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The radial forearm free flap (RFFF) is widely used for oral reconstruction. The superficial circumflex iliac artery perforator (SCIP) flap is an increasingly utilized alternative. The cases of 165 patients who received either an RFFF or SCIP flap for oral reconstruction at Chris O'Brien Lifehouse, Sydney were reviewed. The aim was to report on patient, pathology, treatment, and outcome variables and to compare these between the two flap groups. A RFFF was used in 126 patients and a SCIP flap in 39 patients. SCIP flap patients were younger (P 0.001) and had shorter operative times (P 0.001), shorter anaesthetic times (P 0.001), and more frequent recipient site dehiscence (P = 0.005) when compared to RFFF patients. The SCIP flap was significantly less frequently used for composite resections including bone when compared to the RFFF (P 0.001). The primary site distribution was more even for RFFF patients (P 0.001). There were no SCIP flap failures; three RFFF failures occurred. SCIP flaps performed comparably in terms of operative and clinical outcomes. Most SCIP flaps were utilized in younger patients with partial glossectomy defects.

Background Although autism spectrum disorders (ASD) have been associated with developmental outcomes and parenting stress, it is not known how all variables interact with each other. We estimated prospective associations between ASD screening scores at 24 months and socio-emotional-cognitive development at 36 months while considering parenting stress as a potential moderator of the outcome. Methods Using the Conditions Affecting Neurocognitive Development and Learning in Early Childhood data, ASD-risk behaviors at 24 months and child maturity levels in social, emotional, and cognitive domains at 36 months were reported (N = 1100). Results The number of ASD-type behaviors at 24 months was significantly associated with the socio-emotional-cognitive risk index at 36 months (B = .31, p Conclusions ASD screening scores and parenting stress interact together to have an effect on later child developmental competence. This study suggests that interventions towards early ASD symptoms and parenting stress could enhance subsequent child developmental competence, which is a strong building block for early school readiness and personal success.

This paper presents analytical solutions to heat transfer problems around a crack and derive an adaptive model for effective thermal conductivity of cracked materials based on singular integral equation approach. Potential solution of heat diffusion through two-dimensional cracked media, where crack filled by air behaves as insulator to heat flow, is obtained in a singular integral equation form. It is demonstrated that the temperature field can be described as a function of temperature and rate of heat flow on the boundary and the temperature jump across the cracks. Numerical resolution of this boundary integral equation allows determining heat conduction and effective thermal conductivity of cracked media. Moreover, writing this boundary integral equation for an infinite medium embedding a single crack under a far-field condition allows deriving the closed-form solution of temperature discontinuity on the crack and particularly the closed-form solution of temperature field around the crack. These formulas are then used to establish analytical effective medium estimates. Finally, the comparison between the developed numerical and analytical solutions allows developing an adaptive model for effective thermal conductivity of cracked media. This model takes into account both the interaction between cracks and the percolation threshold.

Radiological release incidents can potentially contaminate widespread areas with radioactive materials and de-contamination efforts are typically focused on populated areas, which means radionuclides may be left in forested areas for long periods of time. Large wildfires in contaminated forested areas have the potential to reintroduce these radionuclides into the atmosphere and cause exposure to first responders and downwind communities. One important radionuclide contaminant released from radiological incidents is radiocesium ((137)Cs) due to high yields and its long half-life of 30.2 years. An Eulerian 3D photochemical transport model was used to estimate potential ambient impacts of (137)Cs re-emission due to wildfire following hypothetical radiological release scenarios. The Community Multiscale Air Quality (CMAQ) model did well at predicting levels and periods of increased PM2.5 carbon due to wildfire smoke at routine surface monitors in California during the summer of 2016. The model also did well at capturing the extent of the surface mixing layer compared to aerosol lidar measurements. Emissions from a large hypothetical wildfire were introduced into the wildland-urban interface (WUI) impacted by a hypothetical radiological release event. While ambient concentrations tended to be highest near the fire, the highest population committed effective dose equivalent by inhalation to an adult from (137)Cs over an hour was downwind where wind flows moved smoke to high population areas. Seasonal variations in meteorology (wind flows) can result in differential population impacts even in the same metropolitan area. Modeled post-incident ambient levels of (137)Cs both near these wildfires and further downwind in nearby urban areas were well below levels that would necessitate population evacuation or warrant other protective action recommendations such as shelter-in-place. These results suggest that 1) the modeling system captures local to regional scale transport and levels of PM2.5 from wildfire and 2) first responders and downwind population would not be expected to be at elevated risk from the initial inhalathion exposure of (137)Cs re-emission.

In this paper, a data-driven controller is synthesised for systems with negative imaginary (NI) properties such as the piezoelectric tube scanner (PTS) of an atomic force microscopy (AFM). The scanning speed of an AFM is limited by the dynamic behaviours of its scanning unit. The controller aims to damp vibrations, increase the closed-loop bandwidth and track reference signals with high accuracy. The measured frequency response of the PTS is used to calculate the controller frequency response at each frequency by minimising a cost function. The data-driven control optimisation problem is constrained by NI properties to guarantee that the controller is stable and identifiable. The designed controller is implemented on the AFM using a dSPACE ds1103 real-time prototyping system. Experimental results show that the controller is able to significantly damp the resonances in the scanner's lateral axes, provide a high-bandwidth closed-loop system and allow reference signal tracking. Refereed/Peer-reviewed

Reinforcement and repair of reinforced concrete structures is often more economical and sustainable (less cement consumption, less CO 2 production) than reconstruction. Currently, the solution of reinforcement/repair by carbon-epoxy materials applied to outer surfaces of the structures is routinely used. However, these composites have limitations in terms of cost, fire resistance and sustainable development criteria. The textile reinforced concrete (TRC) mineral-based composite is envisaged as an alternative solution that can solve, at least partially, the above drawbacks. This work aims to experimentally assess contributions of the strengthening/repair of slender reinforced concrete beams subjected to bending by applying the TRC composite. In the first approach, the use of TRC composites in the case of the repair/strengthening of tank shells will be evaluated on the basis of slender beams. Twelve reinforced concrete “beams” are tested for quasi-static monotonic loading by bending tests over four points among 10 beams that have been reinforced/repaired by composite materials . Several parameters including two different modes of curing conditions (28 days immersion in water at 20 °C; 28 days left in air at 20 °C, 50 RH), and two different types of configurations of the beams (with and without pre-cracking) have been considered. This study highlights the mechanical performance of TRC in strengthening/repair of the reinforced concrete beams by analysing the changes in global behaviour (e.g., load/deflection, failure mode, flexural rigidity) and local behaviour (e.g., deformation of steel, pattern cracking, the crack opening). Further evaluation of the local behaviour of TRC should be conducted to address the damage mechanism by multi-cracking of the material and changing the opening of the crack located on the face of the composite.

© 2016 Elsevier B.V. Searches for rare nuclear processes, such as neutrinoless double beta-decay and the interactions of WIMP dark matter, are motivating experiments with ever-decreasing levels of radioactive backgrounds. These background reductions are achieved using various techniques, but amongst the most important is minimizing radioactive contamination in the materials from which the experiment is constructed. To this end there have been decades of advances in material sourcing, manufacture and certification, during which researchers have accumulated many thousands of measurements of material radiopurity. Some of these assays are described in publications, others are in databases, but many are still communicated informally. Until this work, there has been no standard format for encoding assay results and no effective, central location for storing them. The aim of this work is to address these long-standing problems by creating a concise and flexible material assay data format and powerful software application to manipulate it. A public installation of this software, available at http://www.radiopurity.org, is the largest database of assay results ever compiled and is intended as a long-term repository for the community's data.

