A model for pushover analysis of confined masonry structures : implementation and validation

Confined masonry (CM) is a typical building technique in Latin American countries. This technique, due to its simplicity of construction and similarity with traditional practices of reinforced concrete building, presents a potential of use in European regions with moderate-to-high seismicity. However, most of the procedures for seismic design in codes for Latin America are force-based, which appears to be inadequate due to the high dissipative response observed for CM. This paper presents a simplified numerical-analytical approach to model CM structures using pushover analysis, aiming to apply performance-based design procedures. First, a data mining process is performed on a database of experimental results collected from lateral tests on CM walls to adjust prediction models for the wall shear strength and to determine the input relevance through a sensitivity analysis. Then, an analytