygous for the R101C CARD9 allele. Both alleles are rare deleterious variants. The familial segregation of these alleles was consistent with autosomal recessive inheritance and complete clinical penetrance. CONCLUSIONS All the patients with deep dermatophytosis had autosomal recessive CARD9 deficiency. Deep dermatophytosis appears to be an important clinical manifestation of CARD9 deficiency. (Funded by Agence Nationale pour la Recherche and others.) PMID:24131138

Orbit determination support of the Ocean Topography Experiment (TOPEX)/Poseidon operational orbit

NASA Technical Reports Server (NTRS)

Schanzle, A. F.; Rovnak, J. E.; Bolvin, D. T.; Doll, C. E.

1993-01-01

The Ocean Topography Experiment (TOPEX/Poseidon) mission is designed to determine the topography of the Earth's sea surface over a 3-year period, beginning shortly after launch in July 1992. TOPEX/Poseidon is a joint venture between the United States National Aeronautics and Space Administration (NASA) and the French Centre Nationale d'Etudes Spatiales. The Jet Propulsion Laboratory is NASA's TOPEX/Poseidon project center. The Tracking and Data Relay Satellite System (TDRSS) will nominally be used to support the day-to-day orbit determination aspects of the mission. Due to its extensive experience with TDRSS tracking data, the NASA Goddard Space Flight Center (GSFC) Flight Dynamics Facility (FDF) will receive and process TDRSS observational data. To fulfill the scientific goals of the mission, it is necessary to achieve and maintain a very precise orbit. The most stringent accuracy requirements are associated with planning and evaluating orbit maneuvers, which will place the spacecraft in its mission orbit and maintain the required ground track. To determine if the FDF can meet the TOPEX/Poseidon maneuver accuracy requirements, covariance analysis was undertaken with the Orbit Determination Error Analysis System (ODEAS). The covariance analysis addressed many aspects of TOPEX/Poseidon orbit determination, including arc length, force models, and other processing options. The most recent analysis has focused on determining the size of the geopotential field necessary to meet the maneuver support requirements. Analysis was undertaken with the full 50 x 50 Goddard Earth Model (GEM) T3 field as well as smaller representations of this model.

Rotational Spectroscopy of Isocyanic Molecules: Allyl Isocyanide and Diisocyanomethane

NASA Astrophysics Data System (ADS)

Motiyenko, R. A.; Margules, L.; Haykal, I.; Huet, T. R.; Cocinero, E. J.; Ecija, P.; Fernandez, J. A.; Castano, F.; Lesarri, A.; Guillemin, J.-C.

2012-06-01

Isocyanides are less stable isomers of nitriles and some of them have already been observed in the interstellar medium (HNC, CH_3NC, HCCNC). But still there exists a lack of experimental spectroscopic data on simple isocyanic molecules that can represent potential astrophysical interest. In this view we have performed high resolution studies of rotational spectra of allyl isocyanide (CH_2=CH--CH_2--NC) and diisocyanomethane (CN--CH_2--NC). The rotational spectra of allyl isocyanide have been measured in the frequency range 6 -- 18 GHz by means of FTMW spectrometer in Bilbao and in the frequency range 150 -- 945 GHz by means of classic absorption spectroscopy in Lille. Two stable confomers of allyl isocyanide have been observed in both series of measurements. In addition, all 13C-monosubstituted isotopologues and 15N isotopologues were detected in natural abundance. Due to much lower kinetic stability the rotational spectrum of diisocyanomethane has been measured only in absorption using the Lille spectrometer. The spectral assignments have been supported by high-level quantum chemical calculations. For both molecules accurate sets of rotational and centrifugal distortion constants (up to the octics) have been produced. As a result, reliable predictions of transitions frequencies suitable for astrophysical detection have been obtained for both molecules. Finally, the effective and substitution structures were determined for the two conformers of allyl isocyanide, comparing the result with ab initio data. This work is supported by Centre Nationale d'Etudes Spatiales (CNES), Action sur Projet Physico-Chimie du Milieu Interstellaire (PCMI-CNRS) and by the contract ANR-08-BLAN-0054. Spanish part acknowledges funding from the MICINN and the MINECO.

Satellite remote sensing of hailstorms in France

NASA Astrophysics Data System (ADS)

Melcón, Pablo; Merino, Andrés; Sánchez, José Luis; López, Laura; Hermida, Lucía

2016-12-01

Hailstorms are meteorological phenomena of great interest to the scientific community, owing to their socioeconomic impact, which is mainly on agricultural production. With its global coverage and high spatial and temporal resolution, satellite remote sensing can contribute to monitoring of such events through the development of appropriate techniques. This paper presents an extensive validation in the south of France of a hail detection tool (HDT) developed for the Middle Ebro Valley (MEV). The HDT is based on consecutive application of two filters, a convection mask (CM) and hail mask (HM), using spectral channels of the Meteosat Second Generation (MSG) satellite. The south of France is an ideal area for studying hailstorms, because there is a robust database of hail falls recorded by an extensive network of hailpads managed by the Association Nationale d'Etude et de Lutte contre les Fleáux Atmosphériques (ANELFA). The results show noticeably poorer performance of the HDT in France relative to that in the MEV, with probability of detection (POD) 60.4% and false alarm rate (FAR) 26.6%. For this reason, a new tool to suit the characteristics of hailstorms in France has been developed. The France Hail Detection Tool (FHDT) was developed using logistic regression from channels of the Spinning Enhanced Visible and Infrared Imager (SEVIRI) sensor of the MSG. The FHDT was validated, resulting in POD 69.3% and FAR 15.4%, thus improving hail detection in the study area as compared with the previous tool. The new tool was tested in a case study with satisfactory results, supporting its future practical application.

Attitude of pregnant women towards HIV testing in Abidjan, Côte d'Ivoire and Bobo-Dioulasso, Burkina Faso. DITRAME Study Group (ANRS 049 Clinical Trial). Diminution de la Transmission Mère Enfant du VIH. Agence Nationale de Recherches sur le SIDA.

PubMed

Cartoux, M; Msellati, P; Meda, N; Welffens-Ekra, C; Mandelbrot, L; Leroy, V; Van de Perre, P; Dabis, F

1998-12-03

To evaluate the attitude of pregnant women towards HIV testing in two cities of West Africa: Abidjan, Côte d'Ivoire and Bobo-Dioulasso, Burkina Faso. In the context of a clinical trial to prevent HIV vertical transmission, HIV counselling and testing was offered systematically to women attending antenatal clinics. Informed consent was obtained and test results were given anonymously. Multiple logistic regression was performed to identify factors associated with refusal for testing and failure to return for test results. A total of 9724 pregnant women were interviewed from January 1995 to September 1996. In Abidjan (n=5766) and Bobo-Dioulasso (n=3958), 78 and 92.4% of the women consented to HIV testing, respectively, and 58.4 and 81.8% of them returned for the test results disclosure, respectively. In the two sites, the counsellors themselves and high educational level of the women appeared to be related to refusal of the test, whereas last trimester gestation was associated with failure to return for test results. In Abidjan, foreigners and employees were more likely to refuse testing, and HIV-infected women were three times less likely to return for results than uninfected women. Future implementation of interventions to reduce vertical transmission of HIV that require antenatal HIV testing and counselling will have to solve issue of acceptability of HIV testing by pregnant women.

Vitamin C supplement intake and postmenopausal breast cancer risk: interaction with dietary vitamin C.

PubMed

Cadeau, Claire; Fournier, Agnès; Mesrine, Sylvie; Clavel-Chapelon, Françoise; Fagherazzi, Guy; Boutron-Ruault, Marie-Christine

2016-07-01

Experimental and epidemiologic studies have yielded conflicting results on the relation between vitamin C intake and breast cancer risk. We investigated the relation between vitamin C supplement intake and breast cancer risk while considering dietary vitamin C intake. Between 1995 and 2008, 2482 invasive breast cancer cases occurred in 57,403 postmenopausal women from the Etude Epidémiologique auprès de femmes de la Mutuelle Générale de l'Education Nationale (E3N) prospective cohort during 581,085 person-years. We estimated vitamin C intake from foods with the use of a validated food-frequency questionnaire that was sent to subjects in 1993-1995 and vitamin C supplement use via questionnaires sent in 1995, 2000, 2002, and 2005. Multivariable HRs (95% CIs) for primary invasive breast cancer were estimated with the use of Cox regression models. All statistical tests were 2-sided. Vitamin C supplement use (ever compared with never) was not associated with breast cancer risk overall; it was associated with higher breast cancer risk in women in the fourth quartile of vitamin C intake from foods (HR: 1.32; 95% CI: 1.04, 1.67) but not in other quartiles of dietary vitamin C intake (P-interaction = 0.03). We observed that vitamin C supplement use was associated with increased postmenopausal breast cancer risk in women with high vitamin C intake from foods. Our data suggest a potential U- or J-shaped relation between total vitamin C intake and postmenopausal breast cancer risk that deserves further investigation. © 2016 American Society for Nutrition.

The Mysterious sdO X-ray Binary BD+37°442

NASA Astrophysics Data System (ADS)

Heber, U.; Geier, S.; Irrgang, A.; Schneider, D.; Barbu-Barna, I.; Mereghetti, S.; La Palombara, N.

2014-04-01

Pulsed X-ray emission in the luminous, helium-rich sdO BD +37°442 has recently been discovered (La Palombara et al. 2012). It was suggested that the sdO star has a neutron star or white dwarf companion with a spin period of 19.2 s. After HD 49798, which has a massive white dwarf companion spinning at 13.2 s in an 1.55 day orbit, this is only the second O-type subdwarf from which X-ray emission has been detected. We report preliminary results of our ongoing campaign to obtain time-resolved high-resolution spectroscopy using the CAFE instrument at Calar Alto observatory and SARG at the Telescopio Nationale Galileo. Atmospheric parameters were derived via a quantitative NLTE spectral analysis. The line fits hint at an unusually large projected rotation velocity. Therefore it seemed likely that BD +37°442 is a binary similar to HD 49798 and that the orbital period is also similar. The level of X-ray emission from BD +37°442 could be explained by accretion from the sdO wind by a neutron star orbiting at a period of less than ten days. Hence, we embarked on radial velocity monitoring in order to derive the binary parameters of the BD+37°442 system and obtained 41 spectra spread out over several month in 2012. Unlike for HD 49798, no radial velocity variations were found and, hence, there is no dynamical evidence for the existence of a compact companion yet. The origin of the pulsed X-ray emission remains as a mystery.

Long-term association of food and nutrient intakes with cognitive and functional decline: a 13-year follow-up study of elderly French women.

PubMed

Vercambre, Marie-Noël; Boutron-Ruault, Marie-Christine; Ritchie, Karen; Clavel-Chapelon, Françoise; Berr, Claudine

2009-08-01

The objective of the present study was to determine the potential long-term impact of dietary habits on age-related decline among 4809 elderly women (born between 1925 and 1930) in the 'Etude Epidémiologique de Femmes de la Mutuelle Générale de l'Education Nationale' (E3N) study, a French epidemiological cohort. In 1993, an extensive diet history self-administered questionnaire was sent to all participants, and in 2006 another questionnaire on instrumental activities of daily living (IADL) and recent cognitive change was sent to a close relative or friend of each woman. Logistic models adjusted for socio-demographic, lifestyle and health factors were performed to evaluate associations between habitual dietary intakes and two outcomes of interest based on the informant response: recent cognitive decline and IADL impairment. Recent cognitive decline was associated with lower intakes of poultry, fish, and animal fats, as well as higher intakes of dairy desserts and ice-cream. IADL impairment was associated with a lower intake of vegetables. The odds of recent cognitive decline increased significantly with decreasing intake of soluble dietary fibre and n-3 fatty acids but with increasing intake of retinol. The odds of IADL impairment increased significantly with decreasing intakes of vitamins B2, B6 and B12. These results are consistent with a possible long-term neuroprotective effect of dietary fibre, n-3 polyunsaturated fats and B-group vitamins, and support dietary intervention to prevent cognitive decline.

[Which information is given during the purchase of an HIV self-test in a Caen pharmacy? A Comprehensive transversal and observational study using surveys, without modification of practice].

PubMed

Guitton, S; Rabiaza, A

2018-04-16

HIV infection affects about 150,000 people in France. In total, 30,000 of them are unaware of their serostatus. In this context, HIV self-testing has arrived in France in September 2015. The aim of our study was to analyze the level of application of the recommendations during the purchase of an HIV self-test. Our primary hypothesis was that the delivered information is poor. We realized a comprehensive transversal and observational study with surveys without modification of practice in all Caen pharmacies. The primary endpoint was the seller's assessment of the presence or possibility of an emergency situation requiring a post-exposure prophylaxis and suitability assessment of self-testing for the patient's case. Seven pharmacies out of the 41 visited (17.07%) validated our primary endpoint. In all pharmacies, 43.9% had HIV self-tests available for sale. The availabality of the self-tests is linked to the main endpoint (P<0.005). In total, 31.71% of the vendors redirected the patient to another method of screening (general practitioner, sexual health clinic…). The delivered information about HIV self-tests is poor. Improving it would put the pharmacist at the heart of the HIV screening strategy. The introduction of training for the professionnals in our region could be interesting to improve the dispensing of the self-tests. Copyright © 2018 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

[Paraneoplastic Cushing's syndrome, a real diagnostic and therapeutic challenge: A case report and literature review].

PubMed

Meftah, A; Moumen, A; Massine El Hammoumi, M; Hajhouji, S; El Jadi, H; Anas Guerboub, A; Elmoussaoui, S; Mayaudon, H; Hassane Kabiri, E; Hakkou, K; Belmejdoub, G

2015-12-01

Paraneoplastic Cushing's syndrome is a rare cause of endogenous hypercortisolism attributable to ectopic ACTH secretion by non-pituitary tumors. Imaging and biochemical results are often inconclusive and differential diagnosis with Cushing's disease can then be challenging. Moreover, these tumors may be occult and difficult to find and thus the need of new imaging tools such as (18)FDG-PET scan and (18)DOPA-PET scan. We report a 50-year-old man who presented with very aggressive clinical features related to Cushing's syndrome. Biological work-up confirmed the hypercortisolism and was consistent with an ectopic ACTH secretion. Conventional localization techniques failed to show any tumor and bilateral adrenalectomy was performed because of life-threatening complications. Two years later, thoracic computed tomography reveals an 11 mm mass in the left lower pulmonary lobe, (18)FDG-PET scan found a non-specific mild hypermetabolism of the lung nodule, and the (18)DOPA-PET scan confirmed the high uptake of this nodule suggesting an endocrine carcinoma. Histology confirmed a typical carcinoid tumor. The tumor cells stained positive for ACTH, CD56, chromogranin and synaptophysin. This case illustrates the dilemma between the need for morphological diagnosis of the ectopic ACTH source and control of the life-threatening hypercortisolism. (18)FDG-PET scan and (18)DOPA-PET scan should be considered early as a secondary diagnostic tool when conventional imagery fails to show any tumor. Copyright © 2015 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

[Economic impact of etanercept and adalimumab biosimilars on hospitals scale covered by PharmAlp'Ain, a hospitals grouping of orders for health products].

PubMed

Berreur, B; Guerin, F; Christophe, B; Limido, G; Paubel, P

2018-01-01

To evaluate the economic impact of future prescriptions of etanercept and adalimumab biosimilars at the territorial scale covered by PharmAlp'Ain, a hospitals grouping of orders for health products. Determination of the number and status of patients (naive or in continuation of treatment) from the National Database "Datamart de Consommation Inter-Régimes" of health insurance, concerned by a dispensation in a pharmacy of etanercept or adalimumab in 2015. Calculation of potential savings in case of biosimilar requirements according to 3 hypotheses: 63% (rate observed in a previous study) of initiations are treated with biosimiliaries and the others by princeps (H 1 ); all initiations under biosimilars and continuation therapy with the princeps (H 2 ) or all patients are treated with biosimilars (H 3 ). The annual savings are estimated at 237,000 € with the H 1 hypothesis. In the case of H 2 , the expected savings would be 376,200 € per year. In the case of H 3 , savings for the community could reach almost 1,282,800 € per year. The arrival of biosimilars allows significant savings for medicines market. According to the French recommendations in 2016, the expected savings are between the H 1 and H 2 hypothesis. The rate of penetration of biosimilars depends on many factors such as the involvement of health professionals, patient adherence, or health authority recommendations. Copyright © 2017 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

[A pilot study of the professional ethical thinking of Quebec hospital pharmacists and pharmacy students].

PubMed

Guérin, A; Bussières, J-F

2017-01-01

The main objective was to assess the position of Quebec pharmaceutical community about pharmaceutical ethics statements. The second objective was to compare the level of agreement of pharmacy students and hospitals pharmacists. Survey conducted one day given in 2012 and 2013 for students in 2013 and from 29/08/2014 to 02/09/2014 for pharmacists. A questionnaire of eight themes and 43 statements was developed: training and education (5 questions), clinical research (7) advertising and marketing (5) evaluation (5) dispensing medication (4), pharmaceutical care (9) economic aspect (6) and code of ethics (2). A Likert scale with four choices was used to measure the level of agreement. The primary outcome was the difference between the level of agreement of pharmacy students and hospital pharmacists. The Chi 2  test was used. A total of 347 students and 398 pharmacists responded to the survey. There was a statistically significant difference regarding the level of agreement with 28 statements on 43. The differences focused on eight themes of the questionnaire, or training and education (3/5 significantly different questions), clinical research (2/7), advertising and marketing (2/5), Evaluation (4/5) dispensing medication (4/4), pharmaceutical care (5/9), economic aspect (6/6) and ethics (2/2). This study shows that there is a difference between pharmacists and pharmacy students about pharmaceutical ethics statements. Copyright © 2016 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

Adaptive Automation Triggered by EEG-Based Mental Workload Index: A Passive Brain-Computer Interface Application in Realistic Air Traffic Control Environment.

PubMed

Aricò, Pietro; Borghini, Gianluca; Di Flumeri, Gianluca; Colosimo, Alfredo; Bonelli, Stefano; Golfetti, Alessia; Pozzi, Simone; Imbert, Jean-Paul; Granger, Géraud; Benhacene, Raïlane; Babiloni, Fabio

2016-01-01

Adaptive Automation (AA) is a promising approach to keep the task workload demand within appropriate levels in order to avoid both the under - and over-load conditions, hence enhancing the overall performance and safety of the human-machine system. The main issue on the use of AA is how to trigger the AA solutions without affecting the operative task. In this regard, passive Brain-Computer Interface (pBCI) systems are a good candidate to activate automation, since they are able to gather information about the covert behavior (e.g., mental workload) of a subject by analyzing its neurophysiological signals (i.e., brain activity), and without interfering with the ongoing operational activity. We proposed a pBCI system able to trigger AA solutions integrated in a realistic Air Traffic Management (ATM) research simulator developed and hosted at ENAC (É cole Nationale de l'Aviation Civile of Toulouse, France). Twelve Air Traffic Controller (ATCO) students have been involved in the experiment and they have been asked to perform ATM scenarios with and without the support of the AA solutions. Results demonstrated the effectiveness of the proposed pBCI system, since it enabled the AA mostly during the high-demanding conditions (i.e., overload situations) inducing a reduction of the mental workload under which the ATCOs were operating. On the contrary, as desired, the AA was not activated when workload level was under the threshold, to prevent too low demanding conditions that could bring the operator's workload level toward potentially dangerous conditions of underload.

Safety and immunogenicity of a live recombinant canarypox virus expressing HIV type 1 gp120 MN MN tm/gag/protease LAI (ALVAC-HIV, vCP205) followed by a p24E-V3 MN synthetic peptide (CLTB-36) administered in healthy volunteers at low risk for HIV infection. AGIS Group and L'Agence Nationale de Recherches sur Le Sida.

PubMed

Salmon-Céron, D; Excler, J L; Finkielsztejn, L; Autran, B; Gluckman, J C; Sicard, D; Matthews, T J; Meignier, B; Valentin, C; El Habib, R; Blondeau, C; Raux, M; Moog, C; Tartaglia, J; Chong, P; Klein, M; Milcamps, B; Heshmati, F; Plotkin, S

1999-05-01

A live recombinant canarypox vector expressing HIV-1 gpl20 MN tm/gag/protease LAI (ALVAC-HIV, vCP205) alone or boosted by a p24E-V3 MN synthetic peptide (CLTB-36) was tested in healthy volunteers at low risk for HIV infection for their safety and immunogenicity. Both antigens were well tolerated. ALVAC-HIV (vCP205) induced low levels of neutralizing antibodies against HIV-1 MN in 33% of the volunteers. None of them had detectable neutralizing antibodies against a nonsyncytium-inducing HIV-1 clade B primary isolate (Bx08). After the fourth injection of vCP205, CTL activity was detected in 33% of the volunteers and was directed against Env, Gag, and Pol. This activity was mediated by both CD4+ and CD8+ lymphocytes. On the other hand, the CLTB-36 peptide was poorly immunogenic and induced no neutralizing antibodies or CTLs. Although the ALVAC-HIV (vCP205) and CLTB-36 prime-boost regimen was not optimal, further studies with ALVAC-HIV (vCP205) are warranted because of its clear induction of a cellular immune response and utility as a priming agent for other subunit antigens such as envelope glycoproteins, pseudoparticles, or new peptides.

Lead exposure from food: the German LExUKon project.

PubMed

Schneider, Klaus; Schwarz, Markus A; Lindtner, Oliver; Blume, Katrin; Heinemeyer, Gerhard

2014-01-01

Lead is a highly toxic contaminant with food being the major source of exposure for the general public. The second German food consumption survey (Nationale Verzehrsstudie II - NVS II) with about 20 000 participants (15 371 for dietary history interviews used for this study) allowed for an updated exposure assessment for the German population. Based on these comprehensive data, information on consumption of 545 individual food items by the German population was generated. Lead concentrations in food were compiled from the German food monitoring programme, European countries' authority programmes and the published literature, covering the years from 2000 to 2009, and were multiplied with consumption data to obtain estimates of lead intake from food. Average lead concentrations per main food group were highest for meat (including offal), followed by fish (including seafood), vegetables and cereals. Due to high consumption, beverages contributed most to the intake of the general public, followed by main groups vegetables, fruits & nuts and cereals. Lead intake from food was estimated to be 0.53 and 0.72 µg kg(-1) bw and day for average and high-end consumers, respectively. This is close to (average consumers) respectively above (high-end consumers) a reference value derived from a recent health risk evaluation performed by EFSA, using the benchmark approach. Uncertainties in these estimates pertain to the influence of values below the limit of quantification and some foods not considered due to lacking occurrence data. In conclusion, the estimated lead intake of the German population from food is still close to health-based reference values. Further efforts to reduce lead intake are required.

[Diagnostic value of selective anorexia in pathological weight loss].

PubMed

Braquet, P; Mercier, G; Reynes, J; Jeandel, C; Pinzani, V; Guilpain, P; Rivière, S; Le Quellec, A

2016-02-01

The diagnostic value of selective anorexia is debated. Some authors have suggested an association between meat aversion and cancer, but most do not use it as a diagnostic tool. We aimed to characterize anorexia of different diseases to search for an association between selective aversions and diagnostic groups. All the patients admitted to three departments of a teaching hospital were included consecutively for 22months if they had more than 10 % weight loss in less than one year. Patients were excluded if history taking was not reliable, or if they suffered from anorexia nervosa. We compiled diagnoses at discharge and validated them six months later. We used logistic regression to identify independent factors associated with selective anorexia. Inclusion criteria were met in 106patients (female 44 %, median age 65years). Most frequent diagnoses were: cancer (36 %), infection (35 %), digestive diseases (19 %), non organic diseases (21 %). Recent selective anorexia was found in 46 % of the cases. It was significantly associated with female gender (P=0.002), marginally with young age (P=0.069) and long duration of weight loss (P=0.079). Opioid use at admission was negatively associated with selective anorexia (P=0.001). No specific diagnostic category was found to be associated. Selective anorexia does not appear to be a useful symptom to investigate pathological weight loss. It behaves more like a non-specific reactivation by current disease of earlier latent personal food aversions. Copyright © 2015 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Adaptive Automation Triggered by EEG-Based Mental Workload Index: A Passive Brain-Computer Interface Application in Realistic Air Traffic Control Environment

PubMed Central

Aricò, Pietro; Borghini, Gianluca; Di Flumeri, Gianluca; Colosimo, Alfredo; Bonelli, Stefano; Golfetti, Alessia; Pozzi, Simone; Imbert, Jean-Paul; Granger, Géraud; Benhacene, Raïlane; Babiloni, Fabio

2016-01-01

Adaptive Automation (AA) is a promising approach to keep the task workload demand within appropriate levels in order to avoid both the under- and over-load conditions, hence enhancing the overall performance and safety of the human-machine system. The main issue on the use of AA is how to trigger the AA solutions without affecting the operative task. In this regard, passive Brain-Computer Interface (pBCI) systems are a good candidate to activate automation, since they are able to gather information about the covert behavior (e.g., mental workload) of a subject by analyzing its neurophysiological signals (i.e., brain activity), and without interfering with the ongoing operational activity. We proposed a pBCI system able to trigger AA solutions integrated in a realistic Air Traffic Management (ATM) research simulator developed and hosted at ENAC (École Nationale de l'Aviation Civile of Toulouse, France). Twelve Air Traffic Controller (ATCO) students have been involved in the experiment and they have been asked to perform ATM scenarios with and without the support of the AA solutions. Results demonstrated the effectiveness of the proposed pBCI system, since it enabled the AA mostly during the high-demanding conditions (i.e., overload situations) inducing a reduction of the mental workload under which the ATCOs were operating. On the contrary, as desired, the AA was not activated when workload level was under the threshold, to prevent too low demanding conditions that could bring the operator's workload level toward potentially dangerous conditions of underload. PMID:27833542

[Perspective of the transition from reusable instruments to single use ancillary in orthopedic surgery].

PubMed

Steelandt, J; Vaillant, T; Duhamel, C; Haghighat, S; Féron, J-M; Paubel, P; Cordonnier, A-L

2018-03-01

Since 2009, single-use (SU) ancillaries for total knee arthroplasty (TKA) and total hip arthroplasty (THA) have been marketed to replace reusable ancillaries. The concept is not innovative but their use in orthopedics is still uncommon. An assessment has been done for the use of SU ancillary in Assistance publique-hôpitaux de Paris with the consequences for the patient, the surgeon and the hospital. A technical and a clinical review has been done with those devices in 2015. The economic and organizational impacts were identified and submitted for opinion to committee experts in orthopedics. Three SU ancillaries are commercialized. No clinical studies are currently available. There is no reimbursement for SU ancillaries whereas reusable ancillaries are included in prosthesis reimbursement price. Although SU ancillaries (TKA and THA) saving costs for sterilization, the annual additional budget estimated for their purchase would approximately be 2.5 times higher. Nevertheless, indirect savings could be also considered in the long-term period (global costs for sterilization, volume effect…). For the same quality, according to the experts, organizational impacts are low for the patient and the surgeon but potentially important for the hospital, the nursing and pharmaceutical staff, and logistical activities. On logistic, clinical and financial aspects, SU ancillaries need more evaluation. The switch to SU ancillaries allows saving sterilization costs and time, and provided an immediate mobilization of the equipment but their interest must be demonstrated by clinical and economic data. Copyright © 2017 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

[Tranexamic acid as first-line emergency treatment for episodes of bradykinin-mediated angioedema induced by ACE inhibitors].

PubMed

Beauchêne, C; Martins-Héricher, J; Denis, D; Martin, L; Maillard, H

2018-05-04

Episodes of acquired bradykinin-mediated angioedema due to angiotensin-converting enzyme (ACE) inhibitors may result in fatal outcomes. There is no consensus regarding emergency pharmacological management of these episodes. Treatment options include icatibant and C1INH concentrate. Tranexamic acid is administered for moderate episodes. Its efficacy in the treatment of ACE inhibitor-induced episodes of angioedema is not established. The aim of this retrospective study is to assess the benefits of emergency tranexamic acid administration in the management of ACE inhibitor-induced episodes of angioedema. Retrospective analysis of the medical files of patients who consulted between 2010 and 2016 in two French tertiary care hospitals for a bradykinic angioedema attributed to an ACE treatment. All of them had received tranexamic acid as a first line treatment. Thirty three patients who had experienced severe episode of angioedema were included. Twenty seven patients showed significant improvement when treated with tranexamic acid alone. The six remaining patients were treated with icatibant (5/33) or C1INH concentrate (1/33), due to partial improvement after tranexamic acid therapy. None of the patients were intubated, no fatalities were recorded and no side effects were reported. Tranexamic acid is an easily accessible and affordable therapy that may provide effective treatment for ACE inhibitor-induced episodes of angioedema. It may help while waiting for a more specific treatment (icatibant and C1INH concentrate) that is at times unavailable in emergency departments. Copyright © 2018 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Can shale safely host US nuclear waste?

USGS Publications Warehouse

Neuzil, C.E.

2013-01-01

"Even as cleanup efforts after Japan’s Fukushima disaster offer a stark reminder of the spent nuclear fuel (SNF) stored at nuclear plants worldwide, the decision in 2009 to scrap Yucca Mountain as a permanent disposal site has dimmed hope for a repository for SNF and other high-level nuclear waste (HLW) in the United States anytime soon. About 70,000 metric tons of SNF are now in pool or dry cask storage at 75 sites across the United States [Government Accountability Office, 2012], and uncertainty about its fate is hobbling future development of nuclear power, increasing costs for utilities, and creating a liability for American taxpayers [Blue Ribbon Commission on America’s Nuclear Future, 2012].However, abandoning Yucca Mountain could also result in broadening geologic options for hosting America’s nuclear waste. Shales and other argillaceous formations (mudrocks, clays, and similar clay-rich media) have been absent from the U.S. repository program. In contrast, France, Switzerland, and Belgium are now planning repositories in argillaceous formations after extensive research in underground laboratories on the safety and feasibility of such an approach [Blue Ribbon Commission on America’s Nuclear Future, 2012; Nationale Genossenschaft für die Lagerung radioaktiver Abfälle (NAGRA), 2010; Organisme national des déchets radioactifs et des matières fissiles enrichies, 2011]. Other nations, notably Japan, Canada, and the United Kingdom, are studying argillaceous formations or may consider them in their siting programs [Japan Atomic Energy Agency, 2012; Nuclear Waste Management Organization (NWMO), (2011a); Powell et al., 2010]."

[Nocardiosis: A retrospective case series of 19 patients].

PubMed

Le Coustumier, E M; Denes, E; Martin, C; Weinbreck, P

2017-02-01

Nocardiosis are uncommon. The diagnosis may be difficult, with significant morbidity and mortality, often occurring on frail patients. Few data are available in France. A retrospective single center study was conducted from 2002 to 2014 and included all patients with at least one positive microbiological sample for Nocardia with a follow-up in our hospital. Nineteen patients, including 15 men, were included with a mean age of 58 years (25-85). Seventeen had a risk factor (lung diseases [13], corticosteroids [12], solid neoplasia [2], HIV infection [2], diabetes mellitus [3], kidney transplant [2], lymphopenia [1]). Infections' locations were: pulmonary (12), brain (3), skin (2), lymph node (1) and corneal (1). The slow growth leads to a median of 35 days for a positive result (3-95). Nine species were identified. Fifteen patients (79%) received one or more lines of antibiotics including: cotrimoxazole (9), amoxicillin (7) cefotaxime/ceftriaxone (7) imipenem (3), or amikacin (3). The average duration of antibiotic therapy was 207 days. Four patients did not receive antibiotics due to a late result or a bacterial co-infection masking nocardiosis. Five patients died (26%) including 2 with cerebral nocardiosis. Six patients were cured, 4 suffered a relapse, 4 had an unknown evolution, and 1 was still treated. Our study shows that nocardiosis is a disease difficult to treat. A better understanding of this type of infection is necessary. Copyright © 2016 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Observational and Modeling-based Study of Corsica Thunderstorms: Preparation of the EXAEDRE Airborne Campaign

NASA Astrophysics Data System (ADS)

Defer, E.; Coquillat, S.; Lambert, D.; Pinty, J. P.; Prieur, S.; Caumont, O.; Labatut, L.; Nuret, M.; Blanchet, P.; Buguet, M.; Lalande, P.; Labrouche, G.; Pedeboy, S.; Lojou, J. Y.; Schwarzenboeck, A.; Delanoë, J.; Bourdon, A.; Guiraud, L.

2017-12-01

The 4-year EXAEDRE (EXploiting new Atmospheric Electricity Data for Research and the Environment; Oct 2016-Sept 2020) project is sponsored by the French Science Foundation ANR (Agence Nationale de la Recherche). This project is a French contribution to the HyMeX (HYdrological cycle in the Mediterranean EXperiment) program. The EXAEDRE activities rely on innovative multi-disciplinary and state of the art instrumentation and modeling tools to provide a comprehensive description of the electrical activity in thunderstorms. The EXAEDRE observational part is based on i) existing lightning records collected during HyMeX Special Observation Period (SOP1; Sept-Nov 2012), and permanent lightning observations provided by the research Lightning Mapping Array SAETTA and the operational Météorage lightning locating systems, ii) additional lightning observations mapped with a new VHF interferometer especially developed within the EXAEDRE project, and iii) a dedicated airborne campaign over Corsica. The modeling part of the EXAEDRE project exploits the electrification and lightning schemes developed in the cloud resolving model MesoNH and promotes an innovative technique of flash data assimilation in the french operational model AROME of Météo-France. An overview of the EXAEDRE project will be given with an emphasis on the instrumental, observational and modeling activities performed during the 1st year of the project. The preparation of the EXAEDRE airborne campaign scheduled for September 2018 over Corsica will then be discussed. Acknowledgements. The EXAEDRE project is sponsored by grant ANR-16-CE04-0005 with support from the MISTRALS/HyMeX meta program.

Le paludisme grave d’importation chez l’adulte: étude rétrospective de treize cas admis en réanimation à Marrakech

PubMed Central

El Mezouari, El Mostafa; Belhadj, Ayoub; Ziani, Mohamed; Boughanem, Mohamed; Moutaj, Redouane

2016-01-01

Le paludisme d’importation est une affection de plus en plus fréquente en zone non endémique. Les formes graves représentent 10 % des cas de paludisme à Plasmodium falciparum. Au Maroc, plus de 50 cas de paludisme sont enregistrés chaque année dont 83 % à P. falciparum. Ont été inclus dans l’étude tous les patients ayant développé un paludisme grave, admis au service de réanimation durant la période comprise entre le 1er Novembre 2009 et le 31 décembre 2015. Les principales données épidémiologiques, les motifs d’admission, la prise en charge et l’évolution ont été étudiés. Treize patients sont retenus. L’âge moyen est de 31 ans. Tous les patients ont séjourné en afrique subsaharienne et étaient non-immuns. La chimioprophylaxie était adéquate dans 33% des cas. Le délai moyen entre le début des symptômes et l’instauration du traitement était de six jours. La parasitémie moyenne initiale était de 12 %. Les motifs d’admission en réanimation étaient un coma (15%), une convulsion (07%), une détresse respiratoire (07%), une prostration (07%), une insuffisance rénale (07%), un choc associé à un ictère et une acidose (07%) et enfin une insuffisance rénale conjuguée à un coma (07%). Tous les patients ont reçu un traitement par la quinine intraveineuse avec une dose de charge dans 100 % des cas. Le taux de mortalité était de 23 %. Les causes du décès étaient dues à la défaillance multi viscérale et au syndrome de détresse respiratoire aigu. La mortalité des formes graves du paludisme reste élevée. L’adéquation de la chimioprophylaxie associée à la précocité du diagnostic et du traitement permettrait d’améliorer significativement le pronostic de cette parasitose. PMID:28292141

Numerical simulations of thermo-compositional global convection with generation of proto-continental crust

NASA Astrophysics Data System (ADS)

Rozel, A. B.; Golabek, G.; Gerya, T.; Jain, C.; Tackley, P. J.

2017-12-01

We study the creation of primordial continental crust (TTG rocks) employing fully self-consistent numerical models of thermo-chemical convection on a global scale at the Archean. We use realistic rheological parameters [1] in 2D spherical annulus geometry using the convection code StagYY [2] for a one billion years period. Starting from a pyrolytic composition and an initially warm core, our simulations first generate mafic crust and depleted mantle in the upper mantle. The basaltic material can be both erupted (cold) and/or intruded (warm) at the base of the crust following a predefined partitioning. At all times, water concentration is considered fully saturated in the top 10 km of the domain, and it simply advected with the deforming material elsewhere. We track the pressure-temperature conditions of the newly formed hydrated basalt and check if it matches the conditions necessary for the formation of proto-continental crust [3]. We systematically test the influence of volcanism (eruption, also called "heat pipe") and plutonism (intrusive magmatism) on the time-dependent geotherm in the lithosphere. We show that the "heat-pipe" model (assuming 100% eruption) suggested to be the main heat loss mechanism during the Archean epoch [4] is not able to produce continental crust since it forms a too cold lithosphere. We also systematically test various friction coefficients and show that an intrusion fraction higher than 60% (in agreement with [5]) combined with a friction coefficient larger than 0.1 produces the expected amount of the three main petrological TTG compositions previously reported [3]. This result seems robust as the amount of TTG rocks formed vary over orders of magnitude. A large eruption over intrusion ratio can result in up to 100 times less TTG felsic crust production than a case where plutonism dominates. This study represents a major step towards the production of self-consistent convection models able to generate the continental crust of the Earth.[1] Lourenço D. et al. (2016) Earth Plan. Sci. Lett. 438, 18-28. [2] Tackley P.J. (2008) Phys. Earth Plan. Int. 171, 7-18. [3] Moyen J.-F. (2011) Lithos 123, 21-36. [4] Moore, W. and Webb, A. (2013) Nature, 501, 501-505. [5] Crisp, J. A. (1984) Journ. Volc. Geoth. Res., 20, 177-211.

Examining Environmental Gradients with Remotely Sensed Data - the ESA GlobPermafrost project

NASA Astrophysics Data System (ADS)

Bartsch, Annett; Grosse, Guido; Kääb, Andreas; Westermann, Sebastian; Strozzi, Tazio; Wiesmann, Andreas; Duguay, Claude; Seifert, Frank Martin; Obu, Jaroslav; Nitze, Ingmar; Heim, Birgit; Haas, Antoni; Widhalm, Barbara

2017-04-01

Permafrost cannot be directly detected from space, but many surface features of permafrost terrains and typical periglacial landforms are observable with a variety of EO sensors ranging from very high to medium resolution at various wavelengths. In addition, landscape dynamics associated with permafrost changes and geophysical variables relevant for characterizing the state of permafrost, such as land surface temperature or freeze-thaw state can be observed with space-based Earth Observation. Suitable regions to examine environmental gradients across the Arctic have been defined in a community white paper (Bartsch et al. 2014). These transects have been updated within the ESA DUE GlobPermafrost project. The ESA DUE GlobPermafrost project develops, validates and implements Earth Observation (EO) products to support research communities and international organisations in their work on better understanding permafrost characteristics and dynamics. Prototype product cases will cover different aspects of permafrost by integrating in situ measurements of subsurface properties and surface properties, Earth Observation, and modelling to provide a better understanding of permafrost today. The project will extend local process and permafrost monitoring to broader spatial domains, support permafrost distribution modelling, and help to implement permafrost landscape and feature mapping in a GIS framework. It will also complement active layer and thermal observing networks. Both lowland (latitudinal) and mountain (altitudinal) permafrost issues are addressed. The selected transects and first results will be presented. This includes identified needs from the user requirements survey, a review of existing land surface products available for the Arctic as well as prototypes of GlobPermafrost datasets, and the permafrost information system through which they can be accessed. Bartsch, Annett; Allard, Michel; Biskaborn, Boris Kolumban; Burba, George; Christiansen, Hanne H; Duguay, Claude R; Grosse, Guido; Günther, Frank; Heim, Birgit; Högström, Elin; Kääb, Andreas; Keuper, Frida; Lanckman, Jean-Pierre; Lantuit, Hugues; Lauknes, Tom Rune; Leibman, Marina O; Liu, Lin; Morgenstern, Anne; Necsoiu, Marius; Overduin, Pier Paul; Pope, Allen; Sachs, Torsten; Séjourné, Antoine; Streletskiy, Dmitry A; Strozzi, Tazio; Ullmann, Tobias; Ullrich, Matthias S; Vieira, Goncalo; Widhalm, Barbara (2014): Requirements for monitoring of permafrost in polar regions - A community white paper in response to the WMO Polar Space Task Group (PSTG), Version 4, 2014-10-09. Austrian Polar Research Institute, Vienna, Austria, 20 pp, hdl:10013/epic.45648.d001

Nutrient profiles discriminate between foods according to their contribution to nutritionally adequate diets: a validation study using linear programming and the SAIN,LIM system.

PubMed

Darmon, Nicole; Vieux, Florent; Maillot, Matthieu; Volatier, Jean-Luc; Martin, Ambroise

2009-04-01

The nutrient profile concept implies that it is possible to discriminate between foods according to their contribution to a healthy diet on the basis of their nutrient contents only. The objective was to test the compatibility between nutrient profiling and nutrient-based recommendations by using diet modeling with linear programming. Food consumption data from the French "Individuelle et Nationale sur les Consommations Alimentaires" dietary survey and its associated food-composition database were used as input data. Each food was allocated to 1 of 4 classes, according to the SAIN,LIM system -- a nutrient profiling system based on 2 independent scores, including a total of 8 basic plus 4 optional nutrients. The possibility to model diets fulfilling a set of 40 nutrient recommendations (healthy models) was tested by using foods from a given nutrient profile class only or from a combination of classes. The possibility to fulfill a set of nutrient constraints in contradiction with the recommendations (unhealthy models) was also tested. For each model, the feasible energy range was assessed by minimizing and maximizing total energy content. With foods from the most favorable nutrient profile class, healthy diets could be modeled, but it was impossible to design unhealthy diets within a realistic range of energy intake with these foods. With foods from the least favorable class, unhealthy, but not healthy, diets could be designed. Both healthy and unhealthy diets could be designed with foods from intermediate classes. On the basis of a few key nutrients, it is possible to predict the ability of a given food to facilitate -- or to impair -- the fulfillment of a large number of nutrient recommendations.

[Inventory of training of internal medicine in France: Results of a national survey].

PubMed

Samson, M; Terrier, B; Mangin, O; Mouthon, L

2017-05-01

To make an inventory of training of Internal Medicine in France. This study was conducted between May and September 2015 with coordinators (interviews of 45minutes) of local Internal Medicine training and fellows (online questionnaire). All coordinators (n=28) responded to the interviews. Local training of Internal Medicine exists in 86% of regions (3.1±3.1hours/month) and an interregional training in all interregions (34.7±13.9hours/year). When excluding Île-de-France, no correlation between the number of teachers and the amount of lessons was noted (P=0.61). Of the 550 fellows in Internal Medicine in 2014-2015, 223 (41%) responded to the online questionnaire. Mean level was 5.5±2.7 semesters. The rate of satisfaction (1=very dissatisfied and 5=very satisfied) was 3.0±1.0 and 3.8±0.8 for regional and interregional teaching, respectively (P<0.0001). Regional teaching satisfaction was correlated with the perceived expanse of diseases covered into the program (P<0.0001). In addition, 89% of fellows wish to evaluate themselves online, 66% wish to have a practical evaluation at the bedside and 70% in simulation centers. Finally, 91% of fellows support the establishment of a national program for the training of Internal Medicine. This survey states for the first time an inventory of training of Internal Medicine dedicated to fellows in France. This report highlights that fellows wish to have a national program, be further evaluated and have access to more interactive approach of teaching. Copyright © 2016 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

[Death certificate data in France: Production process and main types of analyses].

PubMed

Rey, G

2016-10-01

Mortality data, by the unambiguity of their definition and understanding by all stakeholders, and completeness of registration, are a cornerstone of public health statistics in France and in most industrialized countries. This article describes the data production process, and the main types of possible analyses. Data production is composed of different stages: death certification by a medical doctor on paper or electronic (using a web application) format, data transmission to Inserm, capture and coding of information. The encoding of the information follows the WHO recommendations of the International Classification of Diseases ([ICD], 10th revision used since 2000). It is carried out using an automatic coding software, called Iris, developed in an international consortium. The coding aims, first, at assigning an ICD code to all nosologic entities encountered on the certificate, and then at selecting the underlying cause of death. The latter is the main information used for statistical analyses. Three main types of analysis emerge in the literature: the exploitation of data on the death certificate only, ecological analyses (studies of associations between variables measured across groups) and analysis from data individually linked to other databases. Many public health issues can be addressed with these various analyses. Several developments in the production process are being implemented: the deployment of electronic certification, increased automation of the death certificate information processing and durable and complete record linkage with health insurance and hospitalisation data. They could soon be deeply expanding the scope of possible uses of causes of death data. Copyright © 2016 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Atmospheric Measurements by Cavity Enhanced Absorption Spectroscopy

NASA Astrophysics Data System (ADS)

Yi, Hongming; Wu, Tao; Coeur-Tourneur, Cécile; Fertein, Eric; Gao, Xiaoming; Zhao, Weixiong; Zhang, Weijun; Chen, Weidong

2015-04-01

Since the last decade, atmospheric environmental monitoring has benefited from the development of novel spectroscopic measurement techniques owing to the significant breakthroughs in photonic technology from the UV to the infrared spectral domain [1]. In this presentation, we will overview our recent development and applications of cavity enhanced absorption spectroscopy techniques for in situ optical monitoring of chemically reactive atmospheric species (such as HONO, NO3, NO2, N2O5) in intensive campaigns [2] and/or in smog chamber studies [3]. These field deployments demonstrated that modern photonic technologies (newly emergent light sources combined with high sensitivity spectroscopic techniques) can provide a useful tool to improve our understanding of tropospheric chemical processes which affect climate, air quality, and the spread of pollution. Experimental detail and preliminary results will be presented. Acknowledgements. The financial support from the French Agence Nationale de la Recherche (ANR) under the NexCILAS (ANR-11-NS09-0002) and the CaPPA (ANR-10-LABX-005) contracts is acknowledged. References [1] X. Cui, C. Lengignon, T. Wu, W. Zhao, G. Wysocki, E. Fertein, C. Coeur, A. Cassez,L. Croisé, W. Chen, et al., "Photonic Sensing of the Atmosphere by absorption spectroscopy", J. Quant. Spectrosc. Rad. Transfer 113 (2012) 1300-1316 [2] T. Wu, Q. Zha, W. Chen, Z. XU, T. Wang, X. He, "Development and deployment of a cavity enhanced UV-LED spectrometer for measurements of atmospheric HONO and NO2 in Hong Kong", Atmos. Environ. 95 (2014) 544-551 [3] T. Wu, C. Coeur-Tourneur, G. Dhont,A. Cassez, E. Fertein, X. He, W. Chen,"Application of IBBCEAS to kinetic study of NO3 radical formation from O3 + NO2 reaction in an atmospheric simulation chamber", J. Quant. Spectrosc. Rad. Transfer 133 (2014)199-205

Development and validation of a quantitative competitive ELISA for potency testing of equine anti rabies sera with other potential use.

PubMed

Korimbocus, Jehanara; Dehay, Nicolas; Tordo, Noël; Cano, François; Morgeaux, Sylvie

2016-06-14

In case of a bite by a rabies infected animal, the World Health Organisation recommends a prophylactic treatment including the administration of Human Rabies Immunoglobulins (HRIGs) or highly purified F(ab')2 fragments produced from Equine Rabies Immunoglobulin (F(ab')2 - ERIGs). According to international regulation, quality control of F(ab')2 - ERIGs lots requires potency testing by the in vivo Mouse Neutralisation Test (MNT) prior marketing. However, the strategy of the 3Rs (Reduce, Refine, Replace) for animal testing required by the European Directive encourages the replacement of the in vivo potency test by an in vitro assay. In this context, a competitive ELISA method (c-ELISA) has been developed by the Agence Nationale de Sécurité du Médicament et des Produits de Santé where F(ab')2 - ERIGs are in competition with a monoclonal antibody recognizing the trimeric native form of the rabies glycoprotein. After a full validation study, the c-ELISA has been applied to commercial batches of F(ab')2 - ERIGs. A correlation study with the MNT demonstrated a similarity between the two methods (r=0.751). Moreover, the c-ELISA method which does not need any species specific reagent has been applied to HRIGs potency testing as an alternative method to Rapid Fluorescent Focus Inhibition Test (RFFIT), thus avoiding the handling of live rabies virus in BSL3 containment. In conclusion, the c-ELISA has shown its potential to replace MNT and possibly RFFIT for the quantification of rabies immunoglobulin. After optimisation it may be used for the quantification of rabies immunoglobulin in any animal species, notably for rabies immunogenicity assay in mice. Copyright © 2016 Elsevier Ltd. All rights reserved.

A cross-sectional comparison between the perception of physicians and pharmacists concerning the role of the pharmacist in physician training.

PubMed

Béchet, C; Pichon, R; Giordan, A; Bonnabry, P

2018-05-22

This study aimed to identify and compare physician-pharmacist perceptions concerning drug teaching to physicians by pharmacists in Swiss hospital settings. Questionnaires were emailed to all French-speaking physicians (survey A) and pharmacists (survey B) working in Swiss hospitals where medical directors/chief-pharmacists had approved the study. Questions were developed based on previous physician interviews. Most questions used four Likert-type response alternatives. A Mann-Whitney U test was used to compare answers to survey A and B. Fourteen out of 18 medical directors and 16/16 chief-pharmacists gave permission for the study. In total, 244 (11%) physicians answered survey A, and 115 (74%) pharmacists answered survey B. Nearly all participants agreed that pharmacists should take part in both medical student and physician postgraduate training. Most physicians answered wanting additional training and pharmacists are unaware of this need. Only two thirds of physicians reported having acquired knowledge about drugs thanks to pharmacists; document diffusion and direct answers to their questions having contributed the most to their training. Participants agreed that physician training by pharmacists needs a clearer delineation regarding the type of training, its aim, its targeted public, when and what pharmaceutical benefits are used. Physicians' priority-training topics are high-risk drugs, novelties and areas in which they consider their basic training was insufficient. Methods preferred for training are: case studies; exercises with individual corrections; and group work. Improved resources and planning are needed to meet physicians' expectations. Training is often carried out implicitly, through activities with various other aims, and needs to be better defined and formalized collaboratively. Copyright © 2018 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

Hailstorm forecast from stability indexes in Southwestern France

NASA Astrophysics Data System (ADS)

Melcón, Pablo; Merino, Andrés; Sánchez, José Luis; Dessens, Jean; Gascón, Estíbaliz; Berthet, Claude; López, Laura; García-Ortega, Eduardo

2016-04-01

Forecasting hailstorms is a difficult task because of their small spatial and temporal scales. Over recent decades, stability indexes have been commonly used in operational forecasting to provide a simplified representation of different thermodynamic characteristics of the atmosphere, regarding the onset of convective events. However, they are estimated from vertical profiles obtained by radiosondes, which are usually available only twice a day and have limited spatial representativeness. Numerical models predictions can be used to overcome these drawbacks, providing vertical profiles with higher spatiotemporal resolution. The main objective of this study is to create a tool for hail prediction in the southwest of France, one of the European regions where hailstorms have a higher incidence. The Association Nationale d'Etude et de Lutte contre les Fleáux Atmosphériques (ANELFA) maintains there a dense hailpad network in continuous operation, which has created an extensive database of hail events, used in this study as ground truth. The new technique is aimed to classify the spatial distribution of different stability indexes on hail days. These indexes were calculated from vertical profiles at 1200 UTC provided by WRF numerical model, validated with radiosonde data from Bordeaux. Binary logistic regression is used to select those indexes that best represent thermodynamic conditions related to occurrence of hail in the zone. Then, they are combined in a single algorithm that surpassed the predictive power they have when used independently. Regression equation results in hail days are used in cluster analysis to identify different spatial patterns given by the probability algorithm. This new tool can be used in operational forecasting, in combination with synoptic and mesoscale techniques, to properly define hail probability and distribution. Acknowledgements The authors would like to thank the CEPA González Díez Foundation and the University of Leon for its financial support.

The neutron channeling phenomenon.

PubMed

Khanouchi, A; Sabir, A; Boulkheir, M; Ichaoui, R; Ghassoun, J; Jehouani, A

1997-01-01

Shields, used for protection against radiation, are often pierced with vacuum channels for passing cables and other instruments for measurements. The neutron transmission through these shields is an unavoidable phenomenon. In this work we study and discuss the effect of channels on neutron transmission through shields. We consider an infinite homogeneous slab, with a fixed thickness (20 lambda, with lambda the mean free path of the neutron in the slab), which contains a vacuum channel. This slab is irradiated with an infinite source of neutrons on the left side and on the other side (right side) many detectors with windows equal to 2 lambda are placed in order to evaluate the neutron transmission probabilities (Khanouchi, A., Aboubekr, A., Ghassoun, J. and Jehouani, A. (1994) Rencontre Nationale des Jeunes Chercheurs en Physique. Casa Blanca Maroc; Khanouchi, A., Sabir, A., Ghassoun, J. and Jehouani, A. (1995) Premier Congré International des Intéractions Rayonnements Matière. Eljadida Maroc). The neutron history within the slab is simulated by the Monte Carlo method (Booth, T. E. and Hendricks, J. S. (1994) Nuclear Technology 5) and using the exponential biasing technique in order to improve the Monte Carlo calculation (Levitt, L. B. (1968) Nuclear Science and Engineering 31, 500-504; Jehouani, A., Ghassoun, J. and Aboubker, A. (1994) In Proceedings of the 6th International Symposium on Radiation Physics, Rabat, Morocco). Then different geometries of the vacuum channel have been studied. For each geometry we have determined the detector response and calculated the neutron transmission probability for different detector positions. This neutron transmission probability presents a peak for the detectors placed in front of the vacuum channel. This study allowed us to clearly identify the neutron channeling phenomenon. One application of our study is to detect vacuum defects in materials.

Antioxidant and antimicrobial proprieties of chitin and chitosan extracted from Parapenaeus Longirostris shrimp shell waste.

PubMed

Hafsa, J; Smach, M A; Charfeddine, B; Limem, K; Majdoub, H; Rouatbi, S

2016-01-01

Chitosan, the linear polymer, is produced by alkali deacetylation of chitin (CHI). Recently chitin and chitosan were attracted marked interest due to their biocompatibility, biodegradability and non-toxicity. In this study, chitin was extracted from shrimp shell (Parapenaeus longirostris) and chitosan was deacetylated by classical and ultrasound-assisted method. The identification of functional groups and the determination of degree of deacetylation of chitin (CHI), classical deacetylated chitosan (CDC) and ultrasound-assisted deacetylated chitosan (UDC) were carried through Fourier Transform-Infrared Spectroscopy. Their antimicrobial and antioxidant activity were also investigated. The degree of deacetylation of CHI, CDC and UDC is 33.64%, 73.68% and 83.55%, respectively. Results showed that CHI, CDC and UDC exhibited a good antimicrobial activity against (S. aureus, E. coli, P. aeruginosa, K. pneumonia) and (C. albicans and C. parapsilosis). The scavenging ability of CHI, CDC and UDC on 1,1-diphenyl-2-picrylhydrazyl radicals is ranging from 4.71% to 21.25%, 11.45% to 32.78% and 18.27% to 44.17%, respectively, at the concentrations of 0.25 to 1mg/mL. The inhibition of lipid peroxidation with thiobarbituric acid-reacting substances is ranging from 11.7% to 51.63%, 17.24% to 63.52% and 29.31% to 77.39%, respectively, at varying concentrations of 0.25 to 1mg/mL. The effectiveness of CHI, CDC and UDC is correlated with their degree of deacetylation. The results indicate the possibility of exploiting chitin and chitosan as antimicrobial agent. Copyright © 2015 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

A Secular Variation Model for Igrf-12 Based on Swarm Data and Inverse Geodynamo Modelling

NASA Astrophysics Data System (ADS)

Fournier, A.; Aubert, J.; Erwan, T.

2014-12-01

We are proposing a secular variation candidate model for the 12th generation of the international geomagnetic reference field, spanning the years 2015-2020. The novelty of our approach stands in the initialization of a 5-yr long integration of a numerical model of Earth's dynamo by means of inverse geodynamo modelling, as introduced by Aubert (GJI, 2014). This inverse technique combines the information coming from the observations (in the form of an instantaneous estimate of the Gauss coefficients for the magnetic field and its secular variation) with that coming from the multivariate statistics of a free run of a numerical model of the geodynamo. The Gauss coefficients and their error covariance properties are determined from Swarm data along the lines detailed by Thébault et al. (EPS, 2010). The numerical model of the geodynamo is the so-called Coupled Earth Dynamo model (Aubert et al., Nature, 2013), whose variability possesses a strong level of similarity with that of the geomagnetic field. We illustrate and assess the potential of this methodology by applying it to recent time intervals, with an initialization based on CHAMP data, and conclude by presenting our SV candidate, whose initialization is based on the 1st year of Swarm data This work is supported by the French "Agence Nationale de la Recherche" under the grant ANR-11-BS56-011 (http://avsgeomag.ipgp.fr) and by the CNES. References: Aubert, J., Geophys. J. Int. 197, 1321-1334, 2014, doi: 10.1093/gji/ggu064 Aubert, J., Finlay, C., Fournier, F. Nature 502, 219-223, 2013, doi: 10.1038/nature12574 Thébault E. , A. Chulliat, S. Maus, G. Hulot, B. Langais, A. Chambodut and M. Menvielle, Earth Planets Space, Vol. 62 (No. 10), pp. 753-763, 2010.

[Critical analysis of reference studies on aluminium-based adjuvants toxicokinetics].

PubMed

Masson, J-D; Crépeaux, G; Authier, F-J; Exley, C; Gherardi, R K

2017-07-01

We reviewed the three reference toxicokinetic studies commonly used to suggest innocuity of aluminum (Al)-based adjuvants. A single experimental study was carried out using isotopic 26 Al (Flarend et al., 1997). This study ignored adjuvant cell capture. It was conducted over a short period of time (28 days) and used only two rabbits per adjuvant. At the endpoint, Al retention was 78% for aluminum phosphate and 94% for aluminum hydroxide, both results being incompatible with quick elimination of vaccine-derived Al in urines. Tissue distribution analysis omitted three important retention sites: the injected muscle, the draining lymph node and bone. Two theoretical studies have evaluated the potential risk of vaccine Al in infants, by reference to the oral Minimal Risk Level (MRL) extrapolated from animal studies. Keith et al., 2002 used a too high MRL (2mg/kg/d), an erroneous model of 100% immediate absorption of vaccine Al, and did not consider renal and blood-brain barrier immaturity. Mitkus et al. (2011) only considered absorbed Al, with erroneous calculations of absorption duration. They ignored particulate Al captured by immune cells, which play a role in systemic diffusion and the neuro-inflammatory potential of the adjuvant. MRL they used was both inappropriate (oral Al vs injected adjuvant) and far too high (1mg/kg/d) with regard to experimental studies of Al-induced memory and behavioral changes. Both paucity and serious weaknesses of these studies strongly suggest that novel experimental studies of Al adjuvants toxicokinetics should be performed on the long-term, including post-natal and adult exposures, to ensure innocuity and restore population confidence in Al-containing vaccines. Copyright © 2017 Académie Nationale de Pharmacie. All rights reserved.

[Cryopyrin-associated periodic syndromes].

PubMed

Quartier, P; Rodrigues, F; Georgin-Lavialle, S

2018-04-01

Cryopyrin-associated periodic syndromes (CAPS) are linked to one single gene mutations, however they are associated with 3 syndromes, which are, from the mildest to the most severe phenotype familial cold urticaria, Muckle-Wells syndrome and chronic, infantile, neurologic, cutaneous, articular (CINCA) syndrome also called neonatal-onset multisystem inflammatory disease (NOMID). Autosomic dominant inheritance is present in most cases but in CINCA/NOMID syndrome where neomutations are more common. Mutations in the gene encoding cryopyrin, NLRP3, are associated with deregulation of caspase-1 activity, excessive interleukin-1 production and an autoinflammatory syndrome, which in familial cold urticaria and Muckle-Wells syndrome may be triggered or worsened by exposure to coldness. More and more mutations are described and even somatic mutations that can explain some clinical signs beginning in adulthood. Patients disclose a pseudo-urticarial rash, arthralgia, headaches, sometimes fever, biological inflammation but also, in severe forms of the disease, neurologic inflammation with central deafness, ophthalmologic inflammation, chronic meningitis. Some CINCA/NOMID patients also develop growth cartilage pseudo-tumoral hypertrophy. Natural disease history is usually benign in familial cold urticarial but severe in the other forms, particularly regarding neuro-sensorial involvement. In addition, secondary AA amyloidosis may develop in all forms in the absence of control of chronic inflammation. Anti-interleukin-1 treatment with anakinra, rilonacept or canakinumab induces in most cases complete remission, however sequelae may be present, particularly if central deafness or cartilage bone hypertrophy have already developed. This treatment is also important to prevent secondary amyloidosis or stabilize and even sometimes allow improvement of amyloidosis lesions. Copyright © 2017 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Preparation and efficacy assessment of malva nut polysaccharide for skin hydrating products.

PubMed

Kanlayavattanakul, M; Fungpaisalpong, K; Pumcharoen, M; Lourith, N

2017-11-01

Scaphium scaphigerum or malva nut has long been served in Chinese medicine. However, the use of this herb in modern health care applications has, to date, been rarely reported. Maceration of the herb in water afforded malva nut polysaccharide which was standardized. Safety and skin hydrating efficacy of the polysaccharide and products were evaluated in human volunteers. Malva nut polysaccharide (41.71±0.64%) having 36.58±0.51% total sugar content was isolated, with further analysis quantifying ash, carbohydrate, reducing sugar and moisture contents to be 6.05±0.00, 40.06±1.00, 12.20±0.05 and 12.64±0.31%, respectively. The polysaccharide exhibited swelling and hydrating capacities of 0.46±0.01% and 54.46±0.02g/g, with L*, a* and b* of 52.56±0.04, 9.02±0.06 and 18.42±0.03, respectively, and a viscosity of 1263.00±2.00 cps. Accelerated testing indicated the biopolysaccharide to be stable, resulting in no skin irritation in 15 human volunteers. The skin hydrating efficacy as assessed via a randomized single-blind, placebo-controlled study in 24 volunteers highlighted the superior performance of malva nut over the vehicle (moisture retainment for 70min as examined by Corneometer ® CM 825). A stable skin moisturizing gel containing malva nut was developed and was shown to exhibit improved performance over benchmark tamarind and algae polysaccharide gels (after 180min observation). Malva nut polysaccharide has potential as a key ingredient in skin hydrating products, which should encourage its further development. Copyright © 2017 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

[Day hospital in internal medicine: A chance for ambulatory care].

PubMed

Grasland, A; Mortier, E

2018-04-16

Internal medicine is an in-hospital speciality. Along with its expertise in rare diseases, it shares with general medicine the global care of patients but its place in the ambulatory shift has yet to be defined. The objective of our work was to evaluate the benefits of an internal medicine day-hospital devoted to general medicine. Named "Centre Vi'TAL" to underline the link between the city and the hospital, this novel activity was implemented in order to respond quickly to general practitioners having difficulties to synthesize their complex patients or facing diagnostic or therapeutic problems. Using preferentially email for communication, the general practitioners can contact an internist who is committed to respond on the same day and take over the patient within 7 days if day-hospital is appropriate for his condition. The other patients are directed either to the emergency department, consultation or full hospitalization. In 14 months, the center has received 213 (144 women, 69 men) patients, mean age 53.6, addressed by 88 general practitioners for 282 day-hospital sessions. Requests included problem diagnoses (n=105), synthesis reviews for complex patients (n=65), and treatment (n=43). In the ambulatory shift advocated by the authorities, this experience shows that internal medicine should engage in the recognition of day-hospital as a place for diagnosis and synthesis reviews connected with the city while leaving the general practitioners coordinator of their patient care. This activity of synthesis in day-hospital is useful for the patients and efficient for our healthcare system. Copyright © 2018 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Dietary intake, physical activity and nutritional status in adults: the French nutrition and health survey (ENNS, 2006-2007).

PubMed

Castetbon, Katia; Vernay, Michel; Malon, Aurélie; Salanave, Benoit; Deschamps, Valérie; Roudier, Candice; Oleko, Amivi; Szego, Emmanuelle; Hercberg, Serge

2009-09-01

The French National Programme on Nutrition and Health (Programme national nutrition santé (PNNS)), the aim of which is to reduce nutrition-related chronic diseases, necessitates monitoring of nutritional characteristics. Our objective was to describe dietary intake, physical activity and nutritional status in a national sample of adults, especially according to current French recommendations. The study is based on a cross-sectional population-based survey using a multistage sampling design (Etude nationale nutrition santé (ENNS)). Between February 2006 and March 2007, 3115 18-74-year-old adults were included (participation rate 59.7 %). Energy, macronutrient and food consumption were estimated through three randomly distributed 24 h recalls, and compared to PNNS recommendations; physical activity was described using International Physical Activity Questionnaire guidelines; anthropometry, blood pressure and biochemical measurements were assessed according to national and international references. When compared to current recommendations, intake of carbohydrates (>50 % energy intake without alcohol: 26.4 %), SFA ( < 35 % total lipids: 18.5 %) and total fibre (>25 g/d: 13.7 %) was frequently unsatisfactory. While overall consumption of 'meat, seafood and eggs' was satisfactory, that of fruits and vegetables ( > or = 400 g/d: 43.8 %) and seafood (two or more servings per week: 29.9 %) was frequently too low. The physical activity level was satisfactory at 63.2 %. Overweight was observed in 49.3 % of adults, while 30.9 % were hypertensive and 44.1 % had dyslipidaemia. Vitamin and iron-poor status was found to affect less than 10 % of the population. Based on the ENNS survey, overall nutrition remains a problem in France. Comparison of these data with those of other countries could contribute to a better understanding of variations in nutrition-related diseases.

[Glucocorticoid therapy: what is the information sought by patients? Traffic analysis of the website cortisone-info.fr].

PubMed

Poisson, J; Six, M; Morin, C; Fardet, L

2013-05-01

About 1% of the general population are receiving systemic glucocorticoids. The information about this treatment sought by patients is unknown. The website www.cortisone-info.fr aims to provide therapeutic information about glucocorticoids and glucocorticoid therapy. It was posted on January 16, 2012. The information available on the website is documented and based on the recent medical literature. The website is made of 43 pages divided into five main sections (generalities about glucocorticoids, adverse events, measures associated with glucocorticoid therapy, discontinuation of glucocorticoids and, situations requiring attention). The website traffic between February 1st, 2012 and January 4, 2013 was analyzed using Google Analytics. During the study period, the website was visited by 67,496 people (average number of visitors per day: 33 in February 2012, 326 in December 2012). The number of page views was 230,496 or an average of 3.5 pages per visitor. Of these 230,496 page views, 145,431 (63.1%) were related to adverse events and 37,722 (16.4%) were related to generalities about glucocorticoids (e.g., what is cortisone? For which disease? How does it work?). Information particularly sought by visitors was related to the diet to follow during glucocorticoid therapy (page accessed 11,946 times), data about what cortisone is (page accessed 11,829 times) and the effects of glucocorticoids on weight (page accessed 10,442 times). Knowledge of glucocorticoid-treated patients' expectations may help physicians to optimize information they give, thereby helping to reduce patients' concerns about glucocorticoids and to improve adherence to the treatment. Copyright © 2013 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

[Pathway to diagnosis and real-life experience of patients believing they are affected by "chronic Lyme disease"].

PubMed

Forestier, E; Gonnet, F; Revil-Signorat, A; Zipper, A C

2018-04-26

Chronic Lyme disease is a subject of scientific and social controversy in both Europe and the United States. The aim of our study was to analyze the pathway to diagnosis of patients believing they were affected by the disease, and to describe their real-life experience. A qualitative study was performed with 13 patients declaring themselves to be affected by chronic Lyme disease. Interviews were analyzed by 2 general medical practice interns, supervised by a general practitioner with a diploma in socio-anthropology and an infectious diseases specialist. Internet and other media played a major role in informing the patients or their doctor about the existence and the characteristics of chronic Lyme disease. The diagnosis was confirmed by features considered objective (chronic infection by Borrelia, tick bite, positive serology, beneficial or worsening effects of antibiotics). The long medical diagnosis and treatment process of those interviewed was marked by a conflicted relationship with the medical profession, caused by a feeling of non-recognition and abandonment. They reported their experience as being very painful, both because of the physical pain and also the psychological consequences of their condition. Improving the diagnosis and therapeutic management of patients believing themselves to be affected by chronic Lyme disease appears highly necessary both to limit their search for diagnosis and their experience of pain. It could be based on existing guidelines concerning medically unexplained symptoms to which the chronic Lyme disease issue appears quite similar on several points. Copyright © 2018 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

[Improvement of the recruitment of surgery interns derived from the Epreuves Nationales Classantes (National-Ranking Exam): practical solution applied to urology].

PubMed

Beley, Sébastien; Dubosq, Francis; Simon, Pascal; Larré, Stéphane; Battisti, Simon; Ballereau, Charles; Boublil, Véronique; Richard, François; Rouprêt, Morgan

2005-12-01

To analyse the value of an urology initiation session proposed to young interns to improve recruitment of the discipline since the introduction of the new National-Ranking Exam (NRE). In October 2004, the 77 interns appointed to surgery in Paris on the basis of the ENC participated in a one-day urology initiation session organized by the AFUF, at the AP-HP School of Surgery. All interns were given a questionnaire at the beginning of the session to record the following data: age, gender, teaching hospital, a student attachment in urology and desired specialization as a function of the surgical training programmes proposed by the ENC. Items concerning the desired specialization were resubmitted to the interns at the end of the session. Population. 77 interns, 48 females (62.3%) and 29 males (37.7%) with a mean age of 25.2 +/- 5 years (range: 23-31). 55 interns had trained at a Parisian teaching hospital (67%) and 22 (28.6%) had trained at a provincial teaching hospital. 16 interns (20.8%) had completed at least one urology attachment during their medical training. Desired specialization. Orthopaedics was the discipline most frequently cited (n = 20; 26%). Urology was chosen by 8 interns (10.40%), who had all completed an urology attachment during their medical training. At the end of the urology initiation session, another 8 interns expressed the desire to specialize in urology. Of the 16 potential urology interns, 9 (56.2%) confirmed that their decision was final. Urology occupies a special place and remains a popular surgical speciality among students. Organization of practical sessions constitutes a solution to inform, create an emulation and motivate surgery interns to choose urology.

Prototype pushing robot for emplacing vitrified waste canisters into horizontal disposal drifts

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

Londe, L.; Seidler, W.K.; Bosgiraud, J.M.

2007-07-01

Within the French Underground Disposal concept, as described in ANDRA's (Agence Nationale pour la Gestion des Dechets Radioactifs) Dossier 2005, the Pushing Robot is an application envisaged for the emplacement (and the potential retrieval) of 'Vitrified waste packages', also called 'C type packages'. ANDRA has developed a Prototype Pushing Robot within the framework of the ESDRED Project (Engineering Studies and Demonstration of Repository Design) which is co-funded by the European Commission as part of the sixth EURATOM Research and Training Framework Programme (FP6) on nuclear energy (2002 - 2006). The Rationale of the Pushing Robot technology comes from various considerations,more » including the need for (1) a simple and robust system, capable of moving (and potentially retrieving) on up to 40 metres (m), a 2 tonne C type package (mounted on ceramic sliding runners) inside the carbon steel sleeve constituting the liner (and rock support) of a horizontal disposal cell, (2) small annular clearances between the package and the liner, (3) compactness of the device to be transferred from surface to underground, jointly with the package, inside a shielding cask, and (4) remote controlled operations for the sake of radioprotection. The initial design, based on gripping supports, has been replaced by a 'technical variant' based on inflatable toric jacks. It was then possible, using a test bench, to check that the Pushing Robot worked properly. Steps as high as 7 mm were successfully cleared by a dummy package pushed by the Prototype.. Based on the lessons learned by ANDRA's regarding the Prototype Pushing Robot, a new Scope of Work is being written for the Contract concerning an Industrial Scale Demonstrator. The Industrial Scale Demonstration should be completed by the end of the second Quarter of 2008. (authors)« less

[Use of a Delphi survey to assess the hospital economic impact of innovative products: The example of idarucizumab a dabigatran-specific reversal agent].

PubMed

Jamet, N; Thivilliers, A P; Paubel, P; Chevalier, D; Bourguignon, S; Bézie, Y

2017-11-01

The economic impact of therapeutic innovations on the hospital patient management cannot be easily estimated. The objective of this study is to illustrate the use of a Delphi survey as a support tool to identify the changes following the use of idarucizumab in dabigatran-treated patients with uncontrolled/life-threatening bleeding or who required emergency surgery/urgent procedures. The Delphi questionnaires have been administrated to 8 emergency physicians or anesthetists from 6 different hospital centers. Following the answers, an economic valorization has been carried out on every parameter on which a consensus was reached (at least 4 answers showing an identical trend). A mean management cost for each etiology with and without the use of idarucizumab has thus been identified. For gastro-intestinal and other life-threatening bleedings (excepted intracranial bleedings), the total management cost of the hospital stay was respectively 6058 € (-35%) and 6219 € (-34%) following the use of the reversal agent. The hospital management cost for intracranial bleeding is slightly increasing to 9790 € (+3%). The cost of a stay for emergency surgery decreases to 6962€ (-2%). This study shows a positive economic impact following the use of the dabigatran-specific reversal agent for patients with uncontrolled/life-threatening bleeding excepted in the case of intracranial bleeding. Moreover, it points out that a Delphi survey is an easy way to predict the hospital economic impact of a therapeutic innovation when no other evaluation is possible. Copyright © 2017 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

[Appropriateness of the prescriptions of conventional versus new oral anticoagulants at discharge from a department of internal medicine].

PubMed

Bochatay, L; Beney, J; Jordan-von Gunten, V; Petignat, P A; Roulet, L

2016-09-01

The recently introduced oral direct anticoagulants (ODAs), presumably safer, and with comparable efficacy to the vitamin K antagonists (VKAs), may reshape the world of anticoagulation medicine. This study aimed to assess the prescription appropriateness of ODAs and VKAs at discharge from hospital. We performed a one year retrospective study between August 2012 and July 2013 in the department of internal medicine of a regional hospital (HVs Sion) using Electronic Medical Records. All patients receiving an ODA were included and matched to a patient treated with a VKA. The appropriateness of prescription at discharge was defined by an adequate indication and dosing, the absence of contraindication, a minimal risk of drug-drug interactions and no major bleeding or venous thromboembolism during the hospitalization. The bleeding risk was evaluated with the HAS-BLED score when the indication was atrial fibrillation (AF). Out of the 44patients included (22 with an ODA and 22 with a VKA), 38 received an appropriate prescription according to all criteria. Two patients had an inadequate dosing. A potential drug-drug interaction was detected in 3patients receiving a VKA and in 1patient receiving an ODA. No major contraindication was found, but a relative contraindication was discussed in 3cases. The majority of patients receiving an ODA for an AF had a minor bleeding risk. No significant difference was ascertained between the two groups regarding the appropriateness of prescription. Our results suggest that ODAs were cautiously used in our setting. Copyright © 2015 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

[Survey of the prescriptions of proton pump inhibitors in patients admitted in an internal medicine ward: how is the compliance to the French guidelines?].

PubMed

Sauvaget, L; Rolland, L; Dabadie, S; Desblaches, J; Bernard, N; Vandenhende, M-A; Bonnet, F; Pédeboscq, S; Morlat, P

2015-10-01

In June 2009, the national French authority for Health reported many off-label uses of proton pump inhibitors (PPI). Our objective was to analyse the justification and modalities of PPI prescriptions in patients before their admission in a department of internal medicine. Data were prospectively collected during 5months. At admission, all prescriptions of PPI by general practitioners (GP) were recorded. The accordance of the prescriptions with the marketing authorization indications and the French guidelines in terms of duration of treatment or dosage was analyzed. These informations were obtained from computerized medical records and, if necessary, by contacting GPs. We collected 173 prescriptions. Fifty-six (32%) were in accordance with marketing authorization indications and, among them, 15 prescriptions (9% of all) respected the French guidelines about dosage and duration of treatment. One hundred and six prescriptions (61%) were not adequate and among them an off-label use was notified in 91 (53% of all); among them 33% for simple dyspeptic disorders, 23% for the prevention of NSAID-induced lesions in patients without risk factors, and finally 17% for the prevention of stress ulcer. Fifty-two prescriptions (30%) were unclassified due to incomplete data. Our study showed that a vast majority of the prescriptions for PPIs are not in accordance with French guidelines. Preventive actions against abusive prescriptions, withdrawal strategies or replacement of already prescribed PPIs should be implemented to reduce the risk of side effects and the economic impact of long term use of PPIs. Copyright © 2015 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

A novel stability-indicating UPLC method development and validation for the determination of seven impurities in various diclofenac pharmaceutical dosage forms.

PubMed

Azougagh, M; Elkarbane, M; Bakhous, K; Issmaili, S; Skalli, A; Iben Moussad, S; Benaji, B

2016-09-01

An innovative simple, fast, precise and accurate ultra-high performance liquid chromatography (UPLC) method was developed for the determination of diclofenac (Dic) along with its impurities including the new dimer impurity in various pharmaceutical dosage forms. An Acquity HSS T3 (C18, 100×2.1mm, 1.8μm) column in gradient mode was used with mobile phase comprising of phosphoric acid, which has a pH value of 2.3 and methanol. The flow rate and the injection volume were set at 0.35ml·min(-1) and 1μl, respectively, and the UV detection was carried out at 254nm by using photodiode array detector. Dic was subjected to stress conditions from acid, base, hydrolytic, thermal, oxidative and photolytic degradation. The new developed method was successfully validated in accordance to the International Conference on Harmonization (ICH) guidelines with respect to specificity, limit of detection, limit of quantitation, precision, linearity, accuracy and robustness. The degradation products were well resolved from main peak and its seven impurities, proving the specificity power of the method. The method showed good linearity with consistent recoveries for Dic content and its impurities. The relative percentage of standard deviation obtained for the repeatability and intermediate precision experiments was less than 3% and LOQ was less than 0.5μg·ml(-1) for all compounds. The new proposed method was found to be accurate, precise, specific, linear and robust. In addition, the method was successfully applied for the assay determination of Dic and its impurities in the several pharmaceutical dosage forms. Copyright © 2016 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

Vigie Ciel a collaborative project to study fireballs and organise meteorite recoveries

NASA Astrophysics Data System (ADS)

Colas, F.; Zanda, B.; Bouley, S.; Lewin, E.; Vaubaillon, J.; Marmo, C.; Rotaru, M.; Labenne, L.; Julien, J. F.; Linares, M.; Steinhausser, A.; Rault, J. L.; Vernazza, P.

2015-10-01

Research on fireballs and meteorites has always been of interest to the public, due to the beauty of shooting stars in the night sky and to the extraterrestrial origin of meteorites. A fireball observation network called FRIPON [1] (Colas et al, 2015) is currently being setup, funded by ANR (Agence Nationale pour la Recherche). It will cover France with 100 cameras and is expected to be operational for the end of 2015. FRIPON will detect fireballs and hence allow us to define meteorite strewn fields within 24h, so that meteorite searches can be launched very early on. Because of the need to search all over France, including in private land, it is important that the general public be aware of our project and be willing to help or participate. Indeed, as the main goal of FRIPON is to recover fresh meteorites (within a few days), our aim is to be able to organize a search with at least 50 persons to scan an area of a few km2 within a week. Help from the public would hence be most helpful but it is also important to have an operational and trained research team. This project thus appears as a unique occasion to involve the public in a scientific project while promoting informal scientific education. This prompted us to set up Vigie-Ciel, a citizen science network centered on meteorite recovery. FRIPON is an open network based on open-source software, it will accept citizenrun cameras. In addition to fireballs, it will allow scientists and Vigie-Ciel participants to study anything that can be observed by all-sky cameras: bird migrations, bats, clouds, lightning, etc. The data will be freely available to all.

[Autoantibody profile in myositis].

PubMed

Allenbach, Y; Benveniste, O

2014-07-01

Patients suffering from muscular symptoms or with an increase of creatine kinase levels may present a myopathy. In such situations, clinicians have to confirm the existence of a myopathy and determine if it is an acquired or a genetic muscular disease. In the presence of an acquired myopathy after having ruled out an infectious, a toxic agent or an endocrine cause, physicians must identify which type of idiopathic myopathy the patient is presenting: either a myositis including polymyositis, dermatomyositis, and inclusion body myositis, or an immune-mediated necrotizing myopathy. Histopathology examination of a muscle biopsy is determinant but detection of autoantibody is now also crucial. The myositis-specific antibodies and myositis-associated antibodies lead to a serologic approach complementary to the histological classification, because strong associations of myositis-specific antibodies with clinical features and survival have been documented. The presence of anti-synthetase antibodies is associated with an original histopathologic pattern between polymyositis and dermatomyositis, and defines a syndrome where interstitial lung disease drives the prognosis. Anti-MDA-5 antibody are specifically associated with dermatomyositis, and define a skin-lung syndrome with a frequent severe disease course. Anti-TIF1-γ is also associated with dermatomyositis but its presence is frequently predictive of a cancer association whereas anti-MI2 is associated with the classical dermatomyositis. Two specific antibodies, anti-SRP and anti-HMGCR, are observed in patients with immune-mediated necrotizing myopathies and may be very useful to distinguish acquired myopathies from dystrophic muscular diseases in case of a slow onset and to allow the initiation of effective therapy. Copyright © 2013 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Multivariate statistical process control in product quality review assessment - A case study.

PubMed

Kharbach, M; Cherrah, Y; Vander Heyden, Y; Bouklouze, A

2017-11-01

According to the Food and Drug Administration and the European Good Manufacturing Practices (GMP) guidelines, Annual Product Review (APR) is a mandatory requirement in GMP. It consists of evaluating a large collection of qualitative or quantitative data in order to verify the consistency of an existing process. According to the Code of Federal Regulation Part 11 (21 CFR 211.180), all finished products should be reviewed annually for the quality standards to determine the need of any change in specification or manufacturing of drug products. Conventional Statistical Process Control (SPC) evaluates the pharmaceutical production process by examining only the effect of a single factor at the time using a Shewhart's chart. It neglects to take into account the interaction between the variables. In order to overcome this issue, Multivariate Statistical Process Control (MSPC) can be used. Our case study concerns an APR assessment, where 164 historical batches containing six active ingredients, manufactured in Morocco, were collected during one year. Each batch has been checked by assaying the six active ingredients by High Performance Liquid Chromatography according to European Pharmacopoeia monographs. The data matrix was evaluated both by SPC and MSPC. The SPC indicated that all batches are under control, while the MSPC, based on Principal Component Analysis (PCA), for the data being either autoscaled or robust scaled, showed four and seven batches, respectively, out of the Hotelling T 2 95% ellipse. Also, an improvement of the capability of the process is observed without the most extreme batches. The MSPC can be used for monitoring subtle changes in the manufacturing process during an APR assessment. Copyright © 2017 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

[End-of-life debate: Citizen's point of view about deep and continuous sedation].

PubMed

Toporski, J; Jonveaux-Rivasseau, T; Lamouille-Chevalier, C

2017-12-01

Sedation in palliative care meets a precise definition and corresponds to a medical practice. We assessed the comprehension of this practice by the French population. In 2015, citizen expressed their views on the Claeys-Leonetti bill by means of a consultative forum made available on the Internet site of the National Assembly. The content of the messages filed, regarding the right to deep and continuous sedation until death was analyzed using the ALCESTE textual data analysis software, supplemented by a thematic analysis in order to identify the perception that Internet users had of this practice. Among the 1819 Internet users who participated in the forum, 67 expressed their views as Health professionals, 25 of whom were directly involved in palliative care, as well as 10 sick persons. Analysis with the ALCESTE software highlighted two classes of statements. The first dealing with deep and continuous sedation, reflecting the specificity of the discourse of the Internet users. The second one consisted of textual units in which the modal verbs were dominant and overrepresented, thus providing information on the participants' perceptions. The thematic analysis highlighted four themes: death, intent, treatment and fear. Deep and continuous sedation is perceived as a euthanasic practice or raises fear of such a drift. Provision of extended and accurate information to the population and health professionals is essential to ensure that this new model of sedation is integrated into the care of the terminally ill patients and their families. Copyright © 2017 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Lipid intake in children under 3 years of age in France. A position paper by the Committee on Nutrition of the French Society of Paediatrics.

PubMed

Briend, A; Legrand, P; Bocquet, A; Girardet, J-P; Bresson, J-L; Chouraqui, J-P; Darmaun, D; Dupont, C; Frelut, M L; Goulet, O; Hankard, R; Rieu, D; Simeoni, U; Turck, D; Vidailhet, M

2014-04-01

Lipids are an important source of energy for young children and play a major role in the development and functioning of nervous tissue. Essential fatty acids and their long-chain derivatives also fulfill multiple metabolic functions and play a role in the regulation of numerous genes. The Food and Agriculture Organization of the United Nations (FAO), the World Health Organization (WHO), and the French Agency for Food, Environmental and Occupational Health & Safety (Agence nationale de sécurité sanitaire de l'alimentation, de l'environnement et du travail [ANSES]) have recently recommended a minimum daily intake in preformed long-chain polyunsaturated fatty acids (LC-PUFAs): arachidonic acid (ARA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA). Mother's milk remains the only reference, but the large variability in its DHA content does not guarantee that breastfed children receive an optimal DHA intake if the mother's intake is insufficient. For children fed with infant formulas, ARA and DHA intake is often below the recommended intake because only one-third of infant formulas available on the market in France are enriched in LC-PUFAs. For all children, linoleic acid (LA) intake is on average higher than the minimal recommended values. The consequences of these differences between intake and recommended values are uncertain. A cautious attitude is to come close to the current recommendations and to advise sufficient consumption of DHA in breastfeeding women. For bottle-fed children, infant formulas enriched in LC-PUFAs and with moderate levels of LA should be preferred. LC-PUFA-rich fish should be consumed during breastfeeding, and adapted vegetable oils when complementary foods are introduced. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Short communication. Antiretroviral drug resistance among drug-naive HIV-1-infected individuals in Djibouti (Horn of Africa).

PubMed

Maslin, Jérôme; Rogier, Christophe; Caron, Melanie; Grandadam, Marc; Koeck, Jean-Louis; Nicand, Elisabeth

2005-01-01

To survey the frequency of genotypic antiretroviral resistance in drug-naive HIV-1-infected Djiboutians. A national study was conducted in the general population of Djibouti in March 2002 to determine HIV-1 seroprevalence. Blood samples were collected anonymously and plasma samples scoring positive for HIV-1 antibodies were tested for viral load. Genotypic studies were performed with viral RNA from plasma using the consensus technique of the Agence Nationale de Recherche sur le SIDA (www.hivfrenchresistance.org). Mutations were identified using the International AIDS Society-USA resistance panel and resistant virus was defined according to the ANRS algorithm. A panel of 2423 individuals representing the general population of Djibouti was included. Antibodies were detected in 53 of 2423 samples tested. The HIV-1 seroprevalence in the general population was 2.2%. Genotype C was the most prevalent, and the other isolates were CRF_02 AG, or subtype A or D. Forty-seven of the 53 samples were tested for genotypic resistance, and mutations concerning all three classes of antiretrovirals were found. The most frequent were secondary mutations associated with protease inhibitors (PIs): M36I, R41K and K20I/R. A few strains displayed primary mutations (the non-nucleoside reverse transcriptase inhibitor [NNRTI]-associated mutations K101E, K103T, L100I and G190V; the PI-associated mutation N88D; and the NRTI-associated mutation K65R). The presence of these mutations may be due to the transmission of strains from treated patients. Substantial polymorphism and a few primary mutations are found in HIV-1 non-B subtype isolates from Djiboutian antiretroviral-drug-naive individuals. This needs to be taken into account to adapt antiretroviral regimens and prophylactic schedules locally.

[Interpretation and use of routine pulmonary function tests: Spirometry, static lung volumes, lung diffusion, arterial blood gas, methacholine challenge test and 6-minute walk test].

PubMed

Bokov, P; Delclaux, C

2016-02-01

Resting pulmonary function tests (PFT) include the assessment of ventilatory capacity: spirometry (forced expiratory flows and mobilisable volumes) and static volume assessment, notably using body plethysmography. Spirometry allows the potential definition of obstructive defect, while static volume assessment allows the potential definition of restrictive defect (decrease in total lung capacity) and thoracic hyperinflation (increase in static volumes). It must be kept in mind that this evaluation is incomplete and that an assessment of ventilatory demand is often warranted, especially when facing dyspnoea: evaluation of arterial blood gas (searching for respiratory insufficiency) and measurement of the transfer coefficient of the lung, allowing with the measurement of alveolar volume to calculate the diffusing capacity of the lung for CO (DLCO: assessment of alveolar-capillary wall and capillary blood volume). All these pulmonary function tests have been the subject of an Americano-European Task force (standardisation of lung function testing) published in 2005, and translated in French in 2007. Interpretative strategies for lung function tests have been recommended, which define abnormal lung function tests using the 5th and 95th percentiles of predicted values (lower and upper limits of normal values). Thus, these recommendations need to be implemented in all pulmonary function test units. A methacholine challenge test will only be performed in the presence of an intermediate pre-test probability for asthma (diagnostic uncertainty), which is an infrequent setting. The most convenient exertional test is the 6-minute walk test that allows the assessment of walking performance, the search for arterial desaturation and the quantification of dyspnoea complaint. Copyright © 2015 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

[Clinical and biological manifestations in primary parvovirus B19 infection in immunocompetent adult: a retrospective study of 26 cases].

PubMed

Parra, D; Mekki, Y; Durieu, I; Broussolle, C; Sève, P

2014-05-01

Parvovirus B19 causes erythema infectiosum in children, transient aplastic anemia in patients with hemoglobinopathies, pur red cell aplasia in immunocompromised persons and hydrops fetalis in pregnancy. The spectrum of clinical and biological manifestations in immunocompetent adult continues to grow up. We report on a case series of 26 patients with primary parvovirus B19 infection in immunocompetent adults. This is a retrospective study over the period 2000 to 2010 in two departments of internal medecine. The diagnostic was clinical, serological or molecular. There was a female predominance (sex-ratio 3.33/1). Median patient age at diagnostic was 38.8 years (range: 18-68). The predominant symptoms were fever (65%), peripheral and symmetrical polyarthralgia (62%) and skin rash (58%). Two patients had neurological manifestations (sixth cranial nerve palsy, distal paresthesia) and one patient had myocarditis. Abnormal laboratory values included increased acute phase reactants (73%), thrombocytopenia (43%), lymphopenia (38%) and elevated liver enzymes (37%). Antinuclear (19%), anti-DNA (28%) and anti-phospholipids antibodies (14%), and hypocomplementemia (32%) were observed. False reaction with anti-CMV and anti-EBV IgM positivity was documented in 27% of cases. Two patients had persistent parvovirus B19 infection. The diversity of the clinical manifestations of parvovirus B19 infection may be misleading for the clinician. However, the diagnosis should be suspected in immunocompetent adults to limit the risk of transmission to the patients who could develop a severe infection such as pregnant women or immunocompromised patients. Copyright © 2013 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Intraadrenal corticotropin in bilateral macronodular adrenal hyperplasia.

PubMed

Louiset, Estelle; Duparc, Céline; Young, Jacques; Renouf, Sylvie; Tetsi Nomigni, Milène; Boutelet, Isabelle; Libé, Rossella; Bram, Zakariae; Groussin, Lionel; Caron, Philippe; Tabarin, Antoine; Grunenberger, Fabienne; Christin-Maitre, Sophie; Bertagna, Xavier; Kuhn, Jean-Marc; Anouar, Youssef; Bertherat, Jérôme; Lefebvre, Hervé

2013-11-28

Bilateral macronodular adrenal hyperplasia is a rare cause of primary adrenal Cushing's syndrome. In this form of hyperplasia, hypersecretion of cortisol suppresses the release of corticotropin by pituitary corticotrophs, which results in low plasma corticotropin levels. Thus, the disease has been termed corticotropin-independent macronodular adrenal hyperplasia. We examined the abnormal production of corticotropin in these hyperplastic adrenal glands. We obtained specimens of hyperplastic macronodular adrenal tissue from 30 patients with primary adrenal disease. The corticotropin precursor proopiomelanocortin and corticotropin expression were assessed by means of a polymerase-chain-reaction assay and immunohistochemical analysis. The production of corticotropin and cortisol was assessed in 11 specimens with the use of incubated explants and cell cultures coupled with hormone assays. Corticotropin levels were measured in adrenal and peripheral venous blood samples from 2 patients. The expression of proopiomelanocortin messenger RNA (mRNA) was detected in all samples of hyperplastic adrenal tissue. Corticotropin was detected in steroidogenic cells arranged in clusters that were disseminated throughout the adrenal specimens. Adrenal corticotropin levels were higher in adrenal venous blood samples than in peripheral venous samples, a finding that was consistent with local production of the peptide within the hyperplastic adrenals. The release of adrenal corticotropin was stimulated by ligands of aberrant membrane receptors but not by corticotropin-releasing hormone or dexamethasone. A semiquantitative score for corticotropin immunostaining in the samples correlated with basal plasma cortisol levels. Corticotropin-receptor antagonists significantly inhibited in vitro cortisol secretion. Cortisol secretion by the adrenals in patients with macronodular hyperplasia and Cushing's syndrome appears to be regulated by corticotropin, which is produced by a subpopulation of steroidogenic cells in the hyperplastic adrenals. Thus, the hypercortisolism associated with bilateral macronodular adrenal hyperplasia appears to be corticotropin-dependent. (Funded by the Agence Nationale de la Recherche and others.).

Isolation, identification and characterisation of three novel probiotic strains (Lactobacillus paracasei CNCM I-4034, Bifidobacterium breve CNCM I-4035 and Lactobacillus rhamnosus CNCM I-4036) from the faeces of exclusively breast-fed infants.

PubMed

Muñoz-Quezada, Sergio; Chenoll, Empar; Vieites, José María; Genovés, Salvador; Maldonado, José; Bermúdez-Brito, Miriam; Gomez-Llorente, Carolina; Matencio, Esther; Bernal, María José; Romero, Fernando; Suárez, Antonio; Ramón, Daniel; Gil, Angel

2013-01-01

The aim of the present study was to isolate, identify and characterise novel strains of lactic acid bacteria and bifidobacteria with probiotic properties from the faeces of exclusively breast-fed infants. Of the 4680 isolated colonies, 758 exhibited resistance to low pH and tolerance to high concentrations of bile salts; of these, only forty-two exhibited a strong ability to adhere to enterocytes in vitro. The identities of the isolates were confirmed by 16S ribosomal RNA (rRNA) sequencing, which permitted the grouping of the forty-two bacteria into three different strains that showed more than 99 % sequence identity with Lactobacillus paracasei, Lactobacillus rhamnosus and Bifidobacterium breve, respectively. The strain identification was confirmed by sequencing the 16S-23S rRNA intergenic spacer regions. Strains were assayed for enzymatic activity and carbohydrate utilisation, and they were deposited in the Collection Nationale de Cultures de Microorganismes (CNCM) of the Institute Pasteur and named L. paracasei CNCM I-4034, B. breve CNCM I-4035 and L. rhamnosus CNCM I-4036. The strains were susceptible to antibiotics and did not produce undesirable metabolites, and their safety was assessed by acute ingestion in immunocompetent and immunosuppressed BALB/c mouse models. The three novel strains inhibited in vitro the meningitis aetiological agent Listeria monocytogenes and human rotavirus infections. B. breve CNCM I-4035 led to a higher IgA concentration in faeces and plasma of mice. Overall, these results suggest that L. paracasei CNCM I-4034, B. breve CNCM I-4035 and L. rhamnosus CNCM I-4036 should be considered as probiotic strains, and their human health benefits should be further evaluated.

Associations between transition to retirement and changes in dietary intakes in French adults (NutriNet-Santé cohort study).

PubMed

Si Hassen, Wendy; Castetbon, Katia; Lelièvre, Eva; Lampuré, Aurélie; Hercberg, Serge; Méjean, Caroline

2017-05-30

Few studies have focused on the influence of retirement on dietary behaviors. Our study aimed at assessing the associations between transition to retirement and changes in dietary intake in French adults, particularly according to spousal retirement and baseline income. This prospective study included 577 French participants from the NutriNet-Santé cohort who retired over a 5-year follow-up (2009-2014 or 2010-2015). At baseline and every year, dietary intakes were assessed using 24 h records. Repeated measures of dietary intake were analysed using mixed models adjusted for energy with random effects of time and period (before and after retirement) to assess changes following retirement for each gender. After retirement, intakes of saturated fatty acids and sodium increased in both genders. Women showed specific changes after retirement: decrease in the score of adherence to recommendations and in intakes of fruits, proteins, vitamins; increase in intakes of fatty sweet products. In men with the lowest income at baseline, specific changes in intake were associated with retirement such as decrease in intake of dairy products and increase in intake of lipids. Transition to retirement was associated with unhealthier dietary intakes. These results may help defining interventions during this vulnerable life-period. This study was conducted according to guidelines laid down in the Declaration of Helsinki and all procedures were approved by the Institutional Review Board of the French Institute for Health and Medical Research (IRB Inserm No. 0000388FWA00005831) and the French Data Protection Authority (Commission Nationale Informatique et Libertés No. 908450 and No. 909216). Electronic informed consents were obtained from all participants.

Trends in child overweight rates and energy intake in France from 1999 to 2007: relationships with socioeconomic status.

PubMed

Lioret, Sandrine; Touvier, M; Dubuisson, C; Dufour, A; Calamassi-Tran, G; Lafay, L; Volatier, J-L; Maire, B

2009-05-01

Our objectives were (i) to assess the current prevalence of childhood overweight (including obesity) (OWOB) in France and its relationship with comprehensive socioeconomic status (SES) indicators and (ii) to examine trends in OWOB prevalence and changes in energy intake (EI) and sedentary behavior (SED) based on the previous INCA 1 (Individuelle Nationale des Consommations Alimentaires) data (1998-1999). A representative sample of children aged 3-14 (n = 1,030) was taken from the 2006-2007 cross-sectional INCA 2 food consumption survey. Weight and height were measured. The prevalence of OWOB was estimated according to the IOTF (International Obesity Task Force) definition. Average daily EI was evaluated using a 7-day food record. SED (screen time) and SES were reported by answering questionnaires. SES indicators included the occupation and level of education of the head of the household (HH), and variables describing household wealth. Composite indices of SES were computed by correspondence analysis, and relationships with OWOB were explored by logistic regression analysis. In total, 14.5% (95% CI: 12.1-17.0) of the children were OWOB. All SES indicators were inversely correlated to OWOB. Average EI was equal to 1,739 kcal/day. Daily, children spent 113.5 min watching television, and 38.5 min playing video games or using a computer. Compared to the INCA 1 study, OWOB prevalence was not significantly different, EI was lower, and SED was higher. These trends were the same across all occupational categories of heads of household. Although overall rates of childhood OWOB are currently stabilizing, no change was observed in the strong inverse socioeconomic gradient of OWOB between the two studies.

[Impact of training conferences on medical student's performance for the French National Ranking Examination in Lorraine University. The ETIMCEL experimental study].

PubMed

Agrinier, N; Bannay, A; Santini, J; Braun, M; Angioi, K; Debouverie, M; Zuily, S

2015-02-01

To describe factors associated with a better rank, and to assess the impact of training conferences on medical student's performance for the French National Ranking Examination (FNRE) in Lorraine University, France in 2012. Between October 2011 and May 2012, assistant professors of the faculty of medicine of Nancy, France, organized a cycle of 15 conferences combining clinical cases theoretical training and student peer assessment. Data were recorded with a self-administered questionnaire in January 2012 to collect potential confounders. Among 287 students enrolled in the last year of medical school in 2011-2012 in Lorraine University, 195 (67.9%) of them registered to the cycle of conferences. Among the potential prognostic factors assessed, not repeating the first year of medical curriculum (P=0.013), the number of courses validated at the first session during the second part of the medical curriculum (P=0.002), absence of difficulties experienced in the fifth and sixth year (P=0.032) and a desired ranking among the best (P=0.011) were independently associated with a better rank at the FNRE. Regular participation in conferences was significantly and independently associated with a higher ranking (mean gain for the participation in 13 or more conferences: 873; mean gain by conference: 63). Regular participation in conferences provided by assistant professors and based on clinical cases theoretical training and student peer assessment was significantly associated with a higher ranking to the FNRE in Lorraine University in 2012. Copyright © 2014 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

[Hereditary hemochromatosis: presenting manifestations and diagnostic delay].

PubMed

Gasser, B; Courtois, F; Hojjat-Assari, S; Sauleau, E A; Buffet, C; Brissot, P

2014-03-01

Hereditary hemochromatosis is characterized by an excessive absorption and progressive accumulation of iron in the liver, the pancreas, the heart, and the joints. Tiredness and joint manifestations occur usually before hepatopathy, diabetes or cardiopathy. Such common and unspecific symptoms seem to be largely unknown and important diagnostic delays have been reported. The aim of this study was to investigate the discovery circumstances and the diagnostic delay. A survey was carried out amongst French patients with C282Y homozygous hemochromatosis who were contacted through patients associations or blood centers. The questionnaire was answered by 374 patients. Mean age at diagnosis was 48.6±11.9years. In 53% of the cases, the serum level of ferritin was greater than 1000 μg/L. Diagnosis was based on family genetic survey (29%), or fortuitous analyses showing an abnormal serum ferritin (26%), or clinical manifestations (45%). Main complaints were joint pain, tiredness or liver disease. Only 2.1% consulted for diabetes, cardiopathy or changed complexion. Time to diagnosis was lower than 1 year for 98% of patients who presented with fatigue but from 1 to 15 years for 23.4% and 29% of patients who presented with arthropathy and hepatopathy, respectively. For 55% of patients, diagnosis was based on familial genetic survey or fortuitous abnormal results of blood samples. An initial serum level of ferritin greater than 1000 μg/L was a factor of severity for 50% of patient. These two elements must be taken into account to consider a population mass screening. Long time to diagnosis required a sensitization of the population to be aware of the clinical manifestations of hemochromatosis. Copyright © 2013 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Comparative plasma disposition kinetics of albendazole and its new benzimidazol prodrug in dog.

PubMed

Khalil, Z; El Karbane, M; Faouzi, M E A; Ansar, M; Azougagh, M; El Harti, J; Taoufik, J

2016-01-01

The comparative pharmacokinetic behavior of albendazole (ABZ) and its new benzimidazol prodrug [1-tert-butyloxycarbonyl-5-propylthio-1-H-benzimidazol-2ylcarbamate of methyl] (ABZBoc), following their oral administration (10mg/kg) to healthy dogs was explored. Blood samples were obtained serially over a 24h period after treatment, then the plasma was analyzed by high-performance liquid chromatography (HPLC) to search the albendazole metabolites (ABZSO and ABZSO2). However, the albendazole parent drug was not detectable at any time after both treatments (ABZ and ABZBoc). By albendazole metabolites (ABZSO and ABZSO2) were the analytes recovered in the plasma after oral administration of ABZ and ABZBoc. Furthermore, some amounts of ABZBoc were also available in the plasma samples treated with this new produg. The plasma profile of each analyte followed a similar pattern after both treatments, the active metabolite (ABZSO) was the major analyte recovered in plasma (between 1 and 24h post-treatment). The pharmacokinetic parameters of both groups were calculated (Cmax, Tmax, t1/2, AUC0-›∞), and analyzed using the Student's t-test, P<0.05. Thus,the pharmacokinetic analysis indicated four statistically significant changes in the pharmacokinetic parameters defined above of the albendazole metabolites (ABZSO, ABZSO2) between the group treated with albendazole (group A) and that treated with ABZBoc prodrug (group B). Hence, the levels of the various pharmacokinetics parameters were low in the group treated with prodrug, as well they did not reach equivalent concentrations to that of albendazole. These differences between albendazole and its new prodrug may be explained by the fact that ABZBoc prodrug was not effectively reduced in the intestine of dogs. Copyright © 2015 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

Development and validation of clinical prediction models for mortality, functional outcome and cognitive impairment after stroke: a study protocol

PubMed Central

Fahey, Marion; Rudd, Anthony; Béjot, Yannick; Wolfe, Charles; Douiri, Abdel

2017-01-01

Introduction Stroke is a leading cause of adult disability and death worldwide. The neurological impairments associated with stroke prevent patients from performing basic daily activities and have enormous impact on families and caregivers. Practical and accurate tools to assist in predicting outcome after stroke at patient level can provide significant aid for patient management. Furthermore, prediction models of this kind can be useful for clinical research, health economics, policymaking and clinical decision support. Methods 2869 patients with first-ever stroke from South London Stroke Register (SLSR) (1995–2004) will be included in the development cohort. We will use information captured after baseline to construct multilevel models and a Cox proportional hazard model to predict cognitive impairment, functional outcome and mortality up to 5 years after stroke. Repeated random subsampling validation (Monte Carlo cross-validation) will be evaluated in model development. Data from participants recruited to the stroke register (2005–2014) will be used for temporal validation of the models. Data from participants recruited to the Dijon Stroke Register (1985–2015) will be used for external validation. Discrimination, calibration and clinical utility of the models will be presented. Ethics Patients, or for patients who cannot consent their relatives, gave written informed consent to participate in stroke-related studies within the SLSR. The SLSR design was approved by the ethics committees of Guy’s and St Thomas’ NHS Foundation Trust, Kings College Hospital, Queens Square and Westminster Hospitals (London). The Dijon Stroke Registry was approved by the Comité National des Registres and the InVS and has authorisation of the Commission Nationale de l’Informatique et des Libertés. PMID:28821511

Asteroid Shapes Are Always Close To Fluid Equilibrium

NASA Astrophysics Data System (ADS)

Tanga, Paolo; Comito, C.; Hestroffer, D.; Richardson, D. C.

2010-10-01

The simple evidence that asteroid are composed by solid rocks suggests that their shape can be rather far from the theoretical equilibrium for rotating fluid bodies. The possible fragmented ("rubble-pile") nature of most of them has suggested interpretations based on elasto-plastic models (such as the Mohr-Coulomb theory) that take into account the static behavior of a granular structure. However, these approaches did not incorporate explicitly the possible evolution of shapes in time due to external factors such as crater forming impacts or tidal deformations. We revisited the theory of equilibrium shapes for fluids, quantitatively evaluating - by appropriate metrics - the distance of the observed shapes from fluid equilibrium. This distance turns out to be much smaller than previously expected. On the basis of this evidence, we simulated numerically the evolution of gravitational aggregates having a small degree of internal friction, consistent with the theoretical findings. Our results offer a global scenario for the evolution of asteroid shapes under the action of gradual stresses due to minor impacts, tidal forces and seismic shaking. We show that actual asteroid shapes are consistent with the evolution of aggregates tending towards minimum free energy states. We are able to explain the samples of observed shapes obtained by different techniques. Our findings strongly support a highly porous and fragmented nature for most asteroids, at least in an external layer. Reference: Tanga et al. 2009: ApJ Letters, 706, 1, L197-L202 Acknowledgments: PT and CC have been supported by the "Programme Nationale de Planetologie" of France; DCR acknowledges support by the NASA (grant no. NNX08AM39G issued through the Office of Space Science) and by the NSF (grant no. AST0708110).

[Assessment of patient needs to design a patient education program in systemic lupus erythematosus].

PubMed

Hervier, B; Devilliers, H; Amiour, F; Ayçaguer, S; Neves, Y; Ganem, M-C; Amoura, Z; Antignac, M

2014-05-01

The aim of this study was to collect information to design a patient education program (PEP) for patients with systemic lupus erythematosus (SLE), based as much as possible on their expectations. Three different approaches were used for addressing patients' needs: 1) A questionnaire on their expectations in terms of a PEP was sent to the members of SLE associations and offered to patients at the French reference center for SLE, 2) A patients' focus group was conducted, and 3) After the teaching sessions, satisfaction questionnaires were also evaluated. The patients who answered the expectation questionnaire (n=422, women/men sex-ratio: 12.6) indicated a major interest in the PEP (70.4%). Their expectations were broad, and covered the topics of pregnancy (90% of the women under the age of 40), the outcome of the disease (80.8%), the respective roles of the different treatments (70.4%), and also the management of everyday symptoms: fatigue and pain (66.4%). The focus group (eight people) highlighted the need for improving how the diagnosis of the disease was delivered, and also revealed the loneliness and the guilty feeling experienced by some patients toward their relatives. Satisfaction questionnaires confirmed these expectations for the PEP, and even extended them to new topics: the mechanisms behind SLE, travel and leisure, and possible accommodations in the workplace. The direct consultation of patients with SLE targeted by a specific PEP program allowed us to confirm and adapt the topics and the content of a program designed by medical staff. Copyright © 2013 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Recurrent pericarditis.

PubMed

Imazio, M; Battaglia, A; Gaido, L; Gaita, F

2017-05-01

Recurrent pericarditis is the most troublesome complication of pericarditis occurring in 15 to 30% of cases. The pathogenesis is often presumed to be immune-mediated although a specific rheumatologic diagnosis is commonly difficult to find. The clinical diagnosis is based on recurrent pericarditis chest pain and additional objective evidence of disease activity (e.g. pericardial rub, ECG changes, pericardial effusion, elevation of markers of inflammation, and/or imaging evidence of pericardial inflammation by CT or cardiac MR). The mainstay of medical therapy for recurrent pericarditis is aspirin or a non-steroidal anti-inflammatory drug (NSAID) plus colchicine. Second-line therapy is considered after failure of such treatments and it is generally based on low to moderate doses of corticosteroids (e.g. prednisone 0.2 to 0.5 mg/kg/day or equivalent) plus colchicine. More difficult cases are treated with combination of aspirin or NSAID, colchicine and corticosteroids. Refractory cases are managed by alternative medical options, including azathioprine, or intravenous human immunoglobulins or biological agents (e.g. anakinra). When all medical therapies fail, the last option may be surgical by pericardiectomy to be recommended in well-experienced centres. Despite a significant impairment of the quality of life, the most common forms of recurrent pericarditis (usually named as "idiopathic recurrent pericarditis" since without a well-defined etiological diagnosis) have good long-term outcomes with a negligible risk of developing constriction and rarely cardiac tamponade during follow-up. The present article reviews current knowledge on the definition, diagnosis, aetiology, therapy and prognosis of recurrent pericarditis with a focus on the more recent available literature. Copyright © 2016 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

High level of APOBEC3F/3G editing in HIV-2 DNA vif and pol sequences from antiretroviral-naive patients.

PubMed

Bertine, Mélanie; Charpentier, Charlotte; Visseaux, Benoit; Storto, Alexandre; Collin, Gilles; Larrouy, Lucile; Damond, Florence; Matheron, Sophie; Brun-Vézinet, Françoise; Descamps, Diane

2015-04-24

In HIV-1, hypermutation introduced by APOBEC3F/3G cytidine deaminase activity leads to defective viruses. In-vivo impact of APOBEC3F/3G editing on HIV-2 sequences remains unknown. The objective of this study was to assess the level of APOBEC3F/3G editing in HIV-2-infected antiretroviral-naive patients. Direct sequencing of vif and pol regions was performed on HIV-2 proviral DNA from antiretroviral-naive patients included in the French Agence Nationale de Recherches sur le SIDA et les hépatites virales CO5 HIV-2 cohort. Hypermutated sequences were identified using Hypermut2.0 program. HIV-1 proviral sequences from Genbank were also assessed. Among 82 antiretroviral-naive HIV-2-infected patients assessed, 15 (28.8%) and five (16.7%) displayed Vif proviral defective sequences in HIV-2 groups A and B, respectively. A lower proportion of defective sequences was observed in protease-reverse transcriptase region. A higher median number of G-to-A mutations was observed in HIV-2 group B than in group A, both in Vif and protease-reverse transcriptase regions (P = 0.02 and P = 0.006, respectively). Compared with HIV-1 Vif sequences, a higher number of Vif defective sequences was observed in HIV-2 group A (P = 0.00001) and group B sequences (P = 0.013). We showed for the first time a high level of APOBEC3F/3G editing in HIV-2 sequences from antiretroviral-naive patients. Our study reported a group effect with a significantly higher level of APOBEC3F/3G editing in HIV-2 group B than in group A sequences.

Seasonal variability of suspended sediment transport in the Seine river catchment area (France)

NASA Astrophysics Data System (ADS)

Franke, Christine; Baati, Selma; Ayrault, Sophie; Bonte, Philippe; Evrard, Olivier; Kissel, Catherine

2010-05-01

This study consists in an innovative application of environmental physico-chemical techniques on fluvial sediments with the aim to trace the seasonal changes in suspended sediment transport of the complex Seine river catchment area in northern France. The aim of this project is to develop a detailed understanding for the discrimination of naturally triggered and anthropogenic induced processes and their temporal changes with weather conditions. With a focus on the heavy metal fraction, we determine the regional distribution of the suspended material and search for environmental fingerprints demonstrating the influence of fluvial transport mechanisms, changes in concentration related to discharge variations or different sediment sources, and in-situ alteration caused by variations in the geochemical conditions (oxy-redox, pH, Eh, etc.). To achieve these goals, we apply a combination of straightforward rock magnetic hysteresis measurements (performed using an AGM2900 at the LSCE) and advanced scanning electron microscopy analyses (SEM). This interdisciplinary approach allows refining the detailed analysis of sediment trap samples, originating from Tessier et al. (2003), as recently shown by Franke et al. (2009). In our preliminary results, we observe a general increase in magnetic concentrations from summer to winter conditions, coupled with a magneto-mineralogic change to rather reduced metallic mineral phases. However, each riversection of the Seine system shows its specific trend line depending on the regional initial input, weathering conditions, drainage area and potential pollution sources. A systematic analysis of the detailed results will allow highlighting the climatic/seasonal influence on the metallic particle assembly. Keywords: Seine river system, environmental magnetism, suspended particulate matter, anthropogenic and natural input, magnetic hysteresis, scanning electron microscopy (SEM),, heavy metal pollution, seasonal variability References: Franke, C., Kissel, C., Robin, E., Bonté, P. and Lagroix, F., 2009, Magnetic particle characterization in the Seine river system: Implications for the determination of natural versus anthropogenic input, Geochem. Geophys. Geosyst., doi:10.1029/2009GC002544. Tessier, L., Bonté, P., Mouchel, J.M., Lefevre, I., Sogon, S., Ayrault, S., Le Cloarec, M.F., 2003, Transport et characterisation des matieres en suspension dans le basin de la Seine : Identification des signatures naturelles et anthropiques, 14èmes Journées Scientifiques de l'Environnement : l'Eau, la Ville, la Vie, Créteil : France 2003. http://hal.archives-ouvertes.fr/docs/00/20/30/84/PDF/4-JSE-2003-Manuscrit-Tessier-HAL-2008-01-08.pdf

Rapid sampling of stochastic displacements in Brownian dynamics simulations with stresslet constraints

NASA Astrophysics Data System (ADS)

Fiore, Andrew M.; Swan, James W.

2018-01-01

Brownian Dynamics simulations are an important tool for modeling the dynamics of soft matter. However, accurate and rapid computations of the hydrodynamic interactions between suspended, microscopic components in a soft material are a significant computational challenge. Here, we present a new method for Brownian dynamics simulations of suspended colloidal scale particles such as colloids, polymers, surfactants, and proteins subject to a particular and important class of hydrodynamic constraints. The total computational cost of the algorithm is practically linear with the number of particles modeled and can be further optimized when the characteristic mass fractal dimension of the suspended particles is known. Specifically, we consider the so-called "stresslet" constraint for which suspended particles resist local deformation. This acts to produce a symmetric force dipole in the fluid and imparts rigidity to the particles. The presented method is an extension of the recently reported positively split formulation for Ewald summation of the Rotne-Prager-Yamakawa mobility tensor to higher order terms in the hydrodynamic scattering series accounting for force dipoles [A. M. Fiore et al., J. Chem. Phys. 146(12), 124116 (2017)]. The hydrodynamic mobility tensor, which is proportional to the covariance of particle Brownian displacements, is constructed as an Ewald sum in a novel way which guarantees that the real-space and wave-space contributions to the sum are independently symmetric and positive-definite for all possible particle configurations. This property of the Ewald sum is leveraged to rapidly sample the Brownian displacements from a superposition of statistically independent processes with the wave-space and real-space contributions as respective covariances. The cost of computing the Brownian displacements in this way is comparable to the cost of computing the deterministic displacements. The addition of a stresslet constraint to the over-damped particle equations of motion leads to a stochastic differential algebraic equation (SDAE) of index 1, which is integrated forward in time using a mid-point integration scheme that implicitly produces stochastic displacements consistent with the fluctuation-dissipation theorem for the constrained system. Calculations for hard sphere dispersions are illustrated and used to explore the performance of the algorithm. An open source, high-performance implementation on graphics processing units capable of dynamic simulations of millions of particles and integrated with the software package HOOMD-blue is used for benchmarking and made freely available in the supplementary material (ftp://ftp.aip.org/epaps/journ_chem_phys/E-JCPSA6-148-012805)

Le Laboratoire de Mécanique Appliquée Raymond Chaléat a 40 ans !

NASA Astrophysics Data System (ADS)

Comité D'Organisation Du Colloque Ime 2002, Le

2002-12-01

Le LMARC a été créé par Raymond Chaléat dans les locaux de l'École Nationale d'Horlogerie (a présent Lycée Technique Jules Haag).L'équipe de recherche était alors constituée de 2 enseignants-chercheurs (Raymond Chaléat et Gérard Lallement) et d'un technicien (Bernard Prêtre). Les travaux de recherche se situaient naturellement dans le domaine de la chronométrie et en particulier dans la mécanique non linéaire analytique inhérente à la montre en fonctionnement. En effet, Raymond Chaléat fut l'élève, puis le collaborateur du Professeur Jules Haag, mathématicien et mécanicien, lui-même élève de Poincarré.Le LMARC a étendu ses activités avec l'arrivée de Claude Oudet, puis de Claude Oytana à la rhéologie des matériaux solides qui est devenue plus tard l'Équipe Propriétés Mécaniques des Matériaux. En parallèle, G. Lallement a créé une équipe Vibrations devenue à ce jour Dynamique des Structures. À ce jour, le Laboratoire compte plus de 110 personnes dont 40 doctorants.Il a depuis diversifié ses activités avec 3 nouvelles équipes tournées vers la Modélisation et la Mise en Forme des Matériaux, les Micromachines et la Biomécanique et les Mécanismes. Il a su également prendre toute sa place au sein de l'Institut des Microtechniques de Franche-Comté en contribuant à plusieurs thèmes.Notre Laboratoire a été l'un des premiers laboratoires associé au CNRS (4ème) et a toujours été rattaché à l'Université de Franche-Comté (Présidence par C. Oytana de 1996 a 2001) par l'entremise de I'UFR Sciences et Techniques. Il a toujours maintenu des liens forts avec I'ENSMM (École Nationale Supérieure de Mécanique et des Microtechniques) d'une part par ses enseignants-chercheurs et d'autre part deux de ses directeurs, Raymond Chaléat et actuellement Jean-Claude Gelin.En plus de ses relations constantes avec l'industrie régionale, le LMARC a développé des actions contractuelles avec de grands groupes tels que EDF, Peugeot SA, Renault, SNECMA, EADS, ...Il a su s'ouvrir aux collaborations internationales tout d'abord avec la Tchécoslovaquie, le Brésil, la Pologne, maintenant la Chine, la Russie, Corée du Sud, la Hongrie, la Roumanie ...Tout ce travail n'aurait pas pu se faire sans des ingénieurs, techniciens et des services techniques et administratifs épaulant efficacement les chercheurs CNRS et les enseignants-chercheurs.Globalement, si les aspects appliqués en mécanique sont un point fort du laboratoire, ce qui justifie son nom, son activité de recherche est restée plus généralement orientée vers les interactions entre expériences et modélisation en mécanique du solide.À l'occasion de ses 40 ans Le LMARC a souhaité organiser une conférence sur ce thème regroupant des chercheurs, collègues et amis pour faire le point sur ce sujet. Grâce à 6 conférences plénières et de 52 conférences en deux sessions, des sujets traitant du comportement des matériaux, de leur mise en forme, de la dynamique des structures, de la biomécanique et de la robotique ont pu être abordés. Ce livre regroupe l'ensemble des papiers présentés lors de cette conférence.

Liver-related deaths in HIV-infected patients between 1995 and 2010 in France: the Mortavic 2010 study in collaboration with the Agence Nationale de Recherche sur le SIDA (ANRS) EN 20 Mortalité 2010 survey.

PubMed

Rosenthal, E; Roussillon, C; Salmon-Céron, D; Georget, A; Hénard, S; Huleux, T; Gueit, I; Mortier, E; Costagliola, D; Morlat, P; Chêne, G; Cacoub, P

2015-04-01

The aim of this study was to describe the proportion of liver-related diseases (LRDs) as a cause of death in HIV-infected patients in France and to compare the results with data from our five previous surveys. In 2010, 24 clinical wards prospectively recorded all deaths occurring in around 26 000 HIV-infected patients who were regularly followed up. Results were compared with those of previous cross-sectional surveys conducted since 1995 using the same design. Among 230 reported deaths, 46 (20%) were related to AIDS and 30 (13%) to chronic liver diseases. Eighty per cent of patients who died from LRDs had chronic hepatitis C, 16.7% of them being coinfected with hepatitis B virus (HBV). Among patients who died from an LRD, excessive alcohol consumption was reported in 41%. At death, 80% of patients had undetectable HIV viral load and the median CD4 cell count was 349 cells/μL. The proportion of deaths and the mortality rate attributable to LRDs significantly increased between 1995 and 2005 from 1.5% to 16.7% and from 1.2‰ to 2.0‰, respectively, whereas they tended to decrease in 2010 to 13% and 1.1‰, respectively. Among liver-related causes of death, the proportion represented by hepatocellular carcinoma (HCC) dramatically increased from 5% in 1995 to 40% in 2010 (p = 0.019). The proportion of LRDs among causes of death in HIV-infected patients seems recently to have reached a plateau after a rapid increase during the decade 1995-2005. LRDs remain a leading cause of death in this population, mainly as a result of hepatitis C virus (HCV) coinfection, HCC representing almost half of liver-related causes of death. © 2014 British HIV Association.

Polylactic acid vs. polyacrylamide hydrogel for treatment of facial lipoatrophy: a randomized controlled trial [Agence Nationale de Recherches sur le SIDA et les Hépatites Virales (ANRS) 132 SMILE].

PubMed

Lafaurie, M; Dolivo, M; Girard, P-M; May, T; Bouchaud, O; Carbonnel, E; Madelaine, I; Loze, B; Porcher, R; Molina, J-M

2013-08-01

The aim of the study was to demonstrate the noninferiority of polyacrylamide hydrogel (PH) vs. polylactic acid (PLA) for the treatment of facial lipoatrophy in HIV-infected adults. A randomized, blinded, multicentre, noninferiority 96-week study was carried out. Patients with facial lipoatrophy were randomly assigned to receive intradermal injections with PH or PLA, and were blinded to the filler. The primary efficacy endpoint was patient satisfaction at week 48 assessed using a visual analogue scale score (VAS). Secondary efficacy end-points included cheek thickness and skin-fold, lipoatrophy grading and quality of life. Safety was assessed by the reporting of adverse events. A total of 148 patients were included in the study; 93% were men, the median age was 47 years, the median CD4 count was 528 cells/μL, and the median duration of antiretroviral therapy was 12 years. Mean VAS increased from 2.8 at baseline to 7.1 and 7.5 in the PLA and PH arms, respectively, at week 48 (P=0.0002 for noninferiority) and was sustained at week 96 (6.7 and 7.9 in the PLA and PH arms, respectively; P=0.003 for noninferiority). Cheek thickness and skin-fold increases and lipoatrophy improvement were similar in the two arms. Quality of life remained unchanged or improved depending on the questionnaire used. In injected patients, subcutaneous nodules emerged in 28 (41%) and 26 (37%) patients in the PLA and PH arms, respectively (P=0.73). Four patients in the PH arm developed severe inflammatory nodules, a median of 17 months after the last injection. PH and PLA have similar efficacies in the treatment of facial lipoatrophy, but PH may be associated with more delayed inflammatory nodules. © 2013 British HIV Association.

[Objective evaluation and comparison of the scientific publication from the departments of the Assistance publique-Hôpitaux de Paris: analysis of the SIGAPS score].

PubMed

Lefèvre, J H; Faron, M; Drouin, S J; Glanard, A; Chartier-Kastler, E; Parc, Y; Rouprêt, M

2013-06-01

To analyze the results of the bibliometric system (SIGAPS score) of scientific publications in the Assistance publique-Hôpitaux de Paris (AP-HP) and to compare the scientific production among the various medical and surgical specialties of the academic hospitals of Paris. All the publications imported from Pubmed between 2006 and 2008 were included. The following data were taken into account and analysed: the hospital department of origin, the number of articles published, the number of full-time physicians, the SIGAPS score. Thirty-eight thousand, seven hundred and nine publications were included. The departments were consisted of 747 full-time practitioners 5719 (1895 Professors [33.1%], 2772 Assistant Professors [48.4%] and 1052 fellows [18.4%]). The average number of full-time practitioner by department was 7.7±6.7 (range 1-69). The average total number of articles published in a department was 51.8±49.4 (range 1-453). The average SIGAPS score was more important in medicine than in surgery (621.2±670.1 vs. 401±382.2; P=0.01) but not the average number of article per practitioner (8.1±8.3 vs. 6.6±6.2; P=0.0797). The mean number of publication by full-time practitioner was 7.9±7.8 (1-45), or an average of 2.7±2.6 for each full-time practitioner each year. Academic hospitals in Paris have a reasonably scientific output but with a mean of 2.7 articles per full-time practitioner per year. No major differences between medical and surgical disciplines were observed. Copyright © 2012 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

[From Crex mutualisation to clinical audit].

PubMed

Debouck, F; Petit, H-B; Lartigau, E

2010-10-01

In mid-2004, following a Mission nationale d'expertise et d'audits hospitaliers (MeaH) proposal, three voluntary cancer centres started setting up a safety procedure in radiotherapy. Their work made it possible to single out the need to continue elaborating a repository, aiming at a "minimal written reference", to take into account the human factor as one of the four families of factors contributing to a systemic deviation and to build collectively, in radiotherapy departments, the experience feedback committee (comité de retour d'expérience [Crex]). Formalizing a comité de retour d'expérience is unavoidable in any safety-management system (SMM or MGS). The comité de retour d'expérience enables every active member of a department to listen to any of the events of the month (incidents and precursors), to select the event which will be under scrutiny for the next systemic analysis (Orion(©) method) and above all to choose the most appropriate correcting action and ensure its proper implementation. That approach has been approved and then acknowledged by the Autorité de sûreté nucléaire (ASN) before being extended to the other radiotherapy departments. The use of the comité de retour d'expérience, which is a safety management tool, should not be limited to a local circle of insiders, but shared to benefit everybody. Putting comité de retour d'expérience together - a move that was hoped for and brought up as soon as the tool was created - is now being implemented. Several initiatives have already permitted to assess its collective interest; other steps have yet to be taken to enable a true collective sharing of experience. On this basis, the definition of quality/safety practices in radiotherapy will allow the professionals to implement clinical audits in 2012. Copyright © 2010 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

[Orientation of patients referred by their general practionner to the public or private hospital sector in France: A prospective epidemiologic study].

PubMed

Reuter, P-G; Kernéis, S; Turbelin, C; Souty, C; Arena, C; Gavazzi, G; Sarazin, M; Blanchon, T; Hanslik, T

2012-12-01

In-patients characteristics generate cost differences between hospitals. In France, there are few data on the characteristics on the patients referred to hospitals by their general practitioners (GPs) and none on the predictors of referral to the public or for-profit hospitals. The aim of this study was to analyze those characteristics and the predictors of referral to the public or for-profit hospitals. We collected, prospectively, the request for hospitalizations made by the GPs of the Sentinelles network in France, from 2007 to 2009. Patients' characteristics and also the reasons for that request were analyzed. A logistic regression was used to compare the population between local hospitals. Ten thousand seven hundred and eighteen statements were collected. The median age was 73 years. Patients were women in 51% of the cases, and only 14% of the hospitalizations had been planned. Hospitalization in the public sector was preferred for young children and the elderly (P<0.001). When compared to the patients referred to the private sector, patients addressed to the public sector were more often seen for emergencies (OR: 2.3 [2.0-2.8]), by a doctor different from their referring GP (OR: 1.7 [1.4-2.1]) and out of the GP's office. The reasons for hospital admission were different depending on the sector of hospitalization (P<0.001), patients addressed to the public sector hospitals presented with greater comorbidity or more complex diagnosis (for example: feeling ill, fainting or syncope and fever) or a greater disability (for example: stroke, neurological and psychiatric diseases). This study suggests that GPs send their patients to the public or for-profit hospitals according to criteria of severity, comorbidity and disability. Copyright © 2012 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

[Qualitative and quantitative evaluation of an internal medicine assistance line dedicated to the diagnosis and treatment of diseases for general practice].

PubMed

Castillo, J-M; Agard, C; Artifoni, M; Brisseau, J-M; Connault, J; Durant, C; Espitia, O; Masseau, A; Neel, A; Perrin, F; Pistorius, M-A; Planchon, B; Ponge, T; Hamidou, M; Pottier, P

2016-05-01

Clinical reasoning and treatment challenges within the scope of general practice led to the development of an internal medicine assistance line provided by Nantes University Hospital. The primary outcome of this study was to describe callers' profile, their requests and answers provided. A prospective, cross-sectional, observational, descriptive study was undertaken. For each call were identified the calling physician, her/his specialty and work setting, the call's object and adequacy, the answer provided, the time needed to connect with the assistance line, the time devoted by the internal medicine physician to provide an answer to the request, and whether the assistance line prevented a visit to the emergency room. Each calling physician was then called back to obtain demographic and professional characteristics, and data relating to the call and to the assistance line. Sixty-three days were analyzed and 276 calls identified. The 237 identified calling physicians were mainly females (54%, n=93), with a mean age of 46 years, graduated from Nantes University (65%, n=86), practicing ambulatory general medicine (69%, n=164) in Loire-Atlantique department area (82%, n=176) for a mean duration of 15 years. Calls were mostly associated with diagnostic challenges (61%, n=166) concerning clinical issues (57%, n=155). A sole telephone advice was the main type of answer provided (56%, n=147) and a visit to the emergency room was prevented for 17% of calls. The assistance line activity is adequate with its missions and seems to facilitate patients' healthcare delivery advocating for the development of similar structures in other units. Improvements relating to the information, availability and physicians' training should be considered. Copyright © 2015 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

[Pharmacovigilance center --internal medicine interactions: A useful diagnostic tool].

PubMed

Rochoy, M; Gautier, S; Bordet, R; Caron, J; Launay, D; Hachulla, E; Hatron, P-Y; Lambert, M

2015-08-01

Patients hospitalized in internal medicine often have unexplained clinical symptoms for which a drug origin can be considered. The prevalence of patients hospitalized for iatrogenic is estimated between 4-22%. We wanted to evaluate the diagnostic value of the regional center of pharmacovigilance to identify or confirm an iatrogenic disease in the department of internal medicine of Lille and characterize factors associated with drug-related side effect. This is a single-center prospective diagnostic study. We included all subsequent requests from the department of internal medicine with the Nord-Pas-de-Calais regional pharmacovigilance center between 2010 and 2012. The opinion of the regional pharmacovigilance centre was held on the record of the adverse drug reaction in the national pharmacovigilance database and analyzed according to the conclusion of iatrogenic used by clinicians in internal medicine (reference diagnosis) with a follow-up to June 2013. The variables relating to the patient, medication and adverse events were analyzed by binary logistic regression. We analyzed 160 contacts: 118 concordant cases, 38 false-positives (drug-related side effect retained by the regional pharmacovigilance center only), 4 false negatives. Registration in the national pharmacovigilance database had a sensitivity of 96% (95% CI [0.92 to 0.99]), a specificity of 46% (95% CI [0.38 to 0.53]), a value positive predictive of 69% (95% CI [0.62 to 0.76]), a negative predictive value of 89% (95% CI [0.84 to 0.94]) and a negative likelihood ratio of 0.1. False-positive had chronological and semiological accountabilities questionable (adjusted RR=2.1, 95% CI [1.2 to 2.8]). In our study, the regional pharmacovigilance center confirms the clinician's suspicion of drug-related side effects and helps to exclude drug-induced with a high negative predictive value. Copyright © 2015 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Development and validation of clinical prediction models for mortality, functional outcome and cognitive impairment after stroke: a study protocol.

PubMed

Fahey, Marion; Rudd, Anthony; Béjot, Yannick; Wolfe, Charles; Douiri, Abdel

2017-08-18

Stroke is a leading cause of adult disability and death worldwide. The neurological impairments associated with stroke prevent patients from performing basic daily activities and have enormous impact on families and caregivers. Practical and accurate tools to assist in predicting outcome after stroke at patient level can provide significant aid for patient management. Furthermore, prediction models of this kind can be useful for clinical research, health economics, policymaking and clinical decision support. 2869 patients with first-ever stroke from South London Stroke Register (SLSR) (1995-2004) will be included in the development cohort. We will use information captured after baseline to construct multilevel models and a Cox proportional hazard model to predict cognitive impairment, functional outcome and mortality up to 5 years after stroke. Repeated random subsampling validation (Monte Carlo cross-validation) will be evaluated in model development. Data from participants recruited to the stroke register (2005-2014) will be used for temporal validation of the models. Data from participants recruited to the Dijon Stroke Register (1985-2015) will be used for external validation. Discrimination, calibration and clinical utility of the models will be presented. Patients, or for patients who cannot consent their relatives, gave written informed consent to participate in stroke-related studies within the SLSR. The SLSR design was approved by the ethics committees of Guy's and St Thomas' NHS Foundation Trust, Kings College Hospital, Queens Square and Westminster Hospitals (London). The Dijon Stroke Registry was approved by the Comité National des Registres and the InVS and has authorisation of the Commission Nationale de l'Informatique et des Libertés. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Comprehensive Chemical Characterisation of Byzantine Glass Weights

PubMed Central

Schibille, Nadine; Meek, Andrew; Tobias, Bendeguz; Entwistle, Chris; Avisseau-Broustet, Mathilde; Da Mota, Henrique; Gratuze, Bernard

2016-01-01

The understanding of the glass trade in the first millennium CE relies on the characterisation of well-dated compositional groups and the identification of their primary production sites. 275 Byzantine glass weights from the British Museum and the Bibliothèque nationale de France dating to the sixth and seventh century were analysed by LA-ICP-MS. Multivariate statistical and graphical data analysis discriminated between six main primary glass types. Primary glass sources were differentiated based on multi-dimensional comparison of silica-derived elements (MgO, Al2O3, CaO, TiO2, Fe2O3, ZrO2) and components associated with the alkali source (Li2O, B2O3). Along with Egyptian and Levantine origins of the glassmaking sands, variations in the natron source possibly point to the exploitation of two different natron deposits. Differences in strontium to calcium ratios revealed variations in the carbonate fractions in the sand. At least two cobalt sources were employed as colouring agents, one of which shows strong correlations with nickel, indicating a specific post-Roman cobalt source. Typological evidence identified chronological developments in the use of the different glass groups. Throughout the sixth century, Byzantine glass weights were predominately produced from two glasses that are probably of an Egyptian origin (Foy-2 and Foy-2 high Fe). Towards the second half of the sixth century a new but related plant-ash glass type emerged (Magby). Levantine I was likewise found among the late sixth- to early seventh-century samples. The use of different dies for the same batch testifies to large-scale, centralised production of the weights, while the same die used for different primary production groups demonstrates the co-existence of alternative sources of supply. Given the comprehensive design of our study, these results can be extrapolated to the wider early Byzantine glass industry and its changes at large. PMID:27959963

Comprehensive Chemical Characterisation of Byzantine Glass Weights.

PubMed

Schibille, Nadine; Meek, Andrew; Tobias, Bendeguz; Entwistle, Chris; Avisseau-Broustet, Mathilde; Da Mota, Henrique; Gratuze, Bernard

2016-01-01

The understanding of the glass trade in the first millennium CE relies on the characterisation of well-dated compositional groups and the identification of their primary production sites. 275 Byzantine glass weights from the British Museum and the Bibliothèque nationale de France dating to the sixth and seventh century were analysed by LA-ICP-MS. Multivariate statistical and graphical data analysis discriminated between six main primary glass types. Primary glass sources were differentiated based on multi-dimensional comparison of silica-derived elements (MgO, Al2O3, CaO, TiO2, Fe2O3, ZrO2) and components associated with the alkali source (Li2O, B2O3). Along with Egyptian and Levantine origins of the glassmaking sands, variations in the natron source possibly point to the exploitation of two different natron deposits. Differences in strontium to calcium ratios revealed variations in the carbonate fractions in the sand. At least two cobalt sources were employed as colouring agents, one of which shows strong correlations with nickel, indicating a specific post-Roman cobalt source. Typological evidence identified chronological developments in the use of the different glass groups. Throughout the sixth century, Byzantine glass weights were predominately produced from two glasses that are probably of an Egyptian origin (Foy-2 and Foy-2 high Fe). Towards the second half of the sixth century a new but related plant-ash glass type emerged (Magby). Levantine I was likewise found among the late sixth- to early seventh-century samples. The use of different dies for the same batch testifies to large-scale, centralised production of the weights, while the same die used for different primary production groups demonstrates the co-existence of alternative sources of supply. Given the comprehensive design of our study, these results can be extrapolated to the wider early Byzantine glass industry and its changes at large.

[Follow-up of patients treated by VKA: Interest of a pharmaceutical link between the hospital and the retail pharmacies].

PubMed

Bidon, D; Lecoeur, A; Segui, E; Seguette, N; Le Mercier, F; Bauler, S

2017-01-01

Vitamin K antagonists (VKA) are used by 1,7% of the French population. Patient education and monitoring can decrease the number of iatrogenic hospitalizations due to VKA. We assessed the impact of a communication between hospital and retail pharmacists about patient's knowledge on VKA. The aim of our study has been to evaluate the value added by the link between the hospital pharmacist and the community pharmacist on the follow-up of patients treated by vitamin K antagonist. Patient information about VKA treatment is offered to inpatients in our hospital. An information form is filled for each patient treated by VKA. Patient's knowledge is assessed on the document (Name of VKA, cause of treatment, monitoring, risks of overdose, compliance…). This form is sent to the community pharmacist after the training when the patient leaves the hospital (by fax or by email). The form is sent back by the community pharmacist after the second training. Sixty-eight patients received the training, 48 forms have been sent to the retail pharmacists and 43 forms have been sent back to the hospital. Seven retail pharmacists replied spontaneously. Twenty-eight patients increased their knowledge (in average+21%) and 12 patients stabilized their knowledge. The best-known concepts were the INR target, the time of drug intake, the risks of overdose and the information of the family. The improvement of knowledge is significant for the name of VKA, the cause of treatment, efficacy assessment and signs of overdose. The implementation of a communication between the hospital and the retail pharmacies is time-consuming but the follow-up of those patients seems essential to keep a good knowledge. Copyright © 2016 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

[Adequacy of antibiotic therapy for urinary tract infection in a Medical Department from the university hospital of Lille: A retrospective cohort study].

PubMed

Deconinck, L; Maillard, H; Lemaitre, M; Barbottin, E; Bakhache, E; Galperine, T; Puisieux, F; Hatron, P-Y; Lambert, M

2015-11-01

The main objective of the study was to assess the adequacy of antibiotic therapy for urinary tract infections (UTI) in a French hospital medical department. The secondary objective was to identify factors associated with inadequacy of the antibiotic therapy. A retrospective single centre cohort study was performed in the Post-Emergency Medicine Department (PEMD) of the university hospital of Lille. All patients presenting with an UTI from May 2012 to April 2014 were included. Adequacy of antibiotic therapy was assessed with reference to local guidelines. Factors associated with inadequacy of antibiotic prescription were determined using a multivariate logistic regression model. Two hundred and twenty-eight patients were included. The antibiotic prescription was fully adequate in 173 patients (76%) with appropriate use of a single or a combination antibiotic therapy in 96%, appropriate drug in 80%, appropriate dosage in 89% and appropriate route of administration in 95%. The risk for antibiotic inadequacy was significantly higher in patients with cystitis than in those with pyelonephritis (OR 12.01; 95% CI 4.17-34.65), when antibiotics were prescribed in the Emergency Department (OR 6.84; 95% CI 2.29-20.47) or before hospital admission (OR 382.46; 95% CI 19.61≥999.99) compared to when antibiotics were first administered in the PEMD, and in patients with severe UTI (OR 19.55; 95% CI 2.79-137.01). Adequacy of antibiotic therapy for UTI is relatively high in our study, reflecting the effective dissemination of antibiotic guidelines. However, antibiotic therapy is still inappropriate in cystitis, severe UTI and in case of prescription before the admission in the PEMD. Copyright © 2015 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Séroprévalence de l’AgHBs chez la femme enceinte dans le centre du Maroc

PubMed Central

Sbiti, Mohammed; Khalki, Hanane; Benbella, Imane; louzi, Lhoussaine

2016-01-01

La transmission materno-fœtale du virus de l'hépatite B (VHB) est un problème qui préoccupe toujours les autorités sanitaires à travers le monde et suscite la mise en place de mesures préventives renforcées. Le statut réplicatif du virus chez la mère séropositive, évalué par la positivité de l'AgHbe et le taux de la charge virale, conditionne le risque de contamination qui est plus important en période péri-natale. Les mères porteuses chroniques du VHB constituent un véritable réservoir de la transmission verticale de cette infection. Nous avons étudié, à travers cette enquête sur 1120 femmes enceintes Marocaines, la séroprévalence de l'AgHBs qui était de 2,35%, dans le but d'alimenter les données nationales sur ce sujet. Parmi ces femmes séropositives pour l'AgHBs, 79,1% avaient un AgHBe négatif et ont bénéficié d'une recherche moléculaire qui s'est révélée positive dans 89,4% des cas. La vaccination de la femme en âge de procréer est l'un des piliers majeurs de la prévention de la transmission verticale du VHB, seulement 2,4% de nos patientes étaient vaccinées. Ceci relève l'intérêt du dépistage au cours de la grossesse, qui doit se focaliser sur la sensibilisation à la vaccination de femmes séronégatives, et le suivi par biologie moléculaire des mères séropositives dans le but d'instaurer un traitement prophylactique adéquat. PMID:27795784

A passive brain-computer interface application for the mental workload assessment on professional air traffic controllers during realistic air traffic control tasks.

PubMed

Aricò, P; Borghini, G; Di Flumeri, G; Colosimo, A; Pozzi, S; Babiloni, F

2016-01-01

In the last decades, it has been a fast-growing concept in the neuroscience field. The passive brain-computer interface (p-BCI) systems allow to improve the human-machine interaction (HMI) in operational environments, by using the covert brain activity (eg, mental workload) of the operator. However, p-BCI technology could suffer from some practical issues when used outside the laboratories. In particular, one of the most important limitations is the necessity to recalibrate the p-BCI system each time before its use, to avoid a significant reduction of its reliability in the detection of the considered mental states. The objective of the proposed study was to provide an example of p-BCIs used to evaluate the users' mental workload in a real operational environment. For this purpose, through the facilities provided by the École Nationale de l'Aviation Civile of Toulouse (France), the cerebral activity of 12 professional air traffic control officers (ATCOs) has been recorded while performing high realistic air traffic management scenarios. By the analysis of the ATCOs' brain activity (electroencephalographic signal-EEG) and the subjective workload perception (instantaneous self-assessment) provided by both the examined ATCOs and external air traffic control experts, it has been possible to estimate and evaluate the variation of the mental workload under which the controllers were operating. The results showed (i) a high significant correlation between the neurophysiological and the subjective workload assessment, and (ii) a high reliability over time (up to a month) of the proposed algorithm that was also able to maintain high discrimination accuracies by using a low number of EEG electrodes (~3 EEG channels). In conclusion, the proposed methodology demonstrated the suitability of p-BCI systems in operational environments and the advantages of the neurophysiological measures with respect to the subjective ones. © 2016 Elsevier B.V. All rights reserved.

[Aortic inflammatory lesions in Behçet's disease].

PubMed

Desbois, A-C; Wechsler, B; Cacoub, P; Saadoun, D

2016-04-01

The arterial lesions affect about 10% of patients with Behçet's disease (BD). Aortic inflammatory involvement includes predominantly aortic aneurysmal lesions affecting most often the abdominal aorta. They account for the severity of the disease and are a leading cause of death when they hit the aorta or pulmonary arteries. Within the arterial lesions of BD, aortic involvement is, with femoral lesions, the most common site involved (18-28% of patients with vascular disease). Unlike other large vessels vasculitis (i.e. giant cell arteritis and Takayasu's arteritis) diffuse aortitis is observed in less than 5% of patients with BD. Aortic lesions of BD may be asymptomatic (systematic imaging or occasionally associated with other vascular event) or be revealed by the occurrence of abdominal, thoracic or lumbar pain, or an aortic valve insufficiency. Fever is frequently associated. Increase in acute phase reactants is common in these patients. Histological analysis may show infiltration by lymphocytes, neutrophils and plasma cells in the media and adventitia and a proliferation of the vasa vasorum in the media as well as a fibroblastic proliferation. In the later phase, a fibrous thickening of the media and adventitia is observed as well as a proliferation and thickening of the vasa vasorum. The therapeutic management should always include a medical treatment for the control of inflammation (corticosteroids, immunosuppressive drugs and/or biotherapy) and often an endovascular or surgical treatment if the aneurysm is threatening. The choice between endovascular or surgical treatment is considered case by case, depending on the experience of the team, anatomical conditions and of the clinical presentation. In this review, we provide a detailed and updated review of the literature to describe the aortic inflammatory damage associated with Behçet's disease. Copyright © 2015 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

[Doctor-Patient Communication Training in Simulated Situations: Emotions and Perceptions of Simulated Patients during Patient-Centered Conversations].

PubMed

Butollo, Maria Asisa; Holzinger, Anita; Wagner-Menghin, Michaela

2018-04-13

The use of simulated patients (SPs) for doctor-patient communication training has been established in medical curricula as an important didactic method. The study addresses the question, if patients' emotions and perceptions are represented adequately in patient-centered communication. 22 of 37 SPs of the Medical University of Vienna (12 women, 10 men) were asked openly about their feelings after having acted as an SP in a semi-structured interview, which employed the Critical Incident Technique. The interviews were recorded, transcribed, separated into situational analysis units und analyzed deductively; we used the evidence based qualities of patient-centered communication and the "Nationaler Kompetenzbasierter Lernzielkatalog Medizin" as a guideline. Out of 192 analysis units, 67 were evaluated as positive and 125 as negative. The SPs reported positive feelings, such as perceiving "stability and trust in relationships" (22%), perception of congruence (15%), acceptance (27%) and empathy (36%). As to negative feelings, SPs reported "perceiving instability" (18%), "incongruence" (11%), "lack of acceptance" (40%) and "lack of empathy" (30%). Additionally, 50% of SPs were positively affected when observing students' learning success. When SPs perceived patient-centered communication, they reported positive emotions. A lack of patient centeredness, on the contrary, provoked negative emotions. An empathic attitude, as well as a "lack of acceptance" with contrary effects had the strongest influence on the SPs' mental state. The reaction of SPs to patient centeredness is sufficiently authentic to reach learning objectives, however it is also affected by reactions of SPs to the learning success of students, which is irrelevant for the real-life doctor-patient interaction. SP reactions are affected by students' attitudes. Students should therefore be prepared well before interacting with SPs in a roleplay setting. While SPs' behavior is authentic in patient-centered communication in general, SPs should be trained to hide their positive emotions concerning students' learning success during roleplay. © Georg Thieme Verlag KG Stuttgart · New York.

High quality silicon-based substrates for microwave and millimeter wave passive circuits

NASA Astrophysics Data System (ADS)

Belaroussi, Y.; Rack, M.; Saadi, A. A.; Scheen, G.; Belaroussi, M. T.; Trabelsi, M.; Raskin, J.-P.

2017-09-01

Porous silicon substrate is very promising for next generation wireless communication requiring the avoidance of high-frequency losses originating from the bulk silicon. In this work, new variants of porous silicon (PSi) substrates have been introduced. Through an experimental RF performance, the proposed PSi substrates have been compared with different silicon-based substrates, namely, standard silicon (Std), trap-rich (TR) and high resistivity (HR). All of the mentioned substrates have been fabricated where identical samples of CPW lines have been integrated on. The new PSi substrates have shown successful reduction in the substrate's effective relative permittivity to values as low as 3.7 and great increase in the substrate's effective resistivity to values higher than 7 kΩ cm. As a concept proof, a mm-wave bandpass filter (MBPF) centred at 27 GHz has been integrated on the investigated substrates. Compared with the conventional MBPF implemented on standard silicon-based substrates, the measured S-parameters of the PSi-based MBPF have shown high filtering performance, such as a reduction in insertion loss and an enhancement of the filter selectivity, with the joy of having the same filter performance by varying the temperature. Therefore, the efficiency of the proposed PSi substrates has been well highlighted. From 1994 to 1995, she was assistant of physics at (USTHB), Algiers . From 1998 to 2011, she was a Researcher at characterization laboratory in ionized media and laser division at the Advanced Technologies Development Center. She has integrated the Analog Radio Frequency Integrated Circuits team as Researcher since 2011 until now in Microelectronic and Nanotechnology Division at Advanced Technologies Development Center (CDTA), Algiers. She has been working towards her Ph.D. degree jointly at CDTA and Ecole Nationale Polytechnique, Algiers, since 2012. Her research interest includes fabrication and characterization of microwave passive devices on porous silicon as new substrate, such as characterization of FinFET components.

Protoplanetary disk formation and evolution models: DM Tau and GM Aur

NASA Astrophysics Data System (ADS)

Hueso, R.; Guillot, T.

2002-09-01

We study the formation and evolution of protoplanetary disks using an axisymmetric turbulent disk model. We compare model results with observational parameters derived for the DM Tau and GM Aur systems. These are relatively old T Tauri stars with large and massive protoplanetary disks. Early disk formation is studied in the standard scenario of slowly rotating isothermal collapsing spheres and is strongly dependent on the initial angular momentum and the collapse accretion rate. The viscous evolution of the disk is integrated in time using the classical Alpha prescription of turbulence. We follow the temporal evolution of the disks until their characteristics fit the observed characteristics of DM Tau and GM Aur. We therefore obtain the set of model parameters that are able to explain the present state of these disks. We also study the disk evolution under the Beta parameterization of turbulence, recently proposed for sheared flows on protoplanetary disks. Both parameterizations allow explaining the present state of both DM Tau and GM Aur. We infer a value of Alpha between 5x10-3 to 0.02 for DM Tau and one order of magnitude smaller for GM Aur. Values of the Beta parameter are in accordance with theoretical predictions of Beta around 2x10-5 but with a larger dispersion on other model parameters, which make us favor the Alpha parameterization of turbulence. Implications for planetary system development in these systems are presented. In particular, GM Aur is a massive and slowly evolving disk where conditions are very favorable for planetesimal growth. The large value of present disk mass and the relatively small observed accretion rate of this system may also be indicative of the presence of an inner gas giant planet. Acknowledgements: This work has been supported by Programme Nationale de Planetologie. R. Hueso acknowledges a post-doctoral fellowship from Gobierno Vasco.

[Cost of systemic lupus erythematosus for adult patients with active and treated disease in France (LUCIE study)].

PubMed

Amoura, Z; Deligny, C; Pennaforte, J-L; Hamidou, M; Blanco, P; Hachulla, E; Pourrat, J; Queyrel, V; Garofano, A; Maurel, F; Levy-Bachelot, L; Boucot, I

2014-11-01

To evaluate in France the annual direct medical cost of adult patients with active systemic lupus erythematosus (SLE) on medication and estimate the cost of a flare. A two-year, observational, retrospective, multicenter study, carried out between December 2010 and February 2011. Patients' characteristics, SLE disease activity and severity, rate of flares, healthcare consumption (medications, hospitalisations, etc.) were evaluated. Medical costs were assessed from the national Health Insurance perspective. Cost predictors were estimated using multivariate regression models. Eight centres specialized in SLE management included 93 eligible patients (including 50.5% severe). The mean age was 39.9 (11.9) years and 93.5% were women. At baseline, the mean SLE duration was 9.8 (6.6) years. The mean scores of the SELENA-SLEDAI instrument and the SLICC/ACR index were higher in severe patients (9.8 vs 5.6, and 1.2 vs 0.4 respectively; P<0.001). Over the study period, 51% of patients received the combination containing at least corticosteroids or immunosuppressants. The mean annual direct medical cost of severe patients was €4660 versus €3560 for non-severe patients (non-significant difference). The cost of medications (61.8% of the annual cost) was higher in severe patients (€3214 vs €1856; P<0.05). Immunosuppressants and biologics represented 26.5% and 4.6% of the annual total cost respectively. Patients experienced on average 1.10 (0.59) flares/year, of which 0.50 were severe flare. The occurrence of a new severe flare incremented the annual cost of €1330 (P<0.05). Medications represented the major component of the annual direct medical cost. Severe flares increase significantly the cost of SLE care management. Copyright © 2014 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Lymphoproliferative disorders in patients receiving thiopurines for inflammatory bowel disease: a prospective observational cohort study.

PubMed

Beaugerie, Laurent; Brousse, Nicole; Bouvier, Anne Marie; Colombel, Jean Frédéric; Lémann, Marc; Cosnes, Jacques; Hébuterne, Xavier; Cortot, Antoine; Bouhnik, Yoram; Gendre, Jean Pierre; Simon, Tabassome; Maynadié, Marc; Hermine, Olivier; Faivre, Jean; Carrat, Fabrice

2009-11-07

Reports of an increased risk of lymphoproliferative disorders in patients receiving thiopurines for inflammatory bowel disease are controversial. We assessed this risk in a prospective observational cohort study. 19,486 patients with inflammatory bowel disease, of whom 11,759 (60.3%) had Crohn's disease and 7727 (39.7%) had ulcerative colitis or unclassified inflammatory bowel disease, were enrolled in a nationwide French cohort by 680 gastroenterologists, who reported details of immunosuppressive therapy during the observation period, cases of cancer, and deaths. The risk of lymphoproliferative disorder was assessed according to thiopurine exposure. Median follow-up was 35 months (IQR 29-40). At baseline, 5867 (30.1%) of patients were receiving, 2809 (14.4%) had discontinued, and 10,810 (55.5%) had never received thiopurines. 23 new cases of lymphoproliferative disorder were diagnosed, consisting of one case of Hodgkin's lymphoma and 22 cases of non-Hodgkin lymphoproliferative disorder. The incidence rates of lymphoproliferative disorder were 0.90 per 1000 (95% CI 0.50-1.49) patient-years in those receiving, 0.20/1000 (0.02-0.72) patient-years in those who had discontinued, and 0.26/1000 (0.10-0.57) patient-years in those who had never received thiopurines (p=0.0054). The multivariate-adjusted hazard ratio of lymphoproliferative disorder between patients receiving thiopurines and those who had never received the drugs was 5.28 (2.01-13.9, p=0.0007). Most cases associated with thiopurine exposure matched the pathological range of post-transplant disease. Patients receiving thiopurines for inflammatory bowel disease have an increased risk of developing lymphoproliferative disorders. Programme Hospitalier de Recherche Clinique National (AOM05157), Association François Aupetit, Délégation Inter-régionale de la Recherche clinique Ile de France-Assistance Publique Hôpitaux de Paris (AP-HP), Ligue contre le Cancer, and Fonds de Recherche de la Société Nationale Française de Gastro-entérologie.

Using Remotely Piloted Aircraft System to Study the Evolution of the Boundary Layer Related to Fog Events

NASA Astrophysics Data System (ADS)

Roberts, G. C.; Cayez, G.; Ronflé-Nadaud, C.; Albrand, M.; Dralet, J. P.; Momboisse, G.; Nicoll, K.; Seity, Y.; Bronz, M.; Hattenberger, G.; Gorraz, M.; Bustico, A.

2014-12-01

Over the past decade, the scientific community has embraced the use of RPAS (remotely piloted aircraft system) as a tool to improve observations of the Earth's surface and atmospheric phenomena. The use of small RPAS (Remotely Piloted Aircraft System) in atmospheric research has increased because of their relative low-cost, compact size and ease of operation. Small RPAS are especially adapted for observing the atmospheric boundary layer processes at high vertical and temporal resolution. To this end, CNRM, ENAC, and ENM have developed the VOLTIGE (Vecteurs d'Observation de La Troposphere pour l'Investigation et la Gestion de l'Environnement) program to study the life cycle of fog with multiple, small RPAS. The instrumented RPAS flights have successfully observed the evolution of the boundary layer and dissipation of fog events. In addition, vertical profiles from the RPAS have been compared with Météo France forecast models, and the results suggest that forecast models may be improved using high resolution and frequent in-situ measurements. Within the VOLTIGE project, a flying-wing RPAS with four control surfaces was developed to separate elevator and aileron controls in order to reduce the pitch angle envelope and improve turbulence and albedo measurements. The result leads to a small RPAS with the capability of flying up to two hours with 150 grams of payload, while keeping the hand-launch capability as a constraint for regular atmospheric research missions. High frequency data logging has been integrated into the main autopilot in order to synchronize navigation and payload measurements, as well as allowing an efficient sensor-based navigation. The VOLTIGE program also encourages direct participation of students on the advancement of novel observing systems for atmospheric sciences, and provides a step towards deploying small RPAS in an operational network. VOLTIGE is funded by the Agence Nationale de Recherche (ANR-Blanc 2012) and supported by Aerospace Valley.

A prime-boost approach to HIV preventive vaccine using a recombinant canarypox virus expressing glycoprotein 160 (MN) followed by a recombinant glycoprotein 160 (MN/LAI). The AGIS Group, and l'Agence Nationale de Recherche sur le SIDA.

PubMed

Pialoux, G; Excler, J L; Rivière, Y; Gonzalez-Canali, G; Feuillie, V; Coulaud, P; Gluckman, J C; Matthews, T J; Meignier, B; Kieny, M P

1995-03-01

The safety and the immunogenicity of a recombinant canarypox live vector expressing the human immunodeficiency virus type 1 (HIV-1) gp160 gene from the MN isolate, ALVAC-HIV (vCP125), followed by booster injections of a soluble recombinant hybrid envelope glycoprotein MN/LAI (rgp160), were evaluated in vaccinia-immune, healthy adults at low risk for acquiring HIV-1 infection. Volunteers (n = 20) received vCP125 (10(6) TCID50) at 0 and 1 month, followed randomly by rgp160 formulated in alum or in Freund's incomplete adjuvant (FIA) at 3 and 6 months. Local and systemic reactions were mild or moderate and resolved within the first 72 hr after immunization. No significant biological changes in routine tests were observed in any volunteer. Two injections of vCP125 did not elicit antibodies. Neutralizing antibodies (NA) against the HIV-1 MN isolate were detected in 65 and 90% of the subjects after the first and the second rgp 160 booster injections, respectively. Six months after the last boost, only 55% were still positive. Seven of 14 sera with the highest NA titers against MN weakly cross-neutralized the HIV-1 SF2 isolate; none had NA against the HIV-1 LAI or against a North American primary isolate. Specific lymphocyte T cell proliferation to rgp 160 was detected in 25% of the subjects after vCP125 and in all subjects after the first booster injection and 12 months after the first injection. An envelope-specific cytotoxic lymphocyte activity was found in 39% of the volunteers and characterized for some of them as CD3+, CD8+, MHC class I restricted. The adjuvant formulation did not influence significantly the immune responses.(ABSTRACT TRUNCATED AT 250 WORDS)

[Anticoagulation in the aged patient with atrial fibrillation: What are prescribing cardiologists, geriatricians and general practitioners?].

PubMed

Fuchs, P; Vogel, T; Lang, P-O

2015-08-01

To assess prescribing of anticoagulants in atrial fibrillation (AF) in the elderly, both a quantitative point of view (rate of anticoagulation) and qualitative (type of anticoagulation). Determinants of prescribing and non-prescribing were also analysed. Prospective survey of practice, based on one clinical case and questionnaire conducted in 60 practitioners (20 cardiologists [C], 20 geriatricians [G] and 20 general practitioners [GP]). In reading the clinical case, 88.3% of physicians would have initiated a treatment; three types of treatments would have been chosen: AVK (68.3%), ODA (20.0%) and platelet antiaggregant (11.7%). Criteria taken into account to initiate anticoagulation varied according to the specialty. Cardiologists considered more the age criteria (C: 95.0%, G: 75.0%, MG: 60.0%; P<0.05), diabetes (C: 90.0%, G: 60.0%, MG: 55.0%; P<0.05), hypertension (C: 85.0%, G: 55.0%, MG: 60.0%; P<0.05) and female gender (C: 80.0%, G: 35.0%, MG: 25.0%; P<0.05). The quality of renal function was however a more secondary criteria (C: 15.0%, G: 5.0%, MG: 0.0%; P<0.05). General practitioners considered most frequently the presence of underlying heart disease (C: 35.0%, G: 5.0%, MG: 45.0%; P<0.05) as well as usual cardiovascular risk factors (overweight, dyslipidaemia; P<0.05). Risk of bleeding, however, was observed by 76.7% of physicians in the clinical situation presented (C: 70.0%, G: 75.0%, MG: 85.0%; P<0.05). This survey confirms that the FA remains under anticoagulated in the elderly and the barriers to the prescription of oral anticoagulation are often without rational basis. Copyright © 2015 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Hail prevention by ground-based silver iodide generators: Results of historical and modern field projects

NASA Astrophysics Data System (ADS)

Dessens, J.; Sánchez, J. L.; Berthet, C.; Hermida, L.; Merino, A.

2016-03-01

The science of hail suppression by silver iodide (AgI) cloud seeding was developed during the second half of the 20th century in laboratory and tested in several research or operational projects using three delivery methods for the ice forming particles: ground generators, aircraft, and rockets. The randomization process for the seeding was often considered as the imperative method for a better evaluation but failed to give firm results, mostly because the projects did not last long enough considering the hazardous occurrence of severe hailfalls, and also probably due to the use of improper hail parameters. At the same time and until now, a continuous long-term research and operational field project (1952-2015) using ground generator networks has been conducted in France under the leadership of the Association Nationale d'Etude et de Lutte contre les Fléaux Atmosphériques (ANELFA), with a control initially based on annual insurance loss-to-risk ratios, then on hailpad data. More recently (2000-2009), a companion ground seeding project was developed in the north of Spain, with control mostly based on microphysical and hailpad data. The present paper, which focuses on hail suppression by ground seeding, reviews the production of the AgI nuclei, their dispersion and measurement in the atmosphere, as well as their observed or simulated effects in clouds. The paper summarizes the results of the main historical projects in Switzerland, Argentina, and North America, and finally concentrates on the current French and Spanish projects, with a review of already published results, complemented by new ones recently collected in Spain. The conclusion, at least for France and Spain, is that if ground seeding is performed starting 3 hours before the hail falls at the ground with a 10-km mesh AgI generator network located in the developing hailstorm areas, each generator burning about 9 g of AgI per hour, the hailfall energy of the most severe hail days is decreased by about 50%.

Forest structures retrieval from LiDAR onboard ULA

NASA Astrophysics Data System (ADS)

Shang, Xiaoxia; Chazette, Patrick; Totems, Julien; Marnas, Fabien; Sanak, Joseph

2013-04-01

Following the United Nations Framework Convention on Climate Change, the assessment of forest carbon stock is one of the main elements for a better understanding of the carbon cycle and its evolution following the climate change. The forests sequester 80% of the continental biospheric carbon and this efficiency is a function of the tree species and the tree health. The airborne backscatter LiDAR onboard the ultra light aircraft (ULA) can provide the key information on the forest vertical structures and evolution in the time. The most important structural parameter is the tree top height, which is directly linked to the above-ground biomass using non-linear relationships. In order to test the LiDAR capability for retrieving the tree top height, the LiDAR ULICE (Ultraviolet LIdar for Canopy Experiment) has been used over different forest types, from coniferous (maritime pins) to deciduous (oaks, hornbeams ...) trees. ULICE works at the wavelength of 355 nm with a sampling along the line-of-sight between 15 and 75 cm. According to the LiDAR signal to noise ratio (SNR), two different algorithms have been used in our study. The first algorithm is a threshold method directly based on the comparison between the LiDAR signal and the noise distributions, while the second one used a low pass filter by fitting a Gaussian curve family. In this paper, we will present these two algorithms and their evolution as a function of the SNR. The main error sources will be also discussed and assessed for each algorithm. The results show that these algorithms have great potential for ground-segment of future space borne LiDAR missions dedicated to the forest survey at the global scale. Acknowledgements: the canopy LiDAR system ULICE has been developed by CEA (Commissariat à l'Energie Atomique). It has been deployed with the support of CNES (Centre National d'Etude Spariales) and ANR (Agence Nationale de la Recherche). We acknowledge the ULA pilots Franck Toussaint for logistical help during the ULA campaign.

Mise à jour sur la prévention et le dépistage selon l’âge à l’intention des médecins de soins primaires canadiens

PubMed Central

Shimizu, Tawnya; Bouchard, Manon; Mavriplis, Cleo

2016-01-01

Résumé Objectif Faire la synthèse des meilleures lignes directrices fondées sur des données probantes concernant la prévention et le dépistage chez les adultes canadiens selon l’âge. Qualité des données Les recommandations du Groupe d’étude canadien sur les soins de santé préventifs représentent la source principale des renseignements et sont complétées par les recommandations pertinentes du Preventive Services Task Force des États-Unis lorsque celles du Groupe d’étude canadien étaient inaccessibles ou désuètes. Les guides de pratique des principales organisations nationales axées spécifiquement sur une maladie ou une spécialité ont aussi fait l’objet d’une révision pour prendre en compte les données factuelles les plus récentes. Message principal Les interventions de dépistage recommandées selon l’âge et le sexe sont présentées dans un tableau de synthèse où est mise en évidence la qualité des données à l’appui de ces recommandations. Un exemple de modèle à suivre dans les dossiers médicaux électroniques ou sur papier est aussi proposé. Conclusion Qu’il s’agisse d’une visite consacrée à la prévention ou d’une occasion saisie autrement de faire du counseling et du dépistage de prévention chez leurs patients, les médecins de soins primaires peuvent se servir de cette synthèse des recommandations fondées sur des données probantes pour maximiser leur efficience et prévenir d’importantes omissions ou des dépistages inutiles.

Estimation de l'equivalent en eau de la neige en milieu subarctique du Quebec par teledetection micro-ondes passives

NASA Astrophysics Data System (ADS)

Vachon, Francois

The snow cover (extent, depth and water equivalent) is an important factor in assessing the water balance of a territory. In a context of deregulation of electricity, better knowledge of the quantity of water resulting from snowmelt that will be available for hydroelectric power generation has become a major challenge for the managers of Hydro-Quebec's generating plant. In fact, the snow on the ground represents nearly one third of Hydro-Quebec's annual energy reserve and the proportion is even higher for northern watersheds. Snowcover knowledge would therefore help optimize the management of energy stocks. The issue is especially important when one considers that better management of water resources can lead to substantial economic benefits. The Research Institute of Hydro-Quebec (IREQ), our research partner, is currently attempting to optimize the streamfiow forecasts made by its hydrological models by improving the quality of the inputs. These include a parameter known as the snow water equivalent (SWE) which characterizes the properties of the snow cover. At the present time, SWE data is obtained from in situ measurements, which are both sporadic and scattered, and does not allow the temporal and spatial variability of SWE to be characterized adequately for the needs of hydrological models. This research project proposes to provide the Quebec utility's hydrological models with distributed SWE information about its northern watersheds. The targeted accuracy is 15% for the proposed period of analysis covering the winter months of January, February and March of 2001 to 2006. The methodology is based on the HUT snow emission model and uses the passive microwave remote sensing data acquired by the SSM/I sensor. Monitoring of the temporal and spatial variations in SWE is done by inversion of the model and benefits from the assimilation of in situ data to characterize the state of snow cover during the season. Experimental results show that the assimilation technique of in situ data (density and depth) can reproduce the temporal variations in SWE with a RMSE error of 15.9% (R2=0.76). The analysis of land cover within the SSMI pixels can reduce this error to 14.6% ( R2=0.66) for SWE values below 300 mm. Moreover, the results show that the fluctuations of SWE values are driven by changes in snow depths. Indeed, the use of a constant value for the density of snow is feasible and makes it possible to get as good if not better results. These results will allow IREQ to assess the suitability of using snow cover information provided by the remote sensing data in its forecasting models. This improvement in SWE characterization will meet the needs of IREQ for its work on optimization of the quality of hydrological simulations. The originality and relevance of this work are based primarily on the type of method used to quantify SWE and the site where it is applied. The proposed method focuses on the inversion of the HUT model from passive remote sensing data and assimilates in situ data. Moreover, this approach allows high SWE values (> 300 mm) to be quantified, which was impossible with previous methods. These high SWE values are encountered in areas with large amounts of snow such as northern Quebec. Keywords. remote sensing, microwave, snow water equivalent (SWE), model, retrieval, data assimilation, SWE monitoring, spatialization Complete reference. Vachon, F. (2009) Snow water equivalent retrieval in a subartic environment of Quebec using passive microwave remote sensing. Ph.D. Thesis, Sherbrooke University, Sherbrooke, 211 p.

Serum lactate levels in infants exposed peripartum to antiretroviral agents to prevent mother-to-child transmission of HIV: Agence Nationale de Recherches Sur le SIDA et les Hépatites Virales 1209 study, Abidjan, Ivory Coast

PubMed Central

Ekouevi, Didier Koumavi; Touré, Ramata; Becquet, Renaud; Viho, Ida; Sakarovitch, Charlotte; Rouet, François; Towne-Gold, Besigin; Fassinou, Patricia; Leroy, Valériane; Blanche, Stéphane; Dabis, François

2006-01-01

Background Mitochondrial toxicity was described in infants exposed to long-term antiretroviral regimens (ARVs) containing nucleoside analogues for the prevention of mother-to-child transmission of HIV (PMTCT). We measured the serum lactate levels in children born to HIV-1 infected (HIV+) African women receiving short-term ARV PMTCT regimens. Methods A prospective study was conducted in women-child pairs from the third trimester of pregnancy to three months of life. The exposed group was formed by children exposed in utero to nucleoside analogue ARVs, zidovudine (ZDV) or ZDV + lamivudine (3TC) from 32–36 weeks of amenorrhea until delivery. All these women received nevirapine single-dose (NVPsd) at the beginning of labor. The children received ZDV during the first 7 days of life and a NVPsd at day 3. The control group was formed by infants born to HIV+ women who had received NVPsd only and not exposed to nucleoside analogue ARVs. Serum lactate levels were measured at 4, 6 and 12 weeks of life by Cobas Integra 400™. Results A total of 836 blood samples from 338 infants were collected (262 exposed and 76 controls). Median lactacidemia was 1.8 mmol/l, Interquartile Range [1.2–2.7 mmol/l]). Overall serum lactate levels ≥2.5 mmol/l, defining hyperlactatemia were observed in 39 of the 292 infants who had at least two serum lactate measurements, 13.4%, 95% confidence Interval [9.6–17.8%]. The three-month period prevalence of hyperlactatemia did not differ between the exposed group (13.1%) and the control group (14.3%) (p=0.84). All serum lactate levels returned to normal values in all subsequent samples No case of symptomatic hyperlactatemia was detected during the study period. Conclusion Increased lactate levels were identified equally in infants whose mother received a short-term of nucleoside analogues or NVPsd for PMTCT. Although not rare, hyperlactatemia was not related to short-term exposure to nucleoside analogue ARVs PMID:16950945

Switch to Rilpivirine/Emtricitabine/Tenofovir Single-Tablet Regimen of Human Immunodeficiency Virus-1 RNA-Suppressed Patients, Agence Nationale de Recherches sur le SIDA et les Hépatites Virales CO3 Aquitaine Cohort, 2012-2014.

PubMed

Cazanave, Charles; Reigadas, Sandrine; Mazubert, Cyril; Bellecave, Pantxika; Hessamfar, Mojgan; Le Marec, Fabien; Lazaro, Estibaliz; Peytavin, Gilles; Bruyand, Mathias; Fleury, Hervé; Dabis, François; Neau, Didier

2015-01-01

Background.  The purpose of this study was to assess the efficacy and tolerability of combined antiretroviral therapy (cART) in human immunodeficiency virus (HIV)-1 virologically suppressed patients who switched to rilpivirine (RPV)/tenofovir disoproxil fumarate (TDF)/emtricitabine (FTC) as a single-tablet regimen (STR). Methods.  A retrospective multicenter cohort study was performed between September 2012 and February 2014 in Bordeaux University Hospital-affiliated clinics. Patients with a plasma HIV viral load (VL) lower than 50 copies/mL and switching to STR were evaluated at baseline, 3, 6, 9, and 12 months from switch time (M3, M6, M9, M12) for VL and other biological parameters. Change from baseline in CD4 cell counts was evaluated at M6 and M12. Virological failure (VF) was defined as 2 consecutive VL >50 copies/mL. Results.  Three hundred four patients were included in the analysis. Single-tablet regimen switch was proposed to 116 patients with adverse events, mostly efavirenz (EFV)-based (n = 59), and to 224 patients for cART simplification. Thirty of 196 patients with available genotype resistance test results displayed virus with ≥1 drug resistance mutation on reverse-transcriptase gene. After 12 months of follow-up, 93.4% (95.5% confidence interval, 89.9-96.2) of patients remained virologically suppressed. There was no significant change in CD4 cell count. During the study period, 5 patients experienced VF, one of them harboring RPV resistance mutation. Clinical cART tolerability improved in 79 patients overall (29.9%) at M6, especially neurological symptoms related to EFV. Fasting serum lipid profiles improved, but a significant estimated glomerular function rate decrease (-11 mL/min/1.73 m(2); P < 10(-4)) was observed. Conclusions.  Overall, virologic suppression was maintained in patients after switching to RPV/TDF/ FTC. This STR strategy was associated with improved tolerability.

Long Period (LP) volcanic earthquake source location at Merapi volcano by using dense array technics

NASA Astrophysics Data System (ADS)

Metaxian, Jean Philippe; Budi Santoso, Agus; Laurin, Antoine; Subandriyo, Subandriyo; Widyoyudo, Wiku; Arshab, Ghofar

2015-04-01

Since 2010, Merapi shows unusual activity compared to last decades. Powerful phreatic explosions are observed; some of them are preceded by LP signals. In the literature, LP seismicity is thought to be originated within the fluid, and therefore to be representative of the pressurization state of the volcano plumbing system. Another model suggests that LP events are caused by slow, quasi-brittle, low stress-drop failure driven by transient upper-edifice deformations. Knowledge of the spatial distribution of LP events is fundamental for better understanding the physical processes occurring in the conduit, as well as for the monitoring and the improvement of eruption forecasting. LP events recorded at Merapi have a spectral content dominated by frequencies between 0.8 and 3 Hz. To locate the source of these events, we installed a seismic antenna composed of 4 broadband CMG-6TD Güralp stations. This network has an aperture of 300 m. It is located on the site of Pasarbubar, between 500 and 800 m from the crater rim. Two multi-parameter stations (seismic, tiltmeter, S-P) located in the same area, equipped with broadband CMG-40T Güralp sensors may also be used to complete the data of the antenna. The source of LP events is located by using different approaches. In the first one, we used a method based on the measurement of the time delays between the early beginnings of LP events for each array receiver. The observed differences of time delays obtained for each pair of receivers are compared to theoretical values calculated from the travel times computed between grid nodes, which are positioned in the structure, and each receiver. In a second approach, we estimate the slowness vector by using MUSIC algorithm applied to 3-components data. From the slowness vector, we deduce the back-azimuth and the incident angle, which give an estimation of LP source depth in the conduit. This work is part of the Domerapi project funded by French Agence Nationale de la Recherche (https://sites.google.com/site/domerapi2).

Genotypic Resistance Analysis of the Virological Response to Fosamprenavir-Ritonavir in Protease Inhibitor-Experienced Patients in CONTEXT and TRIAD Clinical Trials▿

PubMed Central

Marcelin, Anne-Geneviève; Flandre, Philippe; Molina, Jean-Michel; Katlama, Christine; Yeni, Patrick; Raffi, Francois; Antoun, Zeina; Ait-Khaled, Mounir; Calvez, Vincent

2008-01-01

The aim of this study was to identify human immunodeficiency virus (HIV) protease mutations associated with virological response (VR) to fosamprenavir-ritonavir (FPV/r) in 113 protease inhibitor (PI)-experienced patients randomized in both CONTEXT and TRIAD clinical trials and receiving the same dose (700/100 mg twice daily) of FPV/r. The impact of each protease mutation on the VR to FPV/r, defined as the decrease in HIV RNA at week 12, was investigated with nonparametric analyses. A step-by-step procedure was done using a Jonckheere-Terpstra (JT) test that retains the group of mutations most strongly associated with the VR. Mutations at the following 14 codons were associated with a reduced VR to FPV/r: 10, 15, 33, 46, 54, 60, 62, 63, 72, 73, 82, 84, 89, and 90. The JT procedure led to selecting the CONTEXT/TRIAD genotypic set of mutations, I15V, M46I/L, I54L/M/V, D60E, L63P/T, and I84V, as providing the strongest association with the VR (P = 1.45 × 10−11). In the nine patients with zero mutations within this set, the median decrease in HIV RNA was −2.63 log copies/ml, and was −2.22 (n = 45), −1.50 (n = 26), −0.58 (n = 23), −0.47 (n = 6), −0.13 (n = 3), and 0.04 (n = 1) log copies/ml in those with one, two, three, four, five, and six mutations, respectively. This study identified six mutations associated with VR to FPV/r. Some of these mutations are shared with the current FPV/r Agence Nationale de Recherches sur le SIDA (ANRS) resistance score, which has been cross-validated in the CONTEXT/TRIAD data set, suggesting that the current ANRS FPV/r score is a useful tool for the prediction of VR to FPV/r in PI-experienced patients. PMID:18852278

Calibrating a Soil-Vegetation-Atmosphere system with a genetical algorithm

NASA Astrophysics Data System (ADS)

Schneider, S.; Jacques, D.; Mallants, D.