A photochemical model platform for Hawaii, Puerto Rico, and Virgin Islands predicting O(3), PM(2.5), and regional haze would be useful to support assessments relevant for the National Ambient Air Quality Standards (NAAQS), Regional Haze Rule, and the Prevention of Significant Deterioration (PSD) program. These areas have not traditionally been modeled with photochemical transport models, but a reasonable representation of meteorology, emissions (natural and anthropogenic), chemistry, and deposition could support air quality management decisions in these areas. Here, a prognostic meteorological model (Weather Research and Forecasting) and photochemical transport (Community Multiscale Air Quality) model were applied for the entire year of 2016 at 27, 9, and 3 km grid resolution for areas covering the Hawaiian Islands and Puerto Rico/Virgin Islands. Model predictions were compared against surface and upper air meteorological and chemical measurements available in both areas. The vertical gradient of temperature, humidity, and winds in the troposphere was well represented. Surface layer meteorological model performance was spatially variable, but temperature tended to be underestimated in Hawaii. Chemically speciated daily average PM(2.5) was generally well characterized by the modeling system at urban and rural monitors in Hawaii and Puerto Rico/Virgin Islands. Model performance was notably impacted by the wildfire emission methodology. Model performance was mixed for hourly SO(2), NO(2), PM(2.5), and CO and was often related to how well local emissions sources were characterized. SO(2) predictions were much lower than measurements at monitors near active volcanos on Hawaii, which was expected since volcanic emissions were not included in these model simulations. Further research is needed to assess emission inventory representation of these areas and how microscale meteorology influenced by the complex land-water and terrain interfaces impacts higher time resolution performance.

The efficiency of shear walls to sustain the earthquake loads mainly depends on the aspect ratio, the vertical load, and the ratios of longitudinal and transverse reinforcement. In this paper, two lightly reinforced concrete walls have been experimentally and numerically investigate with an aspect ratio equal to 0.67 (short wall) and 2.5 (slender wall). Different retrofitting strategies have been considered using Carbon-Fiber-Reinforced-Polymer (CFRP) materials. Pushover analyses have been carried out using two advanced numerical approaches for the concrete modeling: the first one adopts a 2D plane stress approach with a local concrete model based on the smeared fixed crack approach and a classical regularization technique based on the fracture energy; the second investigates a coupled elastoplastic damage model using local approach in 2D and 3D simulations. The numerical results in terms of the load–displacements are very consistent with experimental data. The observed failure modes and crack patterns are satisfactorily reproduced for both walls, without or with the CFRP strengthening.

The paper presents a spectral fatigue damage analysis of a double hull tanker structural detail accounting for corrosion wastage over time. The cyclic load of the wave-induced vertical bending moment, analysis using a strip theory on the frequency domain, is considered for two loading conditions. The influence of sea environment parameters and operational profiles including the use of different scatter diagrams, and wave variance spectra have been analyzed. The effect on the time-dependent cumulative fatigue damage as a function of corrosion deterioration is calculated.

Fatigue damage assessment of double hull oil tanker structural details is performed, based on global and local structural finite element models. The wave-induced vertical and horizontal bending moments, as well as local pressure loads are accounted for in the fatigue damage calculations. Local stress analyses are considered based on the notch stress approach. Time-dependent stresses as a function of corrosion deterioration are analyzed based on nonlinear corrosion wastage during the design life of ship. The effective notch stress approach is applied for analyzing the stress distributions and the fatigue damage of the welded joint at two hotspots. The hotspots are located between the flat bar stiffener of a transverse web frame and the flange of a longitudinal stiffener at the side shell of a tanker ship hull. The details under consideration are modeled separately in a fine mesh employing the sub model techniques. Finally the fatigue damage assessment accounting for corrosion deterioration of the considered hotspots is analyzed.

In 1888, Wiedemann and Schmidt defined triboluminescence (TL) as the emission of light produced by mechanical action. In 1999, Sage and Geddes patented a design for a sensor capable of discerning the locations of impacts. Their design involved embedding a sensor inside a material coated with a triboluminescent crystal. The resulting impacts would produce light that would be analyzed to determine its location. Using this idea, the authors have been investigating the triboluminescent properties of 27 materials for its possible use as an impact sensor. This paper gives a detailed comparison of the triboluminescent emission yields resulting from low energy drops for 27 luminescent materials. Collection of this data is only the first step towards the development of a practical TL-based impact sensor.

Cyclotides are a new class of plant biologics that display a diverse range of bioactivities with therapeutic potentials. They possess an unusual end-to-end cyclic backbone combined with a cystine knot arrangement, making them exceptionally stable to heat, chemical and enzymatic degradation. Currently, >200 cyclotides have been discovered but only three naturally occurring linear variants (also known as uncyclotides) have been isolated. In this study, we report the discovery of 18 novel peptides, chassatides C1 to C18, composed of 14 new cyclotides and four uncyclotides from Chassalia chartacea (Rubiaceae family). Thus far, this is the largest number of uncyclotides being reported in a single species. Activity testing showed that the uncyclotides not only retain the effectiveness but also are the most potent chassatides in the assays for antimicrobial, cytotoxic, and hemolytic activities. Genetic characterization of novel chassatides revealed that they have the shortest precursors of all known cyclotides hitherto isolated, which represents a new class of cyclotide precursors. This is the first report of cyclotide genes in a second genus, the Chassalia, other than the Hedyotis (Oldenlandia) of the Rubiaceae family. In addition, we also report the characterization of two Met-oxidized derivatives of chassatides C2 and C11. The oxidation of Met residue causes loss of bioactivities, strengthening the importance of the hydrophobic patch for membrane interaction.

The major histocompatibility complex is a multigenic system highly polymorphic coding for human leukocyte antigen (HLA) molecules, which are the strongest antigens for immune response and play a major role in allograft rejection. Class I antigens are expressed on almost all nucleated cells and platelets, whereas HLA class II antigens are mostly on antigen presenting cells. During transfusion, anti-HLA antibodies can induce transfusion incidents like fever, transfusion-related acute lung injury TRALI and refractoriness to the platelets transfusion. Identification of HLA class I antibodies is very important to find HLA compatible platelets concentrates. Since the end of 1960s, the complement-dependent microlymphocytotoxicity assay has been the standard internationally recognized method for cross matching and screening of HLA antibodies. It became necessary to improve the test sensitivity because some clinical relevant antibodies were not detected. Sensitive methods appeared in the 1990 s: flow cytometry, enzyme-linked immunosorbent assay and now Luminex™. This latter is the most sensitive method with single HLA antigen panel assays to generate the most informative reactivity pattern of antibodies. The high sensitivity and specificity of the Luminex™ technology performed to screen HLA antibodies allows the best selection of platelets donors. When no compatible concentrates are available for highly immunized recipients, the cross-matching method could be used to select a platelet concentrate.

The catalytic dehydrogenation (DH) and oxidative dehydrogenation (ODH) of light alkanes are of significant industrial importance. In this work both carbonaceous materials deposited on VOx/Al2O3 catalysts during reaction and unsupported carbon nanofibres (CNFs) are shown to be active for the dehydrogenation of butane in the absence of gas-phase oxygen. Their activity in these reactions is shown to be dependent upon their structure, with different reaction temperatures yielding structurally different coke deposits. Terahertz time-domain spectroscopy (THz-TDS), among other techniques, has been applied to the characterisation of these deposits – the first time this technique has been employed in coke studies. TEM and other techniques show that coke encapsulates the catalyst, preventing access to VOx sites, without a loss of activity. Studies on CNFs confirm that carbonaceous materials act as catalysts in this reaction. Carbon-based catalysts represent an important new class of potential catalysts for DH and ODH reactions.

In this note we classify, up to conjugation, all algebraic subgroups of GL 2 (ℂ).