2009-04-01

Accuracy of model prediction is well known for being very sensitive to the quality of the calibration of the model. It is also known that quantifying soil hydraulic parameters in a Soil-Vegetation-Atmosphere (SVA) system is a highly non-linear parameter estimation problem, and that robust methods are needed to avoid the optimization process to lead to non-optimal parameters. Evolutionary algorithms and specifically genetic algorithms (GAs) are very well suited for those complex parameter optimization problems. The SVA system in this study concerns a pine stand on a heterogeneous sandy soil (podzol) in the north of Belgium (Campine region). Throughfall and other meteorological data and water contents at different soil depths have been recorded during one year at a daily time step. The water table level, which is varying between 95 and 170 cm, has been recorded with a frequency of 0.5 hours. Based on the profile description, four soil layers have been distinguished in the podzol and used for the numerical simulation with the hydrus1D model (Simunek and al., 2005). For the inversion procedure the MYGA program (Yedder, 2002), which is an elitism GA, was used. Optimization was based on the water content measurements realized at the depths of 10, 20, 40, 50, 60, 70, 90, 110, and 120 cm to estimate parameters describing the unsaturated hydraulic soil properties of the different soil layers. Comparison between the modeled and measured water contents shows a good similarity during the simulated year. Impacts of short and intensive events (rainfall) on the water content of the soil are also well reproduced. Errors on predictions are on average equal to 5%, which is considered as a good result. A. Ben Haj Yedder. Numerical optimization and optimal control : (molecular chemistry applications). PhD thesis, Ecole Nationale des Ponts et Chaussées, 2002. Šimůnek, J., M. Th. van Genuchten, and M. Šejna, The HYDRUS-1D software package for simulating the one-dimensional movement of water, heat, and multiple solutes in variably saturated media. Version 3.0, HYDRUS Software Series 1, Department of Environmental Sciences, University of California Riverside, Riverside, CA, 270 pp., 2005.

[Optimizing the financial impact of transitioning to transconjunctival vitrectomy and microincisional phacoemulsification].

PubMed

Cornut, P-L; Soldermann, Y; Robin, C; Barranco, R; Kerhoas, A; Burillon, C

2013-12-01

To report the financial impact of using modern lens and vitreoretinal surgical techniques. Bottom-up sterilization and consumables costs for new surgical techniques (microincisional coaxial phacoemulsification and transconjunctival sutureless vitrectomy) and the corresponding former techniques (phacoemulsification with 3.2-mm incision and 20G vitrectomy) were determined. These costs were compared to each other and to the target costs of the Diagnosis Related Groups for public hospitals (Groupes Homogènes de Séjours [GHS]) concerned, extracted from the analytic accounting data of the French National Cost Study (Étude Nationale des Coûts [ENC]) for 2009 (target=sum of sterilization costs posted under medical logistics, consumables, implantable medical devices, and special pharmaceuticals posted as direct expenses). For outpatient lens surgery with or without vitrectomy (GHS code: 02C05J): the ENC's target cost for 2009 was 339€ out of a total of 1432€. The cost detailed in this study was 4 % higher than the target cost when the procedure was performed using the former technique (3.2mm sutured incision) and 12 % lower when the procedure was performed using the new technique (1.8mm sutureless) after removing now unnecessary consumables and optimization of the technique. For level I retinal detachment surgeries (GHS code: 02C021): the ENC's 2009 target cost was 641€ out of a total of 3091€. The cost specified in this study was 1 % lower than the target cost when the procedure was done using the former technique (20-G vitrectomy) and 16 % less when the procedure was performed using the new technique (transconjunctival vitrectomy) after removal of now unnecessary consumables and optimization of the technique. Contrary to generally accepted ideas, implementing modern techniques in ocular surgery can result in direct cost and sterilization savings when the operator takes advantage of the possibilities these techniques offer in terms of simplification of the procedures to do away with consumables that are no longer necessary. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Les campagnes de dépistage du VIH, une stratégie efficace pour l’accès universel à la prévention et au traitement ? L’expérience du Burkina Faso

PubMed Central

Somé, J.F.; Desclaux, A.; Ky-Zerbo, O.; Lougué, M.; Kéré, S.; Obermeyer, C.; Simaga, F.

2014-01-01

Objectifs l’augmentation du taux de personnes qui connaissent leur statut VIH est un impératif, notamment en Afrique subsaharienne, ce qui impose d’évaluer les stratégies utilisées pour accroître la fréquentation des services de dépistage. Cet article vise à faire le bilan de la pertinence, de la faisabilité et de l’efficacité des campagnes nationales de dépistagemenées entre 2006 et 2010 au Burkina Faso. Méthodologie une analyse de toutes les données de fréquentation du conseil dépistage sur cette période a été faite, couplée à des entretiens avec les principaux acteurs intervenant dans le dépistage. Résultats les résultats montrent que les huit campagnes de dépistage organisées sur la période ont permis à 487 727 personnes de faire leur test VIH. Ce nombre représente 50 % du nombre total de personnes ayant fait leur test et contribue à hauteur de 24,6 % au dépistage des personnes séropositives identifiées au cours de cette période. Les campagnes ont touché des populations difficiles à atteindre (en particulier les jeunes), à un coût moindre. Conclusions cette stratégie est donc pertinente pour identifier les personnes VIH+. Son intérêt pour la prévention, important selon les soignants et au vu des populations jeunes qui y participent, devrait être mesuré par des études complémentaires. Les campagnes sont efficaces et coût-efficaces même dans un pays de niveau de prévalence faible. Ces résultats soulignent l’intérêt de la synergie entre les associations et les services de santé dans l’offre de services de conseil et dépistage. PMID:24681563

Seasonal forecasting for water resource management: the example of CNR Genissiat dam on the Rhone River in France

NASA Astrophysics Data System (ADS)

Dommanget, Etienne; Bellier, Joseph; Ben Daoud, Aurélien; Graff, Benjamin

2014-05-01

Compagnie Nationale du Rhône (CNR) has been granted the concession to operate the Rhone River from the Swiss border to the Mediterranean Sea since 1933 and carries out three interdependent missions: navigation, irrigation and hydropower production. Nowadays, CNR generates one quarter of France's hydropower electricity. The convergence of public and private interests around optimizing the management of water resources throughout the French Rhone valley led CNR to develop hydrological models dedicated to discharge seasonal forecasting. Indeed, seasonal forecasting is a major issue for CNR and water resource management, in order to optimize long-term investments of the produced electricity, plan dam maintenance operations and anticipate low water period. Seasonal forecasting models have been developed on the Genissiat dam. With an installed capacity of 420MW, Genissiat dam is the first of the 19 CNR's hydropower plants. Discharge forecasting at Genissiat dam is strategic since its inflows contributes to 20% of the total Rhone average discharge and consequently to 40% of the total Rhone hydropower production. Forecasts are based on hydrological statistical models. Discharge on the main Rhone River tributaries upstream Genissiat dam are forecasted from 1 to 6 months ahead thanks to multiple linear regressions. Inputs data of these regressions are identified depending on river hydrological regimes and periods of the year. For the melting season, from spring to summer, snow water equivalent (SWE) data are of major importance. SWE data are calculated from Crocus model (Météo France) and SLF's model (Switzerland). CNR hydro-meteorological forecasters assessed meteorological trends regarding precipitations for the next coming months. These trends are used to generate stochastically precipitation scenarios in order to complement regression data set. This probabilistic approach build a decision-making supports for CNR's water resource management team and provides them with seasonal forecasts and their confidence interval. After a presentation of CNR methodology, results for the years 2011 and 2013 will illustrate CNR's seasonal forecasting models ability. These years are of particular interest regarding water resource management seeing that they are, respectively, unusually dry and snowy. Model performances will be assessed in comparison with historical climatology thanks to CRPS skill score.

Prevalence of etravirine mutations and impact on response to treatment in routine clinical care: the Swiss HIV Cohort Study (SHCS).

PubMed

Scherrer, A U; Hasse, B; von Wyl, V; Yerly, S; Böni, J; Bürgisser, P; Klimkait, T; Bucher, H C; Ledergerber, B; Günthard, H F

2009-11-01

Etravirine (ETV) is a novel nonnucleoside reverse transcriptase inhibitor (NNRTI) with reduced cross-resistance to first-generation NNRTIs, which has been primarily studied in randomized clinical trials and not in routine clinical settings. ETV resistance-associated mutations (RAMs) were investigated by analysing 6072 genotypic tests. The antiviral activity of ETV was predicted using different interpretation systems: International AIDS Society-USA (IAS-USA), Stanford, Rega and Agence Nationale de Recherches sur le Sida et les hépatites virales (ANRS). The prevalence of ETV RAMs was higher in NNRTI-exposed patients [44.9%, 95% confidence interval (CI) 41.0-48.9%] than in treatment-naïve patients (9.6%, 95% CI 8.5-10.7%). ETV RAMs in treatment-naïve patients mainly represent polymorphism, as prevalence estimates in genotypic tests for treatment-naïve patients with documented recent (<1 year) infection, who had acquired HIV before the introduction of NNRTIs, were almost identical (9.8%, 95% CI 3.3-21.4). Discontinuation of NNRTI treatment led to a marked drop in the detection of ETV RAMs, from 51.7% (95% CI 40.8-62.6%) to 34.5% (95% CI 24.6-45.4%, P=0.032). Differences in prevalence among subtypes were found for V90I and V179T (P<0.001). Estimates of restricted virological response to ETV varied among algorithms in patients with exposure to efavirenz (EFV)/nevirapine (NVP), ranging from 3.8% (95% CI 2.5-5.6%) for ANRS to 56.2% (95% CI 52.2-60.1%) for Stanford. The predicted activity of ETV decreased as the sensitivity of potential optimized background regimens decreased. The presence of major IAS-USA mutations (L100I, K101E/H/P and Y181C/I/V) reduced the treatment response at week 24. Most ETV RAMs in drug-naïve patients are polymorphisms rather than transmitted RAMs. Uncertainty regarding predictions of antiviral activity for ETV in NNRTI-treated patients remains high. The lowest activity was predicted for patients harbouring extensive multidrug-resistant viruses, thus limiting ETV use in those who are most in need.

Physical stability of highly concentrated injectable drugs solutions used in intensive care units.

PubMed

Closset, M; Hecq, J D; Soumoy, L; Simar, J; Gonzalez, E; Charlet, L; Declave, C; Gillet, P; Galanti, L

2017-05-01

The intensive care department of the institution use drug solutions within higher concentration to avoid fluid overload. The purpose of the study is to prove the physical stability of different injectable drugs within high concentration (amiodarone 25mg/mL, isosorbide 0.60mg/mL, lorazepam 0.16mg/mL, noradrenalin 0.120 and 0.240mg/mL, salbutamol 0.06mg/mL and sodium valproate 12mg/mL) to ensure the patients safety. Five of 30 or 50mL polypropylene syringes were prepared for each solution under aseptic conditions and stored at room temperature. Immediately after the preparation (hour 0) and after 1, 4, 8, 24 and 48hours, 2mL of each solution were withdrawn from each syringe and placed in glass tubes to proceed to the stability test. All specimens were visually inspected in front of a black and of a white background and aliquots of each solution were centrifuged to proceed to microscopic inspection with a ten-fold magnification. The pH of each solution was measured with glass electrode pH-meter (Inolab level 1, WTW Weilhem, Germany with biotrode electrode, Hamilton, Bonaduz, Switzerland) and spectrophotometric measurements (Genesys 10 series, New-York, USA) were performed at three wavelengths (350, 410 and 550nm) to avoid the apparition of turbidity. For all the drugs included in the study, there was no significant change in pH, no color change, no turbidity or opacity and no precipitation observed in the solutions during the storage at room temperature for 48hours. No microaggregates were detected by microscope neither revealed by a change of absorbance. Within these limits, the preparations of amiodarone in 5% glucose polypropylene syringes and isosorbide, lorazepam, noradrenalin, salbutamol, valproate in 0.9% sodium chloride polypropylene syringes are physically stable at room temperature for 48hours. These results allow us to consider a study of chemical stability by high-performance liquid chromatography (HPLC). Copyright © 2016 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

The physics, performance and predictions of the PEGASES ion-ion thruster

NASA Astrophysics Data System (ADS)

Aanesland, Ane

2014-10-01

Electric propulsion (EP) is now used systematically in space applications (due to the fuel and lifetime economy) to the extent that EP is now recognized as the next generation space technology. The uses of EP systems have though been limited to attitude control of GEO-stationary satellites and scientific missions. Now, the community envisages the use of EP for a variety of other applications as well; such as orbit transfer maneuvers, satellites in low altitudes, space debris removal, cube-sat control, challenging scientific missions close to and far from earth etc. For this we need a platform of EP systems providing much more variety in performance than what classical Hall and Gridded thrusters can provide alone. PEGASES is a gridded thruster that can be an alternative for some new applications in space, in particular for space debris removal. Unlike classical ion thrusters, here positive and negative ions are alternately accelerated to produce thrust. In this presentation we will look at the fundamental aspects of PEGASES. The emphasis will be put on our current understanding, obtained via analytical models, PIC simulations and experimental measurements, of the alternate extraction and acceleration process. We show that at low grid bias frequencies (10 s of kHz), the system can be described as a sequence of negative and positive ions accelerated as packets within a classical DC mode. Here secondary electrons created in the downstream chamber play an important role in the beam space charge compensation. At higher frequencies (100 s of kHz) the transit time of the ions in the grid gap becomes comparable to the bias period, leading to an ``AC acceleration mode.'' Here the beam is fully space charge compensated and the ion energy and current are functions of the applied frequency and waveform. A generalization of the Child-Langmuir space charge limited law is developed for pulsed voltages and allows evaluating the optimal parameter space and performance of PEGASES. This work received financial state aid managed by the Agence Nationale de la Recherche under the reference ANR-2011-BS09-40 (EPIC) and ANR-11-IDEX-0004-02 (Plas@Par).

[Comparative evaluation of clinical practice guidelines for the treatment of schizophrenia].

PubMed

Delessert, D; Pomini, V; Grasset, F; Baumann, P

2008-01-01

Many clinical practice guidelines (CPG) have been published in reply to the development of the concept of "evidence-based medicine" (EBM) and as a solution to the difficulty of synthesizing and selecting relevant medical literature. Taking into account the expansion of new CPG, the question of choice arises: which CPG to consider in a given clinical situation? It is of primary importance to evaluate the quality of the CPG, but until recently, there has been no standardized tool of evaluation or comparison of the quality of the CPG. An instrument of evaluation of the quality of the CPG, called "AGREE" for appraisal of guidelines for research and evaluation was validated in 2002. The six principal CPG concerning the treatment of schizophrenia are compared with the help of the "AGREE" instrument: (1) "the Agence nationale pour le développement de l'évaluation médicale (ANDEM) recommendations"; (2) "The American Psychiatric Association (APA) practice guideline for the treatment of patients with schizophrenia"; (3) "The quick reference guide of APA practice guideline for the treatment of patients with schizophrenia"; (4) "The schizophrenia patient outcomes research team (PORT) treatment recommendations"; (5) "The Texas medication algorithm project (T-MAP)" and (6) "The expert consensus guideline for the treatment of schizophrenia". The results of our study were then compared with those of a similar investigation published in 2005, structured on 24 CPG tackling the treatment of schizophrenia. The "AGREE" tool was also used by two investigators in their study. In general, the scores of the two studies differed little and the two global evaluations of the CPG converged; however, each of the six CPG is perfectible. The rigour of elaboration of the six CPG was in general average. The consideration of the opinion of potential users was incomplete, and an effort made in the presentation of the recommendations would facilitate their clinical use. Moreover, there was little consideration by the authors regarding the applicability of the recommendations. Globally, two CPG are considered as strongly recommended: "the quick reference guide of the APA practice guideline for the treatment of patients with schizophrenia" and "the T-MAP".

Prevalence of and factors associated with depression among people living with HIV in France.

PubMed

Feuillet, P; Lert, F; Tron, L; Aubriere, C; Spire, B; Dray-Spira, R

2017-07-01

Depression is common among people living with HIV (PLWHIV) and is associated with poorer therapeutic outcomes and risky behaviours. We sought to estimate the prevalence of major depressive episode (MDE) across PLWHIV groups, to compare this with its prevalence in the general population and to assess factors associated with it. We used data from the Agence Nationale de Recherche sur le Sida et les Hépatites Virales (ANRS)-Vespa2 study, a national study on a representative sample of PLWHIV conducted in France in 2011. The short form of the depression module of the World Health Organization's Composite International Diagnostic Instrument (CIDI-SF) was used to characterize the occurrence of an MDE during the previous year. MDE prevalence was assessed among the various groups of PLWHIV and compared with that in the general population, accounting for the sociodemographic characteristics of the two populations, using multivariate Poisson regression models. The same method was used to assess associated factors. MDE prevalence was 28.1% among PLWHIV, ranging from 10.9 to 55.7% across groups. Compared with the general population by sex, regardless of sexual orientation and origin, MDE prevalence was 5.1-fold higher in HIV-infected men who have sex with men [95% confidence interval (CI) 3.9-6.6], 3.1-fold higher in non-sub-Saharan African (SSA) heterosexual men (95% CI 2.2-4.4), 1.6-fold higher in SSA migrant men (95% CI 0.9-2.6), 2.6-fold higher in non-SSA heterosexual women (95% CI 2.1-3.3), and 1.9-fold higher in SSA migrant women (95% CI 1.5-2.5). In the HIV-infected population, MDE was positively related to unemployment, material deprivation, disclosure, experience of discrimination, and untreated hepatitis C, and negatively related to age. The prevalence of depression varied across the different groups of PLWHIV, with levels much higher than in the general population. Moreover, there was a strong association with socioeconomic status and HIV experience. © 2016 British HIV Association.

Prévention de la transmission mère-enfant du VIH/sida au Bénin: le consentement des femmes au dépistage est-il libre et éclairé ?

PubMed Central

Kêdoté, N.M.; Brousselle, A.; Champagne, F.; Laudy, D.

2016-01-01

Résumé Introduction Dans les politiques internationales et nationales sur le VIH/sida, le consentement libre et éclairé est reconnu comme une composante essentielle des programmes de dépistage. Le consentement libre et éclairé implique pour les femmes enceintes d’obtenir des informations sur le programme de prévention de la transmission du VIH de la mère à l’enfant (PTME), de les comprendre et de faire un choix autonome après avoir évalué les risques et avantages. Cependant, aucune évaluation du programme de PTME ne s’est intéressée au consentement. L’objectif de cet article est d’explorer le caractère libre et éclairé du consentement des femmes enceintes quant au dépistage et à leurs motivations à faire le test. Méthode Nous avons utilisé des données récoltées dans le cadre d’une analyse d’implantation du programme de PTME au Bénin. Cette analyse s’appuie sur un devis d’étude de cas multiples incluant six maternités choisies parmi les 56 sites fonctionnels. Spécifiquement pour l’analyse du consentement, nous avons associé les données provenant d’une enquête à celles d’une recherche qualitative. Résultats Hormis trois cas de dépistage à l’insu, le caractère volontaire du consentement au test est respecté sur les sites de PTME. Vingt-neuf cas de refus ont été identifiés. Les raisons les plus souvent évoquées par les femmes enceintes sont la peur du résultat positif et de ses conséquences sur la vie familiale dans 55,2 % des cas et l’attente de l’accord ou du désaccord du mari dans 27,6 % des cas. Si globalement le consentement a été volontaire sur tous les sites, son caractère éclairé est moins probant. PMID:27840660

Antioxidant activity and total phenolic and flavonoids content variations of leaves extracts of white Horehound (Marrubium vulgare Linné) from three geographical origins.

PubMed

Bouterfas, K; Mehdadi, Z; Elaoufi, M M; Latreche, A; Benchiha, W

2016-11-01

To elucidate the effect of the sampling location of Marrubium vulgare L. leaves on phenolic contents and antioxidant proprieties of flavonoids extracts. M. vulgare L. leaves were collected from three different geographical locations belonging to northwest Algeria: Tessala (mountain region), M'sila forest (coastal region), and Ain Skhouna (steppe region). The flavonoid extraction was achieved using organic solvents with different polarities (methanol, chloroform, ethyl acetate, and hexane). Folin-Ciocalteu colorimetric method was used for quantification of total phenolic contents, and aluminum chloride assay for quantification of total flavonoid contents. The antioxidant properties of flavonoids extract were studied by free l,l-diphenyl-2-picrylhydrazyl radical-scavenging technique. Total phenolic and flavonoids concentrations varied respectively between 40.7 and 160mg gallic acid equivalents/g and 27.4 and 66.3mg catechin equivalents/g. The DPPH free radical-scavenging activity shows that the antioxidant activity of the flavonoid extracts varied significantly (P<0.001) depending on the type of the organic solvent used, and the sampling location. The methanol, chloroform and ethyl acetate extracts exhibited the highest percentages of inhibition unlike to the aqueous and hexane extracts. These percentages are ranged from 54.8 to 98.8% at 1000μg/mL. In general, M'sila forest flavonoids extracts showed the highest free radical inhibition capacity; followed by those of Ain Skhouna and Tessala Mountain. The inhibitory concentration 50 (IC 50 ) ranged from 33.7 to 774μg/mL and often exceeded those recorded by phenolic standards (ascorbic acid, gallic acid, caffeic acid, tannic acid and catechin). The phytochemical screening revealed the presence of some flavonoid classes, such as flavans and flavanols. The results suggested a potent antioxidant activity of M. vulgare flavonoids extracts, which may find its application in feature research for the food and the pharmacological industries. Copyright © 2016 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

Médecine des voyages

PubMed Central

Aw, Brian; Boraston, Suni; Botten, David; Cherniwchan, Darin; Fazal, Hyder; Kelton, Timothy; Libman, Michael; Saldanha, Colin; Scappatura, Philip; Stowe, Brian

2014-01-01

Résumé Objectif Définir la pratique de la médecine des voyages, présenter les éléments fondamentaux d’une consultation complète préalable aux voyages à des voyageurs internationaux et aider à identifier les patients qu’il vaudrait mieux envoyer en consultation auprès de professionnels de la médecine des voyages. Sources des données Les lignes directrices et les recommandations sur la médecine des voyages et les maladies liées aux voyages publiées par les autorités sanitaires nationales et internationales ont fait l’objet d’un examen. Une recension des ouvrages connexes dans MEDLINE et EMBASE a aussi été effectuée. Message principal La médecine des voyages est une spécialité très dynamique qui se concentre sur les soins préventifs avant un voyage. Une évaluation exhaustive du risque pour chaque voyageur est essentielle pour mesurer avec exactitude les risques particuliers au voyageur, à son itinéraire et à sa destination et pour offrir des conseils sur les interventions les plus appropriées en gestion du risque afin de promouvoir la santé et prévenir les problèmes médicaux indésirables durant le voyage. Des vaccins peuvent aussi être nécessaires et doivent être personnalisés en fonction des antécédents d’immunisation du voyageur, de son itinéraire et du temps qu’il reste avant son départ. Conclusion La santé et la sécurité d’un voyageur dépendent du degré d’expertise du médecin qui offre le counseling préalable à son voyage et les vaccins, au besoin. On recommande à ceux qui donnent des conseils aux voyageurs d’être conscients de l’ampleur de cette responsabilité et de demander si possible une consultation auprès de professionnels de la médecine des voyages pour tous les voyageurs à risque élevé.

The French prospective multisite registry on sudden unexpected infant death (OMIN): rationale and study protocol

PubMed Central

Levieux, Karine; Patural, Hugues; Harrewijn, Inge; Briand Huchet, Elisabeth; de Visme, Sophie; Gallot, Géraldine; Chalumeau, Martin; Gras Le Guen, Christèle; Hanf, Matthieu; Garcia-Meric, Patricia

2018-01-01

Introduction Even after ‘back-to-sleep’ campaigns, sudden unexpected infant death (SUID) continues to be the leading cause of death for infants 1 month to 1 year old in developed countries, with devastating social, psychological and legal implications for families. To sustainably tackle this problem and decrease the number of SUIDs, a French SUID registry was initiated in 2015 to (1) inform prevention with standardised data, (2) understand the mechanisms leading to SUID and the contribution of the already known or newly suggested risk factors and (3) gather a multidisciplinary group of experts to coordinate and develop innovative and urgent research in the SUID area. Methods and analysis This observational multisite prospective observatory includes all cases of sudden unexpected deaths in children younger than 2 years occurring in the French territory covered by the 35 participating French referral centres. From these cases, various data concerning sociodemographic conditions, death scene, personal and family medical history, parental behaviours, sleep environment, clinical examinations, biological and imagery investigations and autopsy are systematically collected. These data will be complemented as of 2018 with a biobank of diverse biological samples (blood, hair, urine, faeces and cerebrospinal fluid), with other administrative health-related data (health claim reimbursements and hospital admissions) and socioenvironmental data. Insights from exploratory descriptive statistics and thematic analysis will be combined for the design of targeted strategies to effectively reduce preventable infant deaths. Ethics and dissemination The French sudden unexpected infant death registry (Observatoire National des Morts Inattendues du Nourrisson registry;OMIN) was approved in 2015 by the French Data Protection Authority in clinical research (Commission Nationale de l’Informatique et des Libertés: number 915273) and by an independent ethics committee (Groupe Nantais d’Ethique dans le Domaine de la Santé: number 2015-01-27). Results will be discussed with associations of families affected by SUID, caregivers, funders of the registry, medical societies and researchers and will be submitted to international peer-reviewed journals and presented at international conferences. PMID:29666137

Southern Tunisia as an example of international partnership in cultural and geological heritage conservation

NASA Astrophysics Data System (ADS)

Contessi, M.; Cantelli, L.; Fanti, F.; Gabbianelli, G.; Mohsen, H.

2012-04-01

National Geoparks initiatives are essential strategies to enhance the value of Earth's heritage and to promote a regional sustainable socio-economic and cultural development. As an example for geological heritage development, an ongoing partnership between the Department of Geological and Environmental Sciences of the University of Bologna (Italy) and the Office Nationales des Mines (Tunisia) attempt to ensure divulgation and preservation of the geological, geomorphological and archeological values of the Tataouine region in South Tunisia, with the final goal to create a Geopark. In this region, different environmental and cultural heritages that comprehend paleontology, geomorphology, stratigraphy and archeology coexist. Mesozoic beds that crop out extensively in the Tataouine region known since the beginning of the 20th century as Continental Intercalaire, yield numerous dinosaur and other vertebrate remains as well as tracksites. Moreover these Mesozoic deposits have been intensively modified for centuries by the local populations who created complex systems of artificial terraces, called jessour, in order to retain rainwater in the arid Tunisian climate and to exploit the scarce farm soil. These human artifacts deeply modified the morphological and hydrogeological landscape and created a unique cultural value that need to be preserved. From the perspective of science and conservation, a well-documented geological inventory of the fossiliferous sites has been produced and will be available as an electronic database. In particular, the Beni Ghedir valley, near the Goumrassene village, has been chosen has the main Geopark location as it includes, in a restricted area, a perfect example of jessour artifacts together with some well-preserved Ksour (ancient storage structures) and nicely preserved fossil sites. An interactive map of the artificial terrances has been produced using the ArcGis technology, in order to highlight the connection between the valley morphology, the jessour systems and the hydrologic framework. Concluding, we believe in the importance of the preservation of geological and cultural diversity and the need to establish international collaborations in order to assist the national and regional experts to fully understood and protect the Tunisian sites, as economic and cultural development of the country.

Evaluation de la sécurité du circuit des médicaments anticancéreux dans un hôpital régional en Tunisie

PubMed Central

Sahli, Jihène; El Ghardallou, Meriam; Bougmiza, Iheb; Henchiri, Besma; Limam, Manel; Mejdoub, Rim; Mtiraoui, Ali; Ajmi, Thouraya

2016-01-01

Introduction Parmi les événements indésirables, ceux liés au circuit des médicaments occupent une place importante et risquent de causer un préjudice grave aux patients. Dans ce contexte, nous avons mené cette étude dans l'optique de décrire et d’évaluer le circuit des médicaments anticancéreux dans un hôpital régional tunisien. Méthodes Il s'agit d'une étude évaluative du risque lié aux médicaments anticancéreux, type « visite de risque » menée sur une période de 15 jours au cours de l'année 2014 au service de cancérologie de l'hôpital régional de Gafsa (Tunisie). Cette méthode d’évaluation est inspirée de celle conduite par le projet « SECURIMED » développé par le Comité de Coordination de l'Evaluation Clinique et de la Qualité en Aquitaine (CCECQA), en France. Résultats Dans notre étude, l'observation du circuit des médicaments anticancéreux a révélé certaines insuffisances. On a noté que la répartition des missions des différents acteurs est sujette parfois à des glissements de tâches. Un manque important ainsi que une inadéquation aux normes au niveau des équipements nécessaires pour la préparation et la protection des professionnels manipulant ces médicaments ont été également décelés. Conclusion La sécurisation du circuit des médicaments devrait être une priorité inscrite dans l'ensemble des démarches nationales et partagée par tous les intervenants et ce dans l'optique d'atteindre un objectif prémium: la qualité de la prise en charge globale et la sécurité des patients. PMID:27200135

Targeted temperature management in the ICU: guidelines from a French expert panel.

PubMed

Cariou, Alain; Payen, Jean-François; Asehnoune, Karim; Audibert, Gerard; Botte, Astrid; Brissaud, Olivier; Debaty, Guillaume; Deltour, Sandrine; Deye, Nicolas; Engrand, Nicolas; Francony, Gilles; Legriel, Stéphane; Levy, Bruno; Meyer, Philippe; Orban, Jean-Christophe; Renolleau, Sylvain; Vigue, Bernard; De Saint Blanquat, Laure; Mathien, Cyrille; Velly, Lionel

2017-12-01

Over the recent period, the use of induced hypothermia has gained an increasing interest for critically ill patients, in particular in brain-injured patients. The term "targeted temperature management" (TTM) has now emerged as the most appropriate when referring to interventions used to reach and maintain a specific level temperature for each individual. TTM may be used to prevent fever, to maintain normothermia, or to lower core temperature. This treatment is widely used in intensive care units, mostly as a primary neuroprotective method. Indications are, however, associated with variable levels of evidence based on inhomogeneous or even contradictory literature. Our aim was to conduct a systematic analysis of the published data in order to provide guidelines. We present herein recommendations for the use of TTM in adult and paediatric critically ill patients developed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) method. These guidelines were conducted by a group of experts from the French Intensive Care Society (Société de Réanimation de Langue Française [SRLF]) and the French Society of Anesthesia and Intensive Care Medicine (Société Francaise d'Anesthésie Réanimation [SFAR]) with the participation of the French Emergency Medicine Association (Société Française de Médecine d'Urgence [SFMU]), the French Group for Pediatric Intensive Care and Emergencies (Groupe Francophone de Réanimation et Urgences Pédiatriques [GFRUP]), the French National Association of Neuro-Anesthesiology and Critical Care (Association Nationale de Neuro-Anesthésie Réanimation Française [ANARLF]), and the French Neurovascular Society (Société Française Neurovasculaire [SFNV]). Fifteen experts and two coordinators agreed to consider questions concerning TTM and its practical implementation in five clinical situations: cardiac arrest, traumatic brain injury, stroke, other brain injuries, and shock. This resulted in 30 recommendations: 3 recommendations were strong (Grade 1), 13 were weak (Grade 2), and 14 were experts' opinions. After two rounds of rating and various amendments, a strong agreement from voting participants was obtained for all 30 (100%) recommendations, which are exposed in the present article.

Mecanismes physiques et fondements theoriques de la recuperation d'energie micro-ondes ambiante pour les dispositifs sans fil a faible consommation

NASA Astrophysics Data System (ADS)

Petzl Lorenz, Carlos Henrique

Powering low consumption and low duty cycle devices and circuits using Ambient Microwave Energy Harvesting (AMEH) has been the subject of several investigations in recent years. The interest for this research topic has been promoted mainly by various and new applications driven mainly by the Internet of things, Building Automation and new developments in devices for the Body Area Networks. A common characteristic among several of these applications is the need for a wireless source which does not require regular maintenance, and has a small size and low weight. Batteries are often too cumbersome and require a maintenance plan to recharge or replace them, which is not always possible. A new source of energy is thus necessary. Ambient energy harvesting is proposed as an alternative source of power to these low power consumption devices and circuits. This M.A.Sc. work is developed to explore the microwave ambient energy harvesting using diode rectifier circuits. A mathematical model is first developed to explain the mechanisms that contribute to the process of recovery of microwave energy in the range of power found in the ambient microwave energy harvesting applications. An evaluation of this model is made using simulation results and then measurements results from three prototypes developed under this M.A.Sc. program. The results show an excellent agreement between the three methods. The developed model includes losses in the parasitic components of the non-linear element used for the rectification of energy as well as the impedance matching network insertion losses. Based on this model, two possible ways of improving the efficiency of ambient microwave power rectifiers at the power levels found in the AMEH are explored. In this work, it is considered that the AMEH takes place within the range of powers with a peak value of -30 dBm, however at average power levels well below this threshold. First, a cooperative hybrid circuit of ambient energy harvesting is presented where collected microwave and mechanical energies are converted in a cooperative manner through a single nonlinear component. Theory, simulations and measurements show that the total power recovered by the proposed scheme can provide up to twice the efficiency of a circuit combining the output of two independent harvesters. Then, a work demonstrating for the first time that the limitations of a Schottky diode harvester can be overcome by using backward tunnel diodes is presented. It is shown that the limitation reached by the Schottky diodes half a century ago can be overcome thanks to a higher current responsivity obtained through tunneling transport. The measured power recovery efficiency was equal to 18.2% when a -30 dBm signal at 2.4 GHz was applied to the input of the microwave energy harvesting circuit. The efficiency of conversion for a similar circuit using Schottky diodes, which is presented in the first chapter together with the mathematical model, does not exceed 11% at the same input power level and similar frequency. On the date of publication of the articles presented in this thesis, the highest published microwave power conversion efficiency was close to 5% for input power levels equal to -30 dBm and frequency close to 2 GHz. Finally, an application of microwave power transfer is presented. A rectenna operating at 94 GHz is built and measured, an energy conversion efficiency equal to 37.7% was obtained for an input power equal to 3 dBm. This rectenna is proposed as an alternative power source for microrobots, which may not use batteries due to their small size and light weight.

Profil épidémiologique des hémoglobinopathies: étude transversale descriptive autour du cas index

PubMed Central

Dahmani, Fatima; Benkirane, Souad; Kouzih, Jaafar; Woumki, Aziz; Mamad, Hassan; Masrar, Azlarab

2017-01-01

Les hémoglobinopathies sont des affections constitutionnelles conséquentes à des anomalies des hémoglobines. Elles sont souvent graves dans leurs formes majeures, leur prise en charge est lourde avec un grand impact psycho-social sur les patients et leur famille. Classées parmi les maladies rares, elles sont encore insuffisamment connues des professionnels de santé. Cette méconnaissance est à l'origine d'une errance diagnostique, d'un retard dans leur prise en charge et par conséquent une morbidité et une mortalité élevée chez ces patients. L'Organisation Mondiale de la Santé (OMS) a publié en 2008 des données concernant l'épidémiologie des hémoglobinopathies: plus de 330000 cas naissent chaque année avec une hémoglobinopathie (83% des cas de drépanocytose, 17% des cas de thalassémie). Les troubles de l'hémoglobine sont responsables d'environ 3,4% des décès chez les moins de 5 ans. A l'échelle mondiale, 7% environ des femmes enceintes seraient porteuses d'une forme de la thalassémie et 1% des couples sont à risque. Toutefois, elles sont relativement fréquentes dans certaines régions du globe où les mariages consanguins sont communs. Afin de décrire les caractéristiques épidémiologiques des familles à risque d'hémoglobinopathies (étude autour du cas) dont les cas index sont suivis au service de pédiatrie à l'Hôpital Provincial El Idrisi de Kenitra au Maroc, une étude transversale descriptive a été réalisée durant deux enquêtes la première en mai 2015 et la deuxième en juin de la même année lors des journées de vaccination des cas index contre le pneumocoque. Après avoir recueilli les données épidémiologiques de nos patients, 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) et secondairement à pH acide (5.4) sur gel d'agarose avec intégration densitométrique. 275 patients ont présenté des profils compatibles à une hémoglobinopathie. La majorité de ces malades étaient issus de mariages consanguins (83.1%) et originaires de régions situées dans le nord du Maroc. L'enquête familiale a permis de retrouver les familles à risque, chez lesquelles on note une fréquence élevée de drépanocytose. Nos résultats confirment l'existence de différents types d'hémoglobinopathies dans la population marocaine. PMID:28904678

P and S automatic picks for 3D earthquake tomography in NE Italy

NASA Astrophysics Data System (ADS)

Lovisa, L.; Bragato, P.; Gentili, S.