The Permian–Triassic boundary at Nhi Tao, Cao Bang Province, Vietnam was sampled in a 7.5-m-thick outcrop section at high resolution (∼ 5 cm intervals) for chemostratigraphic and magnetic susceptibility analysis. The section consists entirely of slightly argillaceous limestone representing shallow-marine facies of the Jinxi Platform, one of several large carbonate platforms within the Nanpanjiang Basin, located on the southern margin of the South China Craton. Upper Permian strata (Beds 1–7) are mainly dark-gray, cherty fossiliferous wackestones and packstones containing a diverse open-marine fauna, whereas uppermost Permian and Lower Triassic strata (Beds 9 and higher) are medium-gray calcimicrobial framestones containing rare macrofossils. These facies are separated by a 12-cm-thick oolitic–pisolitic grainstone (Bed 8) that coincides with the disappearance of most Late Permian faunal elements as well as with the first appearance of various geochemical anomalies that continue into the Lower Triassic part of the section. This “Late Permian event horizon” is characterized by (1) an abrupt decline in total organic carbon to near-zero values, (2) the onset of a sustained decline in carbonate δ13C, and (3) the first of eight concentration peaks in pyrite sulfur. Significantly, each sulfide peak is associated with lower pyrite δ34S values as well as with the onset of a negative carbonate δ13C excursion (or the acceleration of an excursion already in progress). These chemostratigraphic relationships are consistent with multiple episodes of upwelling of sulfidic, 34S- and 13C-depleted deep-ocean waters onto the Jinxi Platform. The first upwelling event was the most intense and caused a drastic reduction in primary productivity and the demise of the Late Permian fauna; subsequent episodes were less intense but may have contributed to a delay in recovery of Early Triassic marine ecosystems. A ten-fold increase in magnetic susceptibility in Bed 9 may record the influx of fine detrital particles following destruction of terrestrial ecosystems and massive soil erosion. The terrestrial signal of the end-Permian catastrophe thus follows the marine signal with a 12-cm lag, which may reflect the time-of-transit of soil-derived particles across the Nanpanjiang Basin, suggesting that the marine and terrestrial crises in the Nhi Tao region occurred more-or-less synchronously. These observations suggest a model in which renewal of global-ocean overturn followed a prolonged interval of deep-ocean stagnation during the Late Permian, with upwelling intensity modulated by short-term (∼ 20 kyr) climate cyclicity.

A kinetic model is developed, based on the power law of growth and Avrami's concepts in nuclei growth, to characterise the heterogeneous nature of kraft pulping kinetics, taking into account the effects of effective alkali concentration, sulphidity, and temperature. The final form of the model applied to kraft pulping of thin chips of Eucalyptus nitens in isothermal flow-through reactors can be represented by a first order rate equation with a time-dependent rate constant: − d L d t = 8.55 × 10 9 × [ OH − ] 0.31 × [ HS − ] 0.43 × exp ( − 97.3 R T ) n × t 1 − n × L The exponential n varies within 0.62–1.36. This variation reflexes the non-homogeneous nature of the wood samples. The average value of n for all the samples is close to 1, suggesting that the classic first-order rate equations can be also used to approximate the delignification kinetics of large samples of E. nitens chips.

A study of the sediment bedload in the Mont-Saint-Michel bay is presented here. It combines the use of a 2DH numerical model and a pattern of sediment bedload transport established on the analysis of the statements of sidescan imagery combined with a dense groundwork of sedimentary grab samples. Results show the role of tidal currents asymetry in the realistic bioclastic sand transfert from the subtidal environment to the coast and the divergence of sedimentary dynamic between the maritime bay to the West and the tidal delta to the East. This in-shore transfer is responsable of the Holocene prism construction. The model reproduces tidal sedimentary dynamics with the immediate surroundings of the Mont-Saint-Michel. It shows the interest of the modeling of bedload flows in the reconstitution of the sedimentary processes in the filling bays of Manche-Atlantic coast. (C) 2003 Editions scientifiques et medicales Elsevier SAS and Ifremer/CNRS/IRD. Tous droits reserves., Cette étude des flux sédimentaires en baie du Mont-Saint-Michel combine l'utilisation d'un modèle numérique 2DH résolvant les équations de Saint-Venant et un modèle des transits sédimentaires établis sur l'analyse des levés d'imagerie acoustique calibrée par un canevas dense de prélèvements sédimentaires. Les simulations des flux sédimentaires aux abords du Mont-Saint-Michel montrent le cheminement des sables coquilliers depuis les fonds subtidaux au large de la côte de Saint-Malo jusqu'aux encablures du Mont-Saint-Michel à l'est et la région de Cancale à l'ouest. Ce transfert des sédiments à la côte est à l'origine de la construction du prisme holocène dans cette région. Le modèle physique reproduit la dynamique tidale des sédiments aux abords immédiats du Mont-Saint-Michel sous le jeu de l'asymétrie des courants de marée et montre l'intérêt du couplage modèle numérique¿dynamique de terrain dans la compréhension des processus de comblement des baies de la façade Manche-Atlantique.

The usual approach that is used to characterize the molecular orientation in biaxially oriented samples by infrared spectroscopy is to measure spectra with polarization in all three directions: machine, transverse and normal (or thickness). However, the latter measurement is rather difficult to make experimentally. In the present work we propose a new approach to characterizing the molecular orientation in both uniaxially and biaxially oriented samples of PET, based on the use of front-surface reflection spectra. It makes use of the ratio of the absorption bands at 1330–1240 and 1729 cm−1, the first of which shows parallel dichroism and the second perpendicular dichroism. An equation is developed that relates this ratio to the molecular orientation with respect to the direction of measurement. Thus, it is possible to determine individually the orientation functions with respect to the machine and transverse directions. The validity of functions determined in this way is confirmed by comparison with birefringence results.

In patients with type I diabetes mellitus, clinical studies have demonstrated decreased secretion of pancreatic juice by the pancreatic excretory duct system. The cause of this decrease is unknown, but could involve changes in initial signal transduction pathways or one or more of the electrolyte transport components that subserve regulated fluid secretion. We have compared responsiveness to secretin in pancreatic ducts isolated from healthy and diabetic Hartley guinea pigs and also have compared the expression of CFTR and Na+, K(+)-ATPase in these two groups, as the activities of these two proteins are essential for secretion of pancreatic juice. The increases in cyclic AMP levels evoked by exposure to either 0.1 nM or 0.1 microM secretin were not significantly different in pancreatic ducts isolated from healthy and diabetic guinea pigs nor were levels of CFTR or Na+, K(+)-ATPase expression. By contrast, Na+, K(+)-ATPase activity in pancreatic ducts isolated from diabetic guinea pigs was decreased by 70%, suggesting a change in the enzyme's catalytic properties in the diabetic tissues. The observed decrease would be expected to seriously compromise the production of pancreatic juice.

Gas-assisted injection moulding has shown considerable advantages in the production of complex hollow parts in the plastics industry. This process is capable of reducing the pressure requirements as well as the shrinkage/warpage of the part and the cycle time. Due to gas-polymer interaction during the gas injection phase, the process has significantly different characteristics from conventional injection moulding and, therefore, the control of the process requires a solid technical knowledge in processing and materials. In this study the authors have developed a numerical model capable of predicting the gas penetration using multiple gas-injection units. The pressure and gas-injection duration of these units can be controlled independently to obtain the optimum gas penetration and to avoid undesired gas penetration into the sections. The advantages of using this kind of system are shown through the analysis of an experimental part with three independent gas channels.