2006-12-01

Earthquake tomography is useful to study structural and geological features of the crust. In particular, it uses P and S arrival times for reconstructing weaves velocity fields and locating earthquakes hypocenters. However, tomography needs a large effort to provide a high number of manual picks. On the other side, many automatic picking methods have been proposed, but they are usually applied to preliminary elaboration of the data (fast alert and automatic bulletin generation); they are generally considered not reliable for tomography. In this work, we present and discuss the results of Vp, Vs and Vp/Vs tomographies obtained using automatic picks generated by the system TAPNEI (Gentili and Bragato 2006), applied in the NE Italy. Preliminarily, in order to estimate the error in comparison with the unknown true arrival times, an analysis on the picking quality is done. The tests have been performed using two dataset: the first is made up by 240 earthquakes automatically picked by TAPNEI; the second counts in the same earthquakes but manually picked (OGS database). The grid and the software used to perform tomography (Sim28, Michelini and Mc Evilly, 1991) are the same in the two cases. Vp, Vs and Vp/Vs fields of the two tomographies and their differences are shown on vertical sections. In addiction, the differences in earthquakes locations are studied; in particular, the quality of the accuracy of the localizations has been analyzed by estimating the distance of the hypocenter distributions with respect to the manual locations. The analysis include also a qualitative comparison with an independent tomography (Gentile et al., 2000) performed using Simulps (Evans et al, 1994) on a set of 224 earthquakes accurately selected and manually relocated. The quality of the pickings and the comparison with the tomography obtained by manual data suggest that earthquake tomography with automatic data can provide reliable results. We suggest the use of such data when a large quantity of recordings must by quickly analyzed to provide some preliminary results (e.g., to decide about further data acquisition when using temporary networks) or when a sort of "real-time tomography" is required (e.g., continuous imaging of volcanoes during their activity). References Evans J.R., Eberhart-Phillips D., and Thurber C.H. (1994). User's manual for simulps12 for imaging vp and vp/vs: a derivative of the Thurber tomographic inversion simul3 for local earthquakes locations and explosions, U.S.Geol. Surv. Open File Report, 7 pp. Gentile, G. F., Bressan, G., Burlini, L., De Franco, R., 2000, Three - dimensional Vp and Vp/Vs models of the upper crust in the Friuli area (Northeastern Italy)., Geophys. Journ. Int., 141, 457-478. Gentili S. and Bragato P. L., 2006,"A neural-tree-based system for automatic location of earthquakes in Northeastern Italy" Journal of Seismology, Volume 10, Number 1, pp.73-89. Michelini, A., Mcevilly, T. V., 1991, "Seismological studies at Parkfield; I, Simultaneous inversion for velocity structure and hypocenters using cubic B-splines parameterization.", Bulletin of the Seismological Society of America, 81, 2, 524-552.

Catalytic synthesis of biologically important metabolites from formaldehyde and ammonia as a putative way of their prebiotic emergence

NASA Astrophysics Data System (ADS)

Delidovich, Irina; Taran, Oxana; Simonov, Alexander; Parmon, Valentin

The modern `RNA-world' theory considering the primary life as a system of self-replicating informational and catalytic oligomers is the most widespread hypothesis of life's origin. At the same time an alternative major theory antithetic to the genetic one exists. It is based on the primary formation of important metabolites and building blocks of biopolymers and appearance of the primordial autocatalytic cycles in geochemical environment. [1]. Encouraged by this theory, we suggest the putative emergence pathways to biologically relevant metabolites from simple precursors: formaldehyde (FA) and ammonia, which are known to be present in the interstellar space [2]. Based on our earlier [3, 4] and novel findings as well as on the literature data [5, 6] the scheme of conjugate autocatalytic processes including photochemical condensation of FA yielding C-C bond and catalytic formation of pyruvaldehyde, pyruvic acid, sugars, aminoacids catalyzed by minerals (aluminum silicate, phoshates) and by aminoacids themselves is proposed. Acetaldehyde, glyoxal, glycol-and glyceraldehydes (GA and GCA) were identified in this work as products of photolysis of FA aqueous solution with summary selectivity up to 20% and can serve as substrates for the synthesis of more complex organic compounds. In turn, alanine and pyruvic acid are formed during UV-irradiation of aqueous solution of acetaldehyde and ammonium nitrate [6]. Pyruvaldehyde formation from GCA and FA in presence of amino acids was observed by A. Weber [5]. Finally, we revealed the catalytic activity of zeolite HZSM-5-17 in acid form towards formation of pyruvaldehyde from GA and GCA in presence of alanine with the yield about 5%. This observation indicates that the assumption of catalytic activity of silica-alumina towards the synthesis of metabolites could be realistic. Prebiotic synthesis of sugars from lower monosacharides, as we showed earlier, could take place over phosphate catalysts [4]. The substrates and the products of the proposed scheme were detected in the interstellar space and meteorites [7, 8], evidencing of the possibility of its realization either on the Protoeath or in the protoplanet disk supplying the initial compounds for contemporary metabolism. Acknowledgements. The financial support of Program RAS, IP SB RAS N 10 is gratefully acknowledged. References 1. A. Eschenmoser, in "Origin of life. Chemical approach", Eds. P. Herdewijn, M.V. Kisakurek, Wiley-VCH, placeCityZurich, 2008 and refs therein. 2. D.A. Williams, J. Phys. Conf. 6, 1-17, 2005. 3. Pestunova, O., Simonov, A., Snytnikov, V., et al., Adv. Space Res. 36/2, 214-219, 2005. 4. Simonov, A., Pestunova, O., Matvienko, L., et al., Adv. Space Res. 40, 1634-1640, 2007. 5. A.L. Weber, Orig. Life Evol. Biosph. 31, 71-86, 2001. 6. T.A. Telegina, et. al., Journ. Evol. Biochim. i Fiziol. (Rus). 4/8, 429-434, 1977. 7. Hollis, J., Jewell, P., Lovas, F., et al., The Astrophysical Journal 613, L45-L48, 2004 8. Cooper, G., Kimmich, N., Belisle, W., et al., Nature 414(6866), 879, 2001.

Benefits of task-shifting HIV care to nurses in terms of health-related quality of life in patients initiating antiretroviral therapy in rural district hospitals in Cameroon [Stratall Agence Nationale de Recherche sur le SIDA (ANRS) 12110/Ensemble pour une Solidarité Thérapeutique Hospitalière en Réseau (ESTHER) substudy].

PubMed

Suzan-Monti, M; Blanche, J; Boyer, S; Kouanfack, C; Delaporte, E; Bonono, R-C; Carrieri, P M; Protopopescu, C; Laurent, C; Spire, B

2015-05-01

The World Health Organization (WHO) recommends task-shifting HIV care to nurses in low-resource settings with limited numbers of physicians. However, the effect of such task-shifting on the health-related quality of life (HRQL) of people living with HIV (PLHIV) has seldom been evaluated. We aimed to investigate the effect of task-shifting HIV care to nurses on HRQL outcomes in PLHIV initiating antiretroviral therapy (ART) in rural district hospitals in Cameroon. Outcomes in PLHIV were longitudinally collected in the 2006-2010 Stratall trial. PLHIV were followed up for 24 months by nurses and/or physicians. Six HRQL dimensions were assessed during face-to-face interviews using the WHO Quality of Life (WHOQOL)-HIV BREF scale: physical health; psychological health; independence level; social relationships; environment; and spirituality/religion/personal beliefs. The degree of task-shifting was estimated using a consultant ratio (i.e. the ratio of nurse-led to physician-led visits). The effect of task-shifting and other potential correlates on HRQL dimensions was explored using a Heckman two-stage approach based on linear mixed models to adjust for the potential bias caused by missing data in the outcomes. Of 1424 visits in 440 PLHIV (70.5% female; median age 36 years; median CD4 count 188 cells/μL at enrolment), 423 (29.7%) were task-shifted to nurses. After multiple adjustment, task-shifting was associated with higher HRQL level for four dimensions: physical health [coefficient 0.7; 95% confidence interval (CI) 0.1-1.2; P = 0.01], psychological health (coefficient 0.5; 95% CI 0.0-1.0; P = 0.05), independence level (coefficient 0.6; 95% CI 0.1-1.1; P = 0.01) and environment (coefficient 0.6; 95% CI 0.1-1.0; P = 0.02). Task-shifting HIV care to nurses benefits the HRQL of PLHIV. Together with the previously demonstrated comparable clinical effectiveness of physician-based and nurse-based models of HIV care, our results support the WHO recommendation for task-shifting. © 2015 British HIV Association.

GEOdetic Data assimilation and EStimation of references for climate change InvEstigation. An overall presentation of the French GEODESIE project

NASA Astrophysics Data System (ADS)

Nahmani, S.; Coulot, D.; Biancale, R.; Bizouard, C.; Bonnefond, P.; Bouquillon, S.; Collilieux, X.; Deleflie, F.; Garayt, B.; Lambert, S. B.; Laurent-Varin, S.; Marty, J. C.; Mercier, F.; Metivier, L.; Meyssignac, B.; Pollet, A.; Rebischung, P.; Reinquin, F.; Richard, J. Y.; Tertre, F.; Woppelmann, G.

2017-12-01

Many major indicators of climate change are monitored with space observations. This monitoring is highly dependent on references that only geodesy can provide. The current accuracy of these references does not permit to fully support the challenges that the constantly evolving Earth system gives rise to, and can consequently limit the accuracy of these indicators. Thus, in the framework of the GGOS, stringent requirements are fixed to the International Terrestrial Reference Frame (ITRF) for the next decade: an accuracy at the level of 1 mm and a stability at the level of 0.1 mm/yr. This means an improvement of the current quality of ITRF by a factor of 5-10. Improving the quality of the geodetic references is an issue which requires a thorough reassessment of the methodologies involved. The most relevant and promising method to improve this quality is the direct combination of the space-geodetic measurements used to compute the official references of the IERS. The GEODESIE project aims at (i) determining highly-accurate global and consistent references and (ii) providing the geophysical and climate research communities with these references, for a better estimation of geocentric sea level rise, ice mass balance and on-going climate changes. Time series of sea levels computed from altimetric data and tide gauge records with these references will also be provided. The geodetic references will be essential bases for Earth's observation and monitoring to support the challenges of the century. The geocentric time series of sea levels will permit to better apprehend (i) the drivers of the global mean sea level rise and of regional variations of sea level and (ii) the contribution of the global climate change induced by anthropogenic greenhouse gases emissions to these drivers. All the results and computation and quality assessment reports will be available at geodesie_anr.ign.fr.This project, supported by the French Agence Nationale de la Recherche (ANR) for the period 2017-2020, will be an unprecedented opportunity to provide the French Groupe de Recherche de Géodésie Spatiale (GRGS) with complete simulation and data processing capabilities to prepare the future arrival of space missions such as the European Geodetic Reference Antenna in SPace (E-GRASP) and to significantly contribute to the GGOS with accurate references.

Profil des diabétiques en hémodialyse chronique: étude multicentrique au Maroc

PubMed Central

Kabbali, Nadia; Mikou, Souad; El Pardiya, Nada Tazi; El Bardai, Ghita; Arrayhani, Mohamed; Houssaini, Tarik Sqalli

2014-01-01

Introduction Le diabète représente la première cause de mortalité par insuffisance rénale au Maroc. Sa prévalence selon l'Enquête Nationale sur la Population et la Santé Familiale de 2011 est de 3,3% [1]. Le but de ce travail est de déterminer la prévalence et d’étudier le profil clinique des diabétiques en hémodialyse chronique au Maroc. Méthodes Il s'agit d'une étude transversale multicentrique incluant 2066 hémodialysés chroniques dans les 39 centres d'hémodialyse de quatre régions marocaines. Résultats La prévalence du diabète en hémodialyse est 21,6%. L’âge moyen 59±13,2 ans (26-87). Le sex-ratio est de 1,9. L'IMC moyen est de 24,5 ± 4,4 kg/m2 (15-41). 42 patients sont porteurs d′une hépatite virale. La durée moyenne en HD est 39,3± 67 mois. 57% des patients gardent une diurèse résiduelle versus 43% chez les non diabétiques. Par rapport à ces derniers, nous avons noté plus d'HTA (64% versus 45%), plus de complications cardiovasculaires (23% versus 12%), un âge plus avancé à l'initiation de l'hémodialyse (55,5 versus 47 ans) et un taux de FAV proximales plus important. Conclusion La prévalence des diabétiques en hémodialyse est relativement élevée au Maroc sans tenir compte des patients qui ne bénéficient pas d’épuration extra-rénale pour des raisons socio-économiques. Le taux élevé de mortalité est imputable au retard et/ou à l'absence de la prise en charge néphrologique des diabétiques. Dans nos régions où le système sanitaire dispose de faible moyen, l'accent doit être mis sur le dépistage précoce de la néphropathie chez le diabétique. PMID:25374630

Levels and determinants of breast and cervical cancer screening uptake in HIV-infected women compared with the general population in France.

PubMed

Tron, L; Lert, F; Spire, B; Dray-Spira, R

2017-03-01

Cancer is a growing concern for HIV-infected people, and screening plays a major role in alleviating the burden it causes. We sought to investigate the levels and determinants of breast cancer screening (BCS) and cervical cancer screening (CCS) in HIV-infected women as compared with the general population. The Agence Nationale de Recherche sur le Sida et les Hépatites Virales (ANRS)-Vespa2 study was conducted in 2011 in a national representative sample of 3022 HIV-infected hospital out-patients in France. The rates and correlates of BCS and CCS among HIV-infected women were compared with those in the general population using multivariate Poisson regression models. The BCS rate during the 2 years preceding the survey interview was 80.7% among HIV-infected women vs. 89.1% in the general population (P = 0.146). The CCS rate during the preceding 3 years was 88.1% among HIV-infected women vs. 83.1% in the general population (P = 0.021). During the preceding year, the CCS rate among HIV-infected women was 76.5%. The barriers to BCS and CCS were a low educational level [BCS: adjusted prevalence rate ratio 0.88; 95% confidence interval (CI) 0.80-0.97; CCS: adjusted prevalence rate ratio 0.91; 95% CI 0.83-0.99], not having supplementary health insurance (CCS: adjusted prevalence rate ratio 0.92; 95% CI 0.86-0.98), an irregular gynaecological follow-up (BCS: adjusted prevalence rate ratio 0.77; 95% CI 0.64-0.92; CCS: adjusted prevalence rate ratio 0.72; 95% CI 0.64-0.81) and a low CD4 count (BCS: adjusted prevalence rate ratio 0.83; 95% CI 0.71-0.97; CCS: adjusted prevalence rate ratio 0.78; 95% CI 0.63-0.98). The disparities in CCS uptake in terms of age, employment and gynaecological follow-up were less pronounced among HIV-infected women than in the general population. BCS and CCS uptake was not lower among HIV-infected women than in the general population, but CCS was suboptimal. Specificities in the profile of barriers to screening emerged. © 2016 British HIV Association.

Feedback from uncertainties propagation research projects conducted in different hydraulic fields: outcomes for engineering projects and nuclear safety assessment.

NASA Astrophysics Data System (ADS)

Bacchi, Vito; Duluc, Claire-Marie; Bertrand, Nathalie; Bardet, Lise

2017-04-01

In recent years, in the context of hydraulic risk assessment, much effort has been put into the development of sophisticated numerical model systems able reproducing surface flow field. These numerical models are based on a deterministic approach and the results are presented in terms of measurable quantities (water depths, flow velocities, etc…). However, the modelling of surface flows involves numerous uncertainties associated both to the numerical structure of the model, to the knowledge of the physical parameters which force the system and to the randomness inherent to natural phenomena. As a consequence, dealing with uncertainties can be a difficult task for both modelers and decision-makers [Ioss, 2011]. In the context of nuclear safety, IRSN assesses studies conducted by operators for different reference flood situations (local rain, small or large watershed flooding, sea levels, etc…), that are defined in the guide ASN N°13 [ASN, 2013]. The guide provides some recommendations to deal with uncertainties, by proposing a specific conservative approach to cover hydraulic modelling uncertainties. Depending of the situation, the influencing parameter might be the Strickler coefficient, levee behavior, simplified topographic assumptions, etc. Obviously, identifying the most influencing parameter and giving it a penalizing value is challenging and usually questionable. In this context, IRSN conducted cooperative (Compagnie Nationale du Rhone, I-CiTy laboratory of Polytech'Nice, Atomic Energy Commission, Bureau de Recherches Géologiques et Minières) research activities since 2011 in order to investigate feasibility and benefits of Uncertainties Analysis (UA) and Global Sensitivity Analysis (GSA) when applied to hydraulic modelling. A specific methodology was tested by using the computational environment Promethee, developed by IRSN, which allows carrying out uncertainties propagation study. This methodology was applied with various numerical models and in different contexts, as river flooding on the Rhône River (Nguyen et al., 2015) and on the Garonne River, for the studying of local rainfall (Abily et al., 2016) or for tsunami generation, in the framework of the ANR-research project TANDEM. The feedback issued from these previous studies is analyzed (technical problems, limitations, interesting results, etc…) and the perspectives and a discussion on how a probabilistic approach of uncertainties should improve the actual deterministic methodology for risk assessment (also for other engineering applications) will be finally given.

Cathode-less gridded ion thrusters for small satellites

NASA Astrophysics Data System (ADS)

Aanesland, Ane

2016-10-01

Electric space propulsion is now a mature technology for commercial satellites and space missions that requires thrust in the order of hundreds of mN, and with available electric power in the order of kW. Developing electric propulsion for SmallSats (1 to 500 kg satellites) are challenging due to the small space and limited available electric power (in the worst case close to 10 W). One of the challenges in downscaling ion and Hall thrusters is the need to neutralize the positive ion beam to prevent beam stalling. This neutralization is achieved by feeding electrons into the downstream space. In most cases hollow cathodes are used for this purpose, but they are fragile and difficult to implement, and in particular for small systems they are difficult to downscale, both in size and electron current. We describe here a new alternative ion thruster that can provide thrust and specific impulse suitable for mission control of satellites as small as 3 kg. The originality of our thruster lies in the acceleration principles and propellant handling. Continuous ion acceleration is achieved by biasing a set of grids with Radio Frequency voltages (RF) via a blocking capacitor. Due to the different mobility of ions and electrons, the blocking capacitor charges up and rectifies the RF voltage. Thus, the ions are accelerated by the self-bias DC voltage. Moreover, due to the RF oscillations, the electrons escape the thruster across the grids during brief instants in the RF period ensuring a full space charge neutralization of the positive ion beam. Due to the RF nature of this system, the space charge limited current increases by almost a factor of 2 compared to classical DC biased grids, which translates into a specific thrust two times higher than for a similar DC system. This new thruster is called Neptune and operates with only one RF power supply for plasma generation, ion acceleration and electron neutralization. We will present the downscaling of this thruster to a 3cm diameter unit well adapted for a CubeSat or SmallSat mission. This work was supported by Agence Nationale de la Recherche under contract ANR-11-IDEX-0004-02 (Plas@Par) and by SATT Paris-Saclay.

Energy, nutrient and food content of snacks in French adults.

PubMed

Si Hassen, Wendy; Castetbon, Katia; Tichit, Christine; Péneau, Sandrine; Nechba, Anouar; Ducrot, Pauline; Lampuré, Aurélie; Bellisle, France; Hercberg, Serge; Méjean, Caroline

2018-02-27

Snacking raises concern since it may lead to an additional energy intake and poor nutrient quality. A snacking occasion can be defined as any eating occasion apart from main meals, regardless of the amount or type of foods consumed. We described the frequency of snacking occasions according to daily timing in French adults, and compared them between each other, and with the main meals, in terms of energy intake, energy and nutrient density, and food content. This cross-sectional analysis included 104,265 adults from the NutriNet-Santé cohort. Food intake was estimated using 24-h records of weekdays. For each eating occasion, nutrient density and energy content and density were computed. After weighting, 47.6% of our sample were men and mean age was 45.6 (15.3). Overall, 68% of participants ate at least one snack during the reported record, mainly in the morning or afternoon. Overall snack had a lower nutrient density [22.8 (SD = 278.3)] than main meals [25.8 (36.9) to 30.0 (30.4)]; but higher energy density [222.2 (163.3) kcal/100 g] than meals [133.9 (57.3) to 175.9 (99.6) kcal/100 g]. Morning snack was the snacking occasion with the lowest energy density [211 kcal/100 g], the lowest energy intake [104.1 kcal] and the highest nutrient density [60.1]. Afternoon and evening snacks had the highest energy loads [192.4 kcal and 207.6 kcal], but low nutrient scores [16 and 13, respectively]. The main food groups contributing to energy intake from snacks were fatty-sweet and sugary foods, fruit, hot beverages, and bread. Our findings highlight the frequency of snacking and the varying nutritional quality of snacks over the day. The morning snack was shown to be healthier than afternoon and evening snacks. This study was conducted according to guidelines laid down in the Declaration of Helsinki, and all procedures were approved by the Institutional Review Board of the French Institute for Health and Medical Research (IRB Inserm No. 0000388FWA00005831) and the French Data Protection Authority (Commission Nationale Informatique et Libertés No. 908450 and No. 909216). Electronic informed consent was obtained from all participants (Clinical Trial no. NCT03335644 ).

Long-term stability of dexamethasone and alizapride or ondansetron in sodium chloride 0.9% polyolefin bag at 5±3°C.

PubMed

Simar, J; Godet, M; Hecq, J-D; Closset, M; Gillet, P; Langhendries, C; Bihin, B; Jamart, J; Galanti, L

2017-01-01

The aim of the study was to investigate the long-term stability of dexamethasone 10mg associated with alizapride 100mg or ondansetron 8mg in 100mL of 0.9% sodium chloride solution stored at 5±3°C. Solutions of 0.9% sodium chloride 100mL in polyolefin bags (n=5) containing approximately dexamethasone (DEX) 10mg associated with alizapride (ALI) 100mg or ondansetron (OND) 8mg were prepared under aseptic conditions and stored about 30 days at 5±3°C. ALI, DEX and OND concentrations were measured by high-performance liquid chromatography (HPLC). Optic density measurement at different wavelengths, pH measurement and optic microscope observations were performed periodically during the storage. A forced degradation test with HCL 5M and NaOH 5M before and after heating at 100°C was also performed. Solutions were considered stable if the 95% one-sided lower confidence limit of the concentration remains superior to 90% of the initial concentration or 95% of the initial concentration when any signs of physical instability exist as recently recommend. The calibration was linear over the following range from 20 to 1.25mg/100mL for DEX, from 200 to 12.5mg/100mL for ALI and from 20 to 1.25mg/100mL for OND with a calculated correlation coefficient (r 2 ) of 0.998, 0.999 and 0.999, respectively. The inter- and intra-assay precision was below 10% for both mixtures. All formulations were physically stable during the storage. The lower confidence limit of the concentration for these solutions remains superior to 90% of the initial concentration at this date as recommended by the Food and Drug Administration (FDA) until 30 days. The HPLC method is specific and reproducible and can easily be adopted for monitoring the quality control in the production of DEX-ALI and DEX-OND bags. Solutions of DEX-ALI and DEX-OND were physically and chemically stable for 30 days in polyolefin bags stored at 5±3°C and could therefore be prepared in advance. Copyright © 2016 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

Characterization of a clay-rich rock through development and installation of specific hydrogeological and diffusion test equipment in deep boreholes

NASA Astrophysics Data System (ADS)

Delay, Jacques; Distinguin, Marc; Dewonck, Sarah

Andra (Agence Nationale pour la Gestion des Déchets Radioactifs - National Radioactive Waste Management Agency) has developed specific tools and methodologies to evaluate and understand the main transport mechanisms of solute species in an argillaceous rock in the framework of the scientific program of the Meuse/Haute-Marne Underground Research Laboratory. This paper focuses on three specific equipments already installed in boreholes for the determination of convection and diffusion parameters in a very low permeability environment. The first one is a specific borehole completion for head and permeability measurements with an integrated wireless telemetry device. In 1995, Andra devised a probe equipped with a pressure sensor to monitor the long-term evolution of electro-magnetically transmitted pore pressures. The data gathered by this first device, and a second one installed in 2001, have shown the occurrence of overpressures in very low permeability formations. The second device is derived from the multipacker system used for monitoring the drainage of the Oxfordian limestone due to the sinking of the shaft above the Callovo-Oxfordian. It is used for obtaining from a single borehole, a pressure profile of the argillaceous formation and its encasing units. To date, the major information obtained with these two borehole equipments is the existence of a 25-35 m anomalous excess hydraulic head in the 130 m thick Callovo-Oxfordian argillaceous formation. Head values in the argillaceous rock exceed those in the overlying Oxfordian limestone by 25-35 m, and those in the underlying Dogger by over 45 m. The third equipment described in the paper, is derived from the experiment carried out at the Mont Terri rock laboratory since 1996 for the characterization of diffusion and retention processes. The system is adapted for a borehole drilled from the surface. The objectives of this experiment are as follows: Verification of the predominant role played by molecular diffusion compared with convection; Acquisition of data required to extrapolate and /or interpolate chemical retention and diffusion parameters. The diffusion test performed from the borehole makes it possible to test in situ a small number of tracers (HTO, 36Cl, 134Cs) at a scale of 10 cm for the non sorbing tracers.

Air quality remote sensing over alpine regions with METEOSAT SEVIRI

NASA Astrophysics Data System (ADS)

Emili, E.; Popp, C.; Petitta, M.; Riffler, M.; Wunderle, S.

2009-04-01

It is well demonstrated that small aerosol particles or particulate matter (PM10 and PM2.5) affect air quality and can have severe effects on human's health. Hence, it is of great interest for public institutions to have an efficient PM monitoring network. In the last decades this data has been provided from ground-based instruments. Moreover, due to the fast development of space-borne remote sensing instruments, we can now be able to take advantage of air pollution measurements from space, which bears the potential to fill up the gap of spatial coverage from ground-based networks. This also improves the capability to assess air pollutants transport properties together with a better implementation in forecasting data assimilation procedures. In this study we examine the possibility of using data from the Spinning Enhanced Visible and Infrared Imager (SEVIRI), on-board of the geostationary Meteosat Second Generation (MSG) platform, to provide PM concentrations values over Switzerland. SEVIRI's high temporal resolution (15 minutes) could be very useful in investigating the daily behaviour of air pollutants and therefore be a good complement to measurements from polar orbiting sensors (e.g. MODIS). Switzerland is of particular interest because of its mountainous orography that hampers pollutants dispersion. Further, major transalpine connection routes, often characterised by high traffic load, act as a significant air pollution source. The south of Switzerland is also occasionally influenced by pollutants transported from the highly industrialised Po Valley in northern Italy. We investigate the existence of a linear relation between the SEVIRI retrieved AOD (Aerosol Optical Depth) and the PM concentration obtained from the ground-based air quality network NABEL (Nationales Beobachtungsnetz fuer Luftfremdstoffe). The temporal trend of this two quantities shows a significant relationship over various locations. The correlation coefficient is in some cases higher than 0.6, indicating the possibility of estimating PM concentrations from SEVIRI AOD with a reasonable uncertainty using a statistical empirical linear model. The quality of this approach is highly influenced by the seasonal variability and by the meteorological conditions. We also include meteorological data in order to investigate the observed correlation and to improve the statistical empirical model. Finally, the possible sources of errors for this approach are examined.

[Medico-economic assessment of the Pontoise Hospital stroke unit].

PubMed

Yekhlef, F; Decup, D; Niclot, P; Servan, J; Descombes, S; Richecoeur, J; Ollivier, A

2010-11-01

Annually, approximately 120,000 people in France have a stroke. Various controlled studies have pointed out the benefits of treatment in a stroke unit (SU). The objective of this study was to evaluate, from a medical point of view, the economic impact of the Pontoise Hospital SU. Based on the national cost study (NCS [étude nationale des coûts: ENC]) we analyzed data of five diagnosis related groups (DRG) which have a principle diagnosis in relation with stroke. This work was limited to strokes and transient ischemic events in adults and excluded sub-arachnoid hemorrhage. Medical and economic parameters were collected over the period from January to October 2006 and compared with those of the same period in 2005, that is to say before the opening of the SU. Three hundred and twenty-three hospital stays occurred between January 1st and October 31st, 2006 and 216 during the same time period before the opening of the SU, an increase of approximately 50% of all stroke-related admissions in our hospital. The number of stays carried out in the neurology unit increased by 29%. There was no significant difference between the two periods regarding age (median 69 versus 70 years) and sex- ratio. Average length of stay (ALS) was the same (9 days). There were no significant differences concerning the death rate (5.6% versus 6.2%) and that of discharge to home (44.6% versus 44.4%). The cost by stay in 2006 was 3534 euros [median; min 664-max 57,542] versus 3541 euros in 2005 [681-35,149] (p=0.57). Analysis by DRG highlighted an increase in the cost for serious strokes, cerebral infarctions and hemorrhages. For transitory ischemic events, the cost and the ALS decreased. After the opening of the SU, there was an increase in the activity without an increase in the total cost. This could be related in part to the limited means allocated to the stroke unit at its opening (in particular medical staff). The NCS can be used to evaluate the activity of a stroke unit. This work could be completed on a larger number of units or in several units of different size. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

TN International and ITS operational feedback regarding the decommissioning of obsolete casks dedicated to the transport and/or storage of nuclear raw materials, fuel and used fuel

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

Blachet, L.; Bimet, F.; Rennesson, N.

2008-07-01

Within the AREVA group, TN International is a major actor regarding the design of casks and transportation for the nuclear cycle. In the early 2005, TN International has started the project of decommissioning some of its own equipment and was hence the first company ever in the AREVA Group to implement this new approach. In order to do so, TN International has based this project by taking into account the AREVA Sustainable Development Charter, the French regulatory framework, the ANDRA (Agence Nationale pour la Gestion des Dechets Radioactifs - National Agency for the radioactive waste management) requirements and has deployedmore » a step by step methodology such as radiological characterization following a logical route. The aim was to define a standardized process with optimized solutions regarding the diversity of the cask's fleet. As a general matter, decommissioning of nuclear casks is a brand new field as the nuclear field is more familiar with the dismantling of nuclear facilities and/or nuclear power plant. Nevertheless existing workshops, maintenance facilities, measurements equipments and techniques have been exploited and adapted by TN International in order to turn an ambitious project into a permanent and cost-effective activity. The decommissioning of the nuclear casks implemented by TN International regarding its own needs and the French regulatory framework is formalized by several processes and is materialized for instance by the final disposal of casks as they are or in ISO container packed with cut-off casks and big bags filled with crushed internal cask equipments, etc. The first part of this paper aims to describe the history of the project that started with a specific environmental analysis which took into account the values of AREVA as regards the Sustainable Development principles that were at the time and are still a topic of current concern in the world. The second part will deal with the definition, the design and the implementation of the decommissioning processes and the applied techniques. The third part will present a two years operational feedback. The last part will introduce new processes which are currently under investigation and will put into light that decommissioning of nuclear casks is a continuous activity that is in perpetual mutation. (authors)« less

Evaluation des indicateurs d’alerte précoce de la résistance du VIH aux ARV en Côte d’Ivoire en 2011

PubMed Central

Yao, Kouadio Jean; Damey, Néto Florence; Konan, Diby Jean Paul; Aka, Joseph; Aka-Konan, Sandrine; Ani, Alex; Bonle, Marguerite Te; Kouassi, Dinard

2016-01-01

Introduction En 2001, l'Organisation des Nations Unies recommandait de rendre disponible les médicaments antirétroviraux dans les pays à ressources limitées. Cependant, l'utilisation de ces médicaments à grande échelle s'accompagne du développement de résistance du virus. En Côte d'Ivoire, plusieurs sites prescrivent les antirétroviraux. Cette étude avait pour objectif d'évaluer les facteurs programmatiques associés à un risque élevé d'émergence de résistance du VIH aux antirétroviraux. Méthodes Il s'agit d'une cohorte rétrospective sur 20 sites de prise en charge des personnes vivant avec le VIH. La population d'étude était constituée des personnes ayant initié leur traitement antirétroviral sur les sites en 2008-2009. L'estimation de la taille de l'échantillon a été faite à partir de la stratégie d'échantillonnage de l'OMS. Résultats Sur 20 sites, 98% des prescriptions initiales étaient conformes aux directives nationales et 20% des sites avaient 100% de prescriptions conformes. Au total, 33% des patients étaient perdus de vue au cours des 12 premiers mois de traitement antirétroviral et 20% des sites avaient moins de 20% de perdus de vue. A 12 mois, 51% des patients demeuraient sous traitement de première intention approprié et 11% des sites ont atteint le seuil d'au moins 70% de patients sous traitement de première intention approprié. Un seul site n'a pas connu de rupture d'antirétroviraux sur les 12 mois. Conclusion Des insuffisances relevées dans la prise en charge des personnes vivant avec le VIH traduisent l'existence d'un risque important de résistance du virus aux antirétroviraux en 2008-2009. Pour minimiser ce risque les pratiques de prescription devraient être améliorées, un système de recherche des absents aux rendez-vous devrait être mis en place et la disponibilité constante des antirétroviraux devraient être assurée. PMID:28250876

Gestion de l’anémie des patients hémodialysés chroniques: cas du Service de Néphrologie et d’hémodialyse du CHU du Point G au Mali

PubMed Central

Tounkara, Alhadji Ahmadou; Coulibaly, Abdoul Mahama Sériba; Coulibaly, Nouhoun; Traoré, Békaye; Maïga, Mahamane Kalil

2017-01-01

Introduction L'anémie est une complication fréquente de l'IRC couramment retrouvée chez les patients hémodialysés chroniques. Chez ces derniers, la prise en charge est principalement basée sur l'administration d'érythropoïétine et la supplémentation en fer. Le but de ce travail était d'évaluer la prise en charge de l'anémie des hémodialysés chroniques dans le service de Néphrologie du CHU du Point G. Méthodes Il s'agissait d'une étude transversale réalisée dans ledit service du 1er au 31 Août 2016. Résultats Au total, 63 patients sur 174 participants avaient été retenus, 34 hommes et 29 femmes avec un sex-ratio à 1,17 en faveur des hommes. L'âge moyen des patients était de 48,79 ans ± 11,59, la durée moyenne en hémodialyse était de 3,77ans ± 2,6. La fréquence hospitalière de l'anémie chez nos dialysés était de 84,12%. La transfusion sanguine était retrouvée chez 92,1%, avec une moyenne annuelle de 5,81poches ± 5,91. La supplémentation martiale était notée dans 87,3% des cas. Les moyennes respectives de ferritine et de CST étaient de 1245 ng/ml ± 629,52 et 46,16%±19,12. L'administration occasionnelle d'EPO à des doses n'excédant pas les 4000UI était rapportée par 79,4% des patients. La principale difficulté pour l'utilisation de l' EPO était le coût (74,6%). L'infection au VHC touchait 60,1% des patients ayant réalisé le dit bilan. Conclusion La gestion de l'anémie des dialysés chroniques doit être intégrée dans un cadre politique nationale de la santé. PMID:28674560

Insuffisance cervicale et cerclage cervical.