To identify factors associated with best-corrected visual acuity (BCVA) presentation and 2-year outcome in 479 intermediate, posterior, and panuveitic eyes.Cohort study using randomized controlled trial data.Multicenter Uveitis Steroid Treatment (MUST) Trial masked BCVA measurements at baseline and at 2 years follow-up used gold-standard methods. Twenty-three clinical centers documented characteristics per protocol, which were evaluated as potential predictive factors for baseline BCVA and 2-year change in BCVA.Baseline factors significantly associated with reduced BCVA included age ≥50 vs50 years; posterior vs intermediate uveitis; uveitis duration10 vs6 years; anterior chamber (AC) flaregrade 0; cataract; macular thickening; and exudative retinal detachment. Over 2 years, eyes better than 20/50 and 20/50 or worse at baseline improved, on average, by 1 letter (P = .52) and 10 letters (P.001), respectively. Both treatment groups and all sites of uveitis improved similarly. Factors associated with improved BCVA included resolution of active AC cells, resolution of macular thickening, and cataract surgery in an initially cataractous eye. Factors associated with worsening BCVA included longer duration of uveitis (6-10 or10 vs6 years), incident AC flare, cataract at both baseline and follow-up, pseudophakia at baseline, persistence or incidence of vitreous haze, and incidence of macular thickening.Intermediate, posterior, and panuveitis have a similarly favorable prognosis with both systemic and fluocinolone acetonide implant treatment. Eyes with more prolonged/severe inflammatory damage and/or inflammatory findings initially or during follow-up have a worse visual acuity prognosis. The results indicate the value of implementing best practices in managing inflammation.

Introduction L’incidence des effets indesirables medicamenteux (EIM) chez les enfants hospitalises est de 9,5 % [6,81 ; 12,26] avec un taux d’EIM graves de 12,3 % [8,43 ; 16,7]. Peu d’etudes ont demontre que la prescription hors AMM est significativement associee a un risque superieur de survenue d’EIM. Objectif Etudier la relation entre le risque d’EIM et la prescription hors/sans AMM chez les enfants hospitalises (etude EREMI). Methode Etude observationnelle prospective multicentrique dans divers services pediatriques de l’hopital Femme-Mere–Enfant a Lyon et de l’hopital Robert-Debre a Paris. L’inclusion des patients et l’extraction des donnees ont ete automatisees ainsi que le classement de l’utilisation des medicaments en AMM, hors AMM ou sans AMM. La base de donnees Theriaque des medicaments est la source de reference pour ce classement. Les EIM sont detectes et declares par l’equipe EREMI et par les professionnels de sante en utilisant une liste des signes d’alerte pediatrique « trigger tool » et le dossier informatise du patient. La codification MedDRA des EIM est effectuee par les centres regionaux de pharmacovigilance qui determinent la causalite entre les EIM et les medicaments suspectes avec la methode Naranjo et la methode francaise. La validation du classement AMM et l’evaluation finale des EIM sont faites par un comite independant de pharmacovigilance qui se prononce sur l’evitabilite de la prescription a l’origine de cet evenement et sur l’existence d’alternatives therapeutiques. Resultats preliminaires A Lyon, de novembre 2013 a novembre 2014, 1965 patients ont ete inclus, 19 858 administrations de medicaments par jour et par heure ont ete extraites et 204 EIM ont ete detectes dans les neuf services de pediatrie mis en place a Lyon. Sur les 106 EIM declares, 69 ont ete valides par le centre regional de pharmacovigilance de Lyon, 7 ont ete exclus et 30 sont en cours d’evaluation. Le comite independant de pharmacovigilance a evalue 31 EIM, 29 ont ete valides et la nature de 2 evenements a ete modifiee. Parmi les 9 alternatives therapeutiques proposees 6 concernent des medicaments du systeme nerveux. Conclusion Cette etude, la premiere de ce type en France, permettra la mise a disposition d’informations sur l’amplitude, la nature et les consequences des prescriptions hors AMM et sans AMM ainsi que la detection des facteurs de risque des EIM pour orienter la prise en charge therapeutique et le developpement des medicaments pour la population pediatrique.