PubMed

Brown, Richard; Gagnon, Robert; Delisle, Marie-France

2016-12-01

La présente directive clinique a pour but de fournir un cadre de référence que les cliniciens pourront utiliser pour identifier les femmes qui sont exposées aux plus grands risques de connaître une insuffisance cervicale, ainsi que pour déterminer les circonstances en présence desquelles la mise en place d'un cerclage pourrait s'avérer souhaitable. RéSULTATS: La littérature publiée a été récupérée par l'intermédiaire de recherches menées dans PubMed ou MEDLINE, CINAHL et The Cochrane Library en 2012 au moyen d'un vocabulaire contrôlé (p. ex. « uterine cervical incompetence ») et de mots clés appropriés (p. ex. « cervical insufficiency », « cerclage », « Shirodkar », « cerclage », « MacDonald », « cerclage », « abdominal », « cervical length », « mid-trimester pregnancy loss »). Les résultats ont été restreints aux analyses systématiques, aux essais comparatifs randomisés / essais cliniques comparatifs et aux études observationnelles. Aucune restriction n'a été appliquée en matière de date ou de langue. Les recherches ont été mises à jour de façon régulière et intégrées à la directive clinique jusqu'en janvier 2011. La littérature grise (non publiée) a été identifiée par l'intermédiaire de recherches menées dans les sites Web d'organismes s'intéressant à l'évaluation des technologies dans le domaine de la santé et d'organismes connexes, dans des collections de directives cliniques, dans des registres d'essais cliniques et auprès de sociétés de spécialité médicale nationales et internationales. La qualité des résultats est évaluée au moyen des critères décrits dans le rapport du Groupe d'étude canadien sur les soins de santé préventifs (Tableau). RECOMMANDATIONS. Copyright © 2016. Published by Elsevier Inc.

Antiretroviral-treated HIV-1 patients can harbour resistant viruses in CSF despite an undetectable viral load in plasma.

PubMed

Soulie, Cathia; Grudé, Maxime; Descamps, Diane; Amiel, Corinne; Morand-Joubert, Laurence; Raymond, Stéphanie; Pallier, Coralie; Bellecave, Pantxika; Reigadas, Sandrine; Trabaud, Mary-Anne; Delaugerre, Constance; Montes, Brigitte; Barin, Francis; Ferré, Virginie; Jeulin, Hélène; Alloui, Chakib; Yerly, Sabine; Signori-Schmuck, Anne; Guigon, Aurélie; Fafi-Kremer, Samira; Haïm-Boukobza, Stéphanie; Mirand, Audrey; Maillard, Anne; Vallet, Sophie; Roussel, Catherine; Assoumou, Lambert; Calvez, Vincent; Flandre, Philippe; Marcelin, Anne-Geneviève

2017-08-01

HIV therapy reduces the CSF HIV RNA viral load (VL) and prevents disorders related to HIV encephalitis. However, these brain disorders may persist in some cases. A large population of antiretroviral-treated patients who had a VL > 1.7 log 10 copies/mL in CSF with detectable or undetectable VL in plasma associated with cognitive impairment was studied, in order to characterize discriminatory factors of these two patient populations. Blood and CSF samples were collected at the time of neurological disorders for 227 patients in 22 centres in France and 1 centre in Switzerland. Genotypic HIV resistance tests were performed on CSF. The genotypic susceptibility score was calculated according to the last Agence Nationale de Recherche sur le Sida et les hépatites virales Action Coordonnée 11 (ANRS AC11) genotype interpretation algorithm. Among the 227 studied patients with VL > 1.7 log 10 copies/mL in CSF, 195 had VL detectable in plasma [median (IQR) HIV RNA was 3.7 (2.7-4.7) log 10 copies/mL] and 32 had discordant VL in plasma (VL < 1.7 log 10 copies/mL). The CSF VL was lower (median 2.8 versus 4.0 log 10 copies/mL; P  <   0.001) and the CD4 cell count was higher (median 476 versus 214 cells/mm 3 ; P  <   0.001) in the group of patients with VL < 1.7 log 10 copies/mL in plasma compared with patients with plasma VL > 1.7 log 10 copies/mL. Resistance to antiretrovirals was observed in CSF for the two groups of patients. Fourteen percent of this population of patients with cognitive impairment and detectable VL in CSF had well controlled VL in plasma. Thus, it is important to explore CSF HIV (VL and genotype) even if the HIV VL is controlled in plasma because HIV resistance may be observed. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Préface

NASA Astrophysics Data System (ADS)

Paulus, Werner; Meinnel, Jean

2003-02-01

En 1994, l'attribution du prix Nobel à Cliff Shull et Bert Brockhouse pour leurs travaux de pionniers pendant les années 50, concernant tant la diffusion élastique des neutrons que la diffusion inélastique, a été la reconnaissance éclatante de l'importance de la diffusion neutronique pour toute la communauté scientifique.Le grand intérêt du neutron pour la recherche s'appuie principalement sur ses propriétés physiques particulières :- les neutrons utilisés pour la caractérisation de la matière (et fournis en relativement grandes quantités par les réacteurs ou les sources à spallation) disposent de longueurs d'onde et d'énergies correspondant directement aux distances interatomiques et aux énergies d'agitation de la matière. Ainsi, par diffusion neutronique, on peut étudier en même temps la structure et le comportement dynamique de la matière ;- le fait que le neutron soit doué d'un moment magnétique lui permet d'interagir avec tout atome porteur d'un moment magnétique. Ceci permet de caractériser intimement le comportement magnétique de la matière à l'échelle microscopique ;- la possibilité de pouvoir varier facilement le contraste d'un même élément en utilisant ses différents isotopes fait du neutron un outil irremplaçable en chimie et physique du solide ainsi qu'en biologie et matière molle ;- enfin, n'ayant pas de charge électrique, les neutrons peuvent pénétrer la matière sans être absorbés significativement, ce qui rend possible une caractérisation non destructive des contraintes et textures sur de grosses pièces des matériaux.Toutes les qualités des neutrons mentionnées ci-dessus permettent de comprendre l'importance de la diffusion neutronique pour des domaines très nombreux et très différents à la fois en recherche fondamentale mais aussi pour des applications industrielles. L'utilisation de l'outil-neutron demande toutefois non seulement une bonne connaissance des différents mécanismes d'interaction entre le neutron et la matière, mais également une haute spécificité dans la conception et l'utilisation des diffractomètres et spectromètres neutroniques. Pour ces raisons, l'accès aux neutrons est souvent limité, sinon réservé à des spécialistes, ce qui freine tout naturellement l'utilisation par des chercheurs non familiarisés à ce domaine.Pour combattre ce déficit d'information et cet état de fait, en accord avec de nombreux collègues Rennais, nous avons proposé à la Société Française de Neutronique d'organiser une École d'été qui s'adresse plus spécialement à de non-spécialistes de la diffusion neutronique. Le public visé concernait donc à la fois les chercheurs confirmés mais peu familiarisés avec le domaine neutronique, mais aussi les jeunes chercheurs dès le niveau doctorant. En effet pour ces derniers, l'utilisation des “grands instruments" s'avère nécessaire pour qu'ils soient à la hauteur de leur sujet de thèse. Pour cette raison, il était évident d'intégrer cette École d'été dans le programme de l'École Doctorale “Sciences des Matériaux" de l'Université de Rennes 1 qui rassemble chimistes, physiciens et géologues. Dans le même contexte, notre intérêt était de proposer un large spectre de cours couvrant la diversité des applications de la diffusion neutronique dans les différents domaines de recherche en chimie et physique des matériaux, en sciences de la terre ainsi qu'en sciences pour l'ingénieur. Un deuxième but était de montrer de plus la complémentarité des neutrons et des rayons X et plus spécifiquement des X produits par rayonnement synchrotron.Dans l'avenir, nous sommes persuadés que la diffusion neutronique va jouer un rôle clé pour le développement de nouveaux matériaux et de leur caractérisation. Dans cette optique, des efforts considérables ont été déjà engagés aux États-Unis ainsi qu'au Japon où deux nouvelles sources de neutrons sont en cours de construction. Du point de vue européen, si les sources de l'ILL et d'ISIS peuvent encore être considérées comme des leaders au point de vue mondial, il est évidemment souhaitable que la nouvelle source neutronique à spallation (European Spallation Source : ESS) soit rapidement réalisée. Aujourd'hui ce projet est bien avancé, cette source devrait dépasser le flux des sources actuelles par près de deux ordres de grandeur et ainsi de maintenir au meilleur niveau les compétences Européennes. Il est évident qu'une utilisation efficace et intelligente des sources existantes, mais aussi de celles de la nouvelle génération, implique une certaine infrastructure nationale tant au niveau de la conception, de la réalisation que du fonctionnement des différents spectromètres. Ceci implique un très fort engagement des universités dans les différents projets de recherche. Le devoir des universités qui en résulte est donc d'intégrer l'utilisation des “grands instruments" dans leur programme d'enseignement. Dans ce sens, nous souhaitons que ce cours, entièrement rédigé en français, contribue à la fois à aider les chercheurs “non spécialistes” à accéder plus facilement au domaine neutronique, mais aussi à servir de base aux enseignants pour l'organisation et la préparation de leurs cours.Nous tenons à remercier tous les collègues qui ont accepté de rédiger de façon détaillée les cours qu'ils avaient présentés oralement dans la grande salle du VVF de Trégastel, ainsi que toutes les personnes qui ont contribué à la réussite du séjour ou à la réalisation de ce fascicule. Nous gardons un excellent souvenir de l'atmosphère de l'École qui a eu lieu à Trégastel, en plein centre de la côte de granite rose en Bretagne, en mai 2001 et était jumelée avec les Journées de la diffusion neutronique, elles aussi organisées sous l'égide de la SFN.Nous souhaitons que la lecture de cet ouvrage soit utile à un maximum de chercheurs.

Evénements indésirables peropératoire: lecture critique du registre du bloc opératoire de l’hôpital militaire Moulay Ismail Meknès

PubMed Central

Kechna, Hicham; Ouzzad, Omar; Chkoura, Khalid; Loutid, Jaouad; Hachimi, Moulay Ahmed; Hanafi, Sidi Mohamed

2016-01-01

Introduction Malgré les importants progrès qui ont été faits dans le domaine de la sécurité en anesthésie, la morbidité (grave ou non, liée complètement ou partiellement à l’anesthésie) reste cependant fréquente, et aucun praticien n’est aujourd’hui à l’abri d’un accident. Dans le contexte actuel où la priorité est donnée à la formation, à l’amélioration de la qualité et de la sécurité des soins, la survenue d’un accident d’anesthésie au bloc opératoire est un événement extrêmement traumatisant. La crainte de poursuite, le contexte émotionnel rendent cette gestion parfois très difficile. Pour cette raison, elle doit faire l’objet d’une codification, à la manière des protocoles de bloc, avec trois grands axes de gestion: le patient victime, le personnel médical et paramédical impliqué et l’analyse de l’incident pour éviter une récidive. Méthodes Dans un but d’améliorer les soins prodigués au bloc opératoire nous avons établi un registre où sont consignés continuellement les différents incidents et accidents survenu soit en salle opératoire ou en salle de surveillance post interventionnelle. Une première lecture a été faite à l’occasion des Journées d'Enseignement Post Universitaire (JEPU) de Fès (Maroc) organisées en partenariat avec les JEPU de la Pitié salpêtrière de Paris à la faculté de Médecine et de Pharmacie de Fès sous le thème: «Les Situations Critiques Au Bloc Opératoire» les 17 et 18 Avril 2015. Résultats 1761 patients ont été admis aux différentes salles du bloc opératoire dont 96 en salle d’endoscopie et 17 sédations en radiologie. 29 patients (1.64%) ont présentés un incident et/ou un accident en péri opératoire. La plupart des effets indésirables sont survenus en per opératoire (58,6%). Dans 28,6% des cas en postopératoire immédiat ou en salle de surveillance post interventionnelle (SSPI). La plupart des complications survenues sont d’ordre respiratoire (34%) ou cardio vasculaire (31%). On a colligé 5 décès en périopératoire soit une mortalité de 0,28%. La détermination de la cause n’est pas toujours évidente. Le facteur humain serait responsable de 24% des incidents. Conclusion Cette observation illustre les différents événements indésirables survenus depuis la création de ce registre il y a 6 mois. Nous proposons une lecture critique de ce registre dans le seul souci est d’améliorer nos pratiques dans une perspective de renforcer la sécurité anesthésique. PMID:27795775

Subsolidus and melting phase relations in the system CaCO3-MgCO3-FeCO3 at 35 kbar: from experiments to predictions based on a thermodynamic model

NASA Astrophysics Data System (ADS)

Franzolin, E.; Schmidt, M. W.; Poli, S.

2009-12-01

At convergent margins volatile components, most notably CO2 and H2O, stored in oceanic sediments and MORB are recycled into the mantle. Mafic protoliths become enriched in CO2 and H2O, stored in carbonates and hydrous phases, by hydrothermal alteration. As carbonates are more refractory than hydrous phases, CO2 is more likely to survive in the oceanic lithosphere beyond sub-arc depths [1,2]. Despite the main role of carbonates on cycling crustal and atmospheric CO2 into the mantle, experimental data within the system CaCO3-MgCO3-FeCO3 are scarce. To bridge this gap, piston-cylinder experiments have been performed at 35 kbar, 900-1100 °C to determine subsolidus relations, and up to 1300 °C to constrain melting relations. Pure synthetic calcite, natural magnesite and synthetic siderite have been mixed in different proportions in double Pt-C capsules, to avoid major siderite oxidation. Subsolidus experiments reveal the presence of two miscibility gaps at 900 °C: the solvus dolomite-calcite, which closes at XMgCO3 ~ 0.7, and the solvus dolomite-magnesite, which ranges to the Fe-side of the ternary. Increasing the temperature, the two miscibility gaps became narrower until complete solid solutions between CaCO3-Ca0.5Mg0.5CO3 at 1100 °C, and between CaCO3-FeCO3 at 1000 °C, are observed. The system is characterized by strong compositional asymmetry, thermodynamically described with a van Laar macroscopic formalism [3], and by R-3<=>R-3c phase transitions due to cation disordering, treated by redefining the compositional space with an independent set of end-members that describe both composition and states of ordering. The result is a solid solution model able to reproduce both the phase relations experimentally observed at 35 kbar and those experimentally determined and naturally observed at lower pressure [4-5]. Our model can be reliable extended to pressures of the breakdown of dolomite, e.g. 5-6 GPa, 600-1000 °C. Melting experiments carried out at 1250 °C along the join CaCO3-MgCO3, yield an eutectic at a slightly lower temperature at XCa ~ 0.7; the eutectic temperature decreases with the Fe content in the bulk. The 2-phase field calcite (XCa~0.75) + liquid, broadens with the increase of XFe in the system. Along the join CaMg(CO3)2-CaFe(CO3)2, melting takes place at XFe ~ 0.2, producing Ca enriched melt + Mg enriched dolomite. The new subsolidus and melting data and the ternary thermodynamic solid solution model, have been combined to predict the fate of FeO and CO2 rich systems (i.e. BIF associated with Fe-shale, high-Fe altered basalts and Fe-enriched carbonated metapelites), recycled back into the mantle during the history of the Earth. [1] Kerrick&Connolly, EPSL, 2001, 189, 19-29. [2] Poli et al., EPSL, 2009, 278, 350-360. [3] Holland&Powell, Contr. Min. Pet., 2003, 145, 492-501. [4] Goldsmith et al., Journ. of Geol., 1962, 70, 659-688. [5] Rosenberg, Am. Min., 1967, 52, 787-796.

Fixedwing UAV soundings of the boundary layer during the ScaleX 2015 summer campaign in southern Germany

NASA Astrophysics Data System (ADS)

Philipp, Andreas; Groos, Alexander; Petersen, Erik; Bischoff, Julian; Szogs, Sebastian; Beck, Christoph; Hähner, Jörg; Jacobeit, Jucundus

2016-04-01

In order to examine the potential to close the local water cycle budget and to evaluate models on different scales (among other aims) a fleet of 6 fixed wing UAVs has been operated by the Institute for Geography and the Institute for Informatics of the University of Augsburg during the ScaleX measurement campaign of the KIT/IMK-IFU (Karlsruher Institut für Technologie/Institut für Meteorologie und Klimatologie, Garmisch Partenkirchen). The site is located in southern Germany in a rural, hilly landscape at a small catchment tributing to the Ammersee and equipped with several ground based and remote sensing hydrological instruments. In order to complement these instruments by in situ measurements of the boundary layer, three intensive observation periods (IOPs) for taking temperature and humidity profiles took place, each with a different set up in order to evaluate optimal operation modes. The UAVs are all operated by the open hardware Apogee autopilot and sensor controller developed by ENAC (Ecole Nationale de l'Aviation Civile, Toulouse) operated by the PPRZ open source software package. The first IOP (30.06.-01.07.2015) was an experiment to cover a small site of 500 by 500 meters (well-apointed with hydrological instruments) in a 24 hours period as dense as possible. Thus three simultaneous helical profile flights (radius 70 m) have been run at each full hour around three different centres with heights ranging up to 1000 m above ground level (with special permissions). During a second IOP (15.07.2015) it has been tried to increase the frequence of profile flights up to 2 flights per hours between 7:30 and 14:00 CEST. These soundings have been accompanied by flyovers of a manned ultra light aircraft of the IMK-IFU. Finally a third experiment (06.08.2015) tried to evaluate longer flights (up to 55 minutes) of two UAVs at constant levels of 300 and 500 m above ground level between 6:00 and 14:00 CEST in order to cover the early diurnal cycle even more constantly by the in situ measurements. A midnight profile for measuring the staring conditions of the development has been measured up to a hight of 1600 m, which was the permitted limit for this campaign. Data analysis using a newly developed 3D software showed that these flight experiments are able to reveal several distinct meteorological processes developing during the diurnal cycle which are shortly discussed on the poster.

Telemedicine: what framework, what levels of proof, implementation rules.

PubMed

Zannad, Faiez; Maugendre, Philippe; Audry, Antoine; Avril, Carole; Blaise, Lucile; Blin, Olivier; Burnel, Philippe; Falise-Mirat, Béatrice; Girault, Danièle; Giri, Isabelle; Goehrs, Jean-Marie; Lassale, Catherine; Le Meur, Roland; Leurent, Pierre; Ratignier-Carbonneil, Christelle; Rossignol, Patrick; Satonnet, Evelyne; Simon, Pierre; Treluyer, Laurent

2014-01-01

The concept of telemedicine was formalised in France in the 2009 "Hospital, patients, health territories" (loi hôpital, patients, santé, territoire) law and the 2010 decree through which it was applied. Many experiments have been carried out and the regulatory institutions (Ministry, Regional Health Agency [Agence régionale de santé, ARS], French National Health Authority [Haute autorité de santé, HAS], etc.) have issued various guidance statements and recommendations on its organisation and on the expectations of its evaluation. With this background, the round table wanted to produce recommendations on different areas of medical telemonitoring (the role of telemonitoring, the regulatory system, the principles for assessment, methods of use and conditions for sustained and seamless deployment). Whilst many studies carried out on new medical telemonitoring approaches have led to the postulate that it offers benefit, both clinically and in terms of patient quality of life, more information is needed to demonstrate its impact on the organisation of healthcare and the associated medico-economic benefit (criteria, methods, resources). Similarly, contractual frameworks for deployment of telemonitoring do exist, although they are complicated and involve many different stakeholders (Director General fo the Care Offering [Direction générale de l'offre de soins, DGOS], ARS, HAS, Agency for Shared Health Information Systems [Agence des systèmes d'information partagés de santé, ASIP], French National Data Protection Commission [Commission nationale informatique et libertés, CNIL], French National Medical Council [Conseil national de l'Ordre des médecins, CNOM], etc.) that would benefit from a shared approach and seamless exchange between the partners involved. The current challenge is also to define the conditions required to validate a stable economic model in order to promote organisational change. One topical issue is placing the emphasis on its evaluation and operation. Access to patient data, particularly data from the health insurance funds and the use of these data, may enable the process to be more effective. In addition, the budgetary non-fungibility of the various financial envelopes for the different areas of work, restricts the consolidation of financial impact. Funding methods will need to be adapted to this new distribution of roles, both at the centre of the healthcare system and in the industrial ecosystem. All of these changes will help the leaders of our healthcare system to bring this new ambition closer to all of the people working in the health economy. © 2014 Société Française de Pharmacologie et de Thérapeutique.

Characterization of Heat Waves in the Sahel and associated mechanisms

NASA Astrophysics Data System (ADS)

Oueslati, Boutheina; Pohl, Benjamin; Moron, Vincent; Rome, Sandra

2016-04-01

Large efforts are made to investigate the heat waves (HW) in developed countries because of their devastating impacts on society, economy and environment. This interest increased after the intense event over Europe during summer 2003. However, HWs are still understudied over developing countries. This is particularly true in West Africa, and especially in the Sahel, where temperatures recurrently reach critical values, such as during the 2010 HW event. Understanding the Sahelian HWs and associated health risks constitute the main objective of ACASIS, a 4-year project funded by the French Agence Nationale de la Recherche. Our work contributes to this project and aims at characterizing the Sahelian HWs and understanding the mechanisms associated with such extreme events. There is no universal definition of a HW event, since it is highly dependent on the sector (human health, agriculture, transport...) and region of interest. In our case, a HW is defined when the heat index of the day and of the night exceeds the 90th percentile for at least 3 consecutive days (Rome et al. 2016, in preparation). This index combines temperature and relative humidity in order to determine the human-perceived equivalent temperature (definition adapted from Steadman, 1979). Intrinsic properties of Sahelian HW are analyzed from the Global Summary of the Day (GSOD) synoptic observations and ERA-interim reanalyses over 1979-2014 during boreal spring seasons (April-May-June), the warmest period of the year in the Central Sahel. ERA-interim captures well the observed interannual variability and seasonal cycle at the regional scale, as well as the 1979-2014 increasing linear trend of springtime HW occurrences in the Sahel. Reanalyses, however, overestimate the duration, spatial extent of HW, and underestimate their intensity. For both GSOD and ERA-interim, we show that, over the last three decades, Sahelian HWs tend to become more frequent, last longer, cover larger areas and reach higher intensities. The physical mechanisms associated with HWs are examined to assess the respective roles of atmospheric dynamics, radiative and turbulent fluxes, in the establishment of such events, by analyzing the atmospheric moist static energy budget. The results suggest that the greenhouse effect of water vapor is the main driver of HWs in the Sahel, increasing minimum temperatures by the long-wave radiation radiated back to the surface. Maximum temperature anomalies are explained by increased downward shortwave radiation due to a reduction in cloud albedo. Atmospheric circulation plays an important role in sustaining these warm anomalies by advecting dry static energy from the Sahara and both dry and moist static energy from the Atlantic Ocean into the Sahel.

Tectonic evolution of the Northern Pyrenees. Results of the PYRAMID project

NASA Astrophysics Data System (ADS)

Ford, Mary; Mouthereau, Fredéric; Christophoul, Fredéric; de Saint Blanquat, Michel; Espurt, Nicolas; Labaume, Pierre; Vergés, Jaume; Teixell, Antonio; Bellahsen, Nicolas; Vacharat, Arnaud; Pik, Raphael; Pironon, Jacques; Carpentier, Cédric; Angrand, Paul; Grool, Arjan; Salardon, Roland; Huismans, Ritske; Bader, Anne-Gaëlle; Baudin, Thierry; Aubourg, Charles

2017-04-01

The aims of the PYRAMID project funded by the Agence Nationale de la Recherche of France, were to investigate and constrain the 3D structural style and architecture of the North Pyrenean retrowedge and foreland basin, their evolution through time, to define the character and role of inherited crustal geometries, to investigate the interactions between deformation, fluids and thermicity in the different structural units, and to carry out source to sink studies In this talk we present a series of restored cross sections through the central and eastern Pyrenean retrowedge to illustrate structural style, amount and type of deformation and how it was accommodated within the upper crust along the orogen. The total amount of convergence appears to have been constant and the timing of onset of convergence was synchronous. However, in the retrowedge the complexity of the Cretaceous oblique rift system has led to high lateral structural variability. Inherited vertical late Variscan faults trending NE-SW to ENE-WSW segment the European crust and have strongly compartmentalised both retrowedge and foreland basin evolution along the orogen. Crustal scale restorations provide new evolutionary models for the geometry and style of inversion of the pre-orogenic hyper-extended rift system where mantle was exhumed in the most distal domain. Numerical models provide insight into retrowedge inversion. A new stratigraphic scheme has been developed for the eastern and central foreland. Subsidence analyses and foreland basin reconstructions document two pulses of convergence (Late Santonian to Early Paleocene and Eocene to Oligocene) separated by a quiet phase during the Paleocene. These phases can be linked to deformation in the North Pyrenean Zone thrust belt. The first phase was caused mainly by inversion and emplacement of the Metamorphic Internal Zone onto external zones associated with subduction of the exhumed mantle domain. Little or no relief was created during this phase although thermochronological data records the beginning of inversion in the eastern retrowedge. Full collision began in Early Eocene, distributed between the pro- and retro wedges, with only about 30% of convergence accommodated in the retrowedge. Low temperature thermochronology data records southward migrating exhumation of the axial zone while external basement massifs were being exhumed in the North Pyrenean Zone. The Cretaceous rift system was inverted by a combined thin-skinned-thick-skinned style with a decoupling level in the Keuper evaporites. The North Pyrenean Frontal thrust consists of a series of inverted Cretaceous rift margin faults, which in the east represent the main breakaway fault system.

Phenotype, genotype, and worldwide genetic penetrance of LRRK2-associated Parkinson's disease: a case-control study

PubMed Central

Healy, Daniel G; Falchi, Mario; O'Sullivan, Sean S; Bonifati, Vincenzo; Durr, Alexandra; Bressman, Susan; Brice, Alexis; Aasly, Jan; Zabetian, Cyrus P; Goldwurm, Stefano; Ferreira, Joaquim J; Tolosa, Eduardo; Kay, Denise M; Klein, Christine; Williams, David R; Marras, Connie; Lang, Anthony E; Wszolek, Zbigniew K; Berciano, Jose; Schapira, Anthony HV; Lynch, Timothy; Bhatia, Kailash P; Gasser, Thomas; Lees, Andrew J; Wood, Nicholas W

2008-01-01

Summary Background Mutations in LRRK2, the gene that encodes leucine-rich repeat kinase 2, are a cause of Parkinson's disease (PD). The International LRRK2 Consortium was established to answer three key clinical questions: can LRRK2-associated PD be distinguished from idiopathic PD; which mutations in LRRK2 are pathogenic; and what is the age-specific cumulative risk of PD for individuals who inherit or are at risk of inheriting a deleterious mutation in LRRK2? Methods Researchers from 21 centres across the world collaborated on this study. The frequency of the common LRRK2 Gly2019Ser mutation was estimated on the basis of data from 24 populations worldwide, and the penetrance of the mutation was defined in 1045 people with mutations in LRRK2 from 133 families. The LRRK2 phenotype was defined on the basis of 59 motor and non-motor symptoms in 356 patients with LRRK2-associated PD and compared with the symptoms of 543 patients with pathologically proven idiopathic PD. Findings Six mutations met the consortium's criteria for being proven pathogenic. The frequency of the common LRRK2 Gly2019Ser mutation was 1% of patients with sporadic PD and 4% of patients with hereditary PD; the frequency was highest in the middle east and higher in southern Europe than in northern Europe. The risk of PD for a person who inherits the LRRK2 Gly2019Ser mutation was 28% at age 59 years, 51% at 69 years, and 74% at 79 years. The motor symptoms (eg, disease severity, rate of progression, occurrence of falls, and dyskinesia) and non-motor symptoms (eg, cognition and olfaction) of LRRK2-associated PD were more benign than those of idiopathic PD. Interpretation Mutations in LRRK2 are a clinically relevant cause of PD that merit testing in patients with hereditary PD and in subgroups of patients with PD. However, this knowledge should be applied with caution in the diagnosis and counselling of patients. Funding UK Medical Research Council; UK Parkinson's Disease Society; UK Brain Research Trust; Internationaal Parkinson Fonds; Volkswagen Foundation; National Institutes of Health: National Institute of Neurological Disorders and Stroke and National Institute of Aging; Udall Parkinson's Disease Centre of Excellence; Pacific Alzheimer Research Foundation Centre; Italian Telethon Foundation; Fondazione Grigioni per il Morbo di Parkinson; Michael J Fox Foundation for Parkinson's Research; Safra Global Genetics Consortium; US Department of Veterans Affairs; French Agence Nationale de la Recherche. PMID:18539534

Compliance with French nutrition and health program recommendations is strongly associated with socioeconomic characteristics in the general adult population.

PubMed

Malon, Aurélie; Deschamps, Valérie; Salanave, Benoit; Vernay, Michel; Szego, Emmanuelle; Estaquio, Carla; Kesse-Guyot, Emmanuelle; Hercberg, Serge; Castetbon, Katia

2010-06-01

In many countries, nutrition policies such as the Programme National Nutrition Santé (PNNS), implemented in France since 2001, have been developed to prevent and reduce the risk of chronic disease. However, the way in which such programs might benefit persons having different socioeconomic characteristics is unknown. The French nutrition and health survey (Etude Nationale Nutrition Santé [ENNS]) represented an opportunity to address this issue. To describe compliance with PNNS recommendations in the general population and to investigate the relationship between social, economic, and educational characteristics and poor compliance with French nutrition recommendations. A national cross-sectional multistage sampling survey. Food intake was estimated through three 24-hour recalls. Adherence to French nutrition recommendations was estimated using the PNNS guideline score (15 possible points). Two thousand five hundred seventy-seven adults aged 18 to 74 years living in France in 2006-2007 were included in these analyses. All analyses were carried out in men and women separately. Sex-specific quartiles of score were estimated. Multiple logistic models were used to identify socioeconomic characteristics (ie, age, marital status, occupational status, education level, and holiday trip in the past 12 months) associated with poor compliance with recommendations (first PNNS guideline score quartile vs three other quartiles), estimating odds ratios (ORs), and their 95% confidence intervals (CIs). The mean PNNS guideline score was 7.67+/-0.17 in men and 8.55+/-0.12 in women. In both sex groups, a difference of approximately four attained recommendations (out of 13 maximum) was observed between the lowest and highest quartiles. In multivariate models, being in the first PNNS guideline score quartile was significantly associated with lower age and lower occupational status for both sexes. Moreover, women living without a partner were at higher risk of poor compliance with recommendations (adjusted OR 1.43; 95% CI 1.01 to 2.04, vs women living with a partner), as were men not having taken a holiday trip during the past 12 months (adjusted OR 1.78, 95% CI 1.05 to 3.02, vs at least one holiday trip). Compliance with nutrition recommendations can be improved despite several years of public health interventions carried out by the PNNS. Identification of characteristics associated with poor compliance should help to target future public health measures. 2010 American Dietetic Association. Published by Elsevier Inc. All rights reserved.

Lamivudine-zidovudine combination for prevention of maternal-infant transmission of HIV-1.

PubMed

Mandelbrot, L; Landreau-Mascaro, A; Rekacewicz, C; Berrebi, A; Bénifla, J L; Burgard, M; Lachassine, E; Barret, B; Chaix, M L; Bongain, A; Ciraru-Vigneron, N; Crenn-Hébert, C; Delfraissy, J F; Rouzioux, C; Mayaux, M J; Blanche, S

2001-04-25

Zidovudine reduces maternal-infant transmission of human immunodeficiency virus 1 (HIV-1) infection by two thirds. Combination antiretroviral therapies are potentially more effective prevention. To assess the safety of perinatal lamivudine-zidovudine therapy, especially in children, and its effects on viral load, acquisition of drug resistance, and maternal-infant transmission of HIV-1 in a nonbreastfeeding population. The Agence Nationale de Recherches sur le SIDA (ANRS) 075 Study, an open-label, nonrandomized intervention trial conducted in the context of an ongoing observational cohort study in 48 sites in France. A total of 445 HIV-1-infected pregnant women were enrolled as the study cohort from February 1997 to September 1998; controls consisted of 899 pregnant women who had received zidovudine monotherapy in May 1994 to February 1997 as standard care. The study cohort received lamivudine in addition to the standard Pediatric AIDS Clinical Trial Group 076 Study zidovudine prophylaxis regimen. Lamivudine was initiated in women at 32 weeks' gestation through delivery at 150 mg twice per day orally; children received lamivudine, 2 mg/kg twice per day for 6 weeks. HIV-1 infection status and tolerance of therapy in children through age 18 months; maternal plasma HIV-1 RNA levels through 6 weeks after delivery. The transmission rate in the study group was 1.6% (7/437; 95% confidence interval [CI], 0.7%-3.3%). In a multivariable analysis, transmission in the study group was 5-fold lower than in controls. In the study group, maternal plasma HIV-1 RNA level was less than 500 copies/mL at delivery in 74%; the median decrease was 1.24 (range, -1.63 to 3.40) log(10) copies/mL. The M184V lamivudine resistance mutation was detected at 6 weeks after delivery in specimens from 52 of 132 women. The most frequent serious adverse events in children were neutropenia and anemia, requiring blood transfusion in 9 children and premature treatment discontinuation in 19. Two uninfected children died at age 1 year from neurologic complications related to mitochondrial dysfunction. Lamivudine-zidovudine may be effective in preventing maternal-infant HIV transmission. However, severe adverse effects and emergence of resistance to lamivudine occurred. Thus, the role of this combination therapy in this setting is as yet unclear, and further research involving a variety of strategies is needed to definitively ascertain its utility for preventing maternal-infant HIV transmission.

Serum levels of organochlorine pesticides in the French adult population: the French National Nutrition and Health Study (ENNS), 2006-2007.

PubMed

Saoudi, Abdessattar; Fréry, Nadine; Zeghnoun, Abdelkrim; Bidondo, Marie-Laure; Deschamps, Valérie; Göen, Thomas; Garnier, Robert; Guldner, Laurence

2014-02-15

Although most organochlorine (OC) pesticides were banned in France in the 1970s and 1980s, they remain a source of public concern. Because of their high persistence in the environment, they are still detected in foodstuffs, leading to continued human exposure. The purpose of this study was to assess the distribution of serum organochlorine (OC) pesticides in the French adult population and to identify the main risk factors for p,p'-dichlorodiphenyl dichlorethylene (DDE), β-hexachlorocyclohexane (β-HCH) and hexachlorobenzene (HCB). The selected OC pesticides (HCB, DDE, DDT, α-HCH, β-HCB and γ-HCH) were measured in serum samples collected in 2006-2007 from 386 persons (aged 18-74 years) randomly selected among the participants in the clinical and biological component of the French Nutrition and Health Survey (Etude Nationale Nutrition Santé [ENNS]), a cross-sectional survey carried out in the general population. Collected data included biological samples, socio-demographic characteristics, and data about environmental and occupational exposure factors. Of the six OC pesticides investigated, the highest concentrations were observed for HCB, β-HCH and DDE. Median serum concentrations were as follows: 22.8 ng/g lipid for HCB, 0.74 and 27.0 ng/g lipid, respectively, for α- and ß-HCH, and 3.8 and 104.6 ng/g lipid, respectively, for DDT and DDE. Lindane (γ-HCH) was detected in approximately 10% of the sample. OC pesticide levels in serum in French adults were higher (except for DDT and DDE) than those observed in American, Canadian and German populations and generally lower than or in the same range as those observed in other European countries. The low serum DDT/DDE ratio in the present study (3.7%) would suggest that the concentrations observed for these two OC pesticides were mainly the result of past exposure. The most important predictors of serum DDE, HCB and β-HCH concentrations among the French adult population included individual factors (age, gender, BMI, etc.), dietary factors of animal and vegetable origin, and domestic use of pesticides (in vegetable gardens and/or fruit trees). For the first time in France, a human biomonitoring study has shown that exposure to OC pesticides remains common in the population. French concentrations were higher (except for DDT and DDE) or were similar to those observed in other developed countries. Copyright © 2013 Elsevier B.V. All rights reserved.