Objectif Estimer l’efficacite de strategies interventionnelles et non pharmacologiques sur l’equilibre diabetique. Materiels et methodes La recherche bibliographique a utilise les bases de donnees Medline et Embase de 1966 a Fevrier 2010 et 1974 a Juin 2007, respectivement. Les meta-analyses deja publiees ont ete incluses et les references des articles selectionnes ont ete etudiees. Il n’y a pas eu de restriction de langue. Les criteres de selection etaient : essais cliniques randomises chez des enfants et adolescents ; un des criteres de jugement devait etre l’hemoglobine glyquee (HbA1c). La selection des articles et l’extraction des donnees ont ete realisees par deux auteurs independants. La collecte des donnees et l’analyse statistique ont ete realisees avec le logiciel Easyma. Resultats La recherche bibliographique a permis d’identifier, 152 articles et 7 meta-analyses deja publiees. Apres lecture des articles, 43 ont ete retenus et regroupes en 6 types de prise en charge. D’autres evenements cliniques comme, une hypoglycemie severe, une acidocetose, la variation du poids ont ete releves. Dans la meta-analyse sur les interventions educationnelles, il y a une amelioration de l’HbA1c de − 0,8% [− 1,2 ; − 0,3] (p = 0,0000). Il existe aussi un effet benefique de la prise en charge psychologique : taille de l’effet − 0,23 [− 0,4 ; 0,2] (p = 0,01). Concernant la prise en charge au debut du diabete, un seul essai remplissait les criteres de selection. Pour les systemes de controle des parametres biologiques et la telemedecine, il n’y a pas d’effet statistiquement significatif, meme si on releve une tendance a l’amelioration de l’HbA1c. Il n’est pas possible de conclure sur l’effet des mesures hygieno-dietetiques. Conclusion Il y a un effet statistiquement benefique des mesures educationnelles et psychologiques sur l’equilibre du diabete de type 1 chez l’enfant et l’adolescent. Concernant les autres strategies interventionnelles, il semblerait que ces mesures soient benefiques, mais il faudrait des essais cliniques plus puissants pour les evaluer.

The maximum achievable beta (ratio of plasma pressure to magnetic pressure) value in a bumpy torus such as Elmo (EBT) is determined primarily by the stability of the system to the interchange modes. These modes have as their source of free energy the drifts of the hot electron component that arise from the curvature and gradients of the confining magnetic field. At low (compared to the ion gyro) frequencies the only modes that exist are the core plasma and hot electron interchange, but at frequencies near the ion cyclotron frequency, instabilities arising from coupling of the interchange and compressional Alfven wave also appear. In most, if not all previous treatments of these instabilities, the hot electrons were treated as non-relativistic. In this paper we re-examine these modes using a relativistic formulation for the hot electrons which we also treat as highly anisotropic by neglecting their parallel momenta relative to the perpendicular momenta and their rest mass energy. We find a significant enhancement in the ion beta value as a result of treating the ring electrons relativistically. For typical present day EBT parameters we find that the value of the ion beta increases by about 50% as a result of increasing the hot electron mean energy from about several keV to few MeV. At such an energy the microwave power for heating these electrons is also optimum since the drag on the background plasma also reaches its minimum value.

The effect of ingesting cellulose, pectin, and psyllium with orally administered lactose in water or milk was tested in six lactose malabsorbers. Breath hydrogen tests were used to evaluate lactose malabsorption and mouth-to-cecum transit times. Addition of psyllium significantly reduced the breath hydrogen response, and symptoms in each subject; whereas, less diminution of expired hydrogen was seen after cellulose or pectin was added. The effect of each fiber on gastric emptying rates of an equal volume liquid meal was evaluated in three volunteers. Pectin had no effect, while the cellulose and psyllium modestly delayed emptying at approximately 30 min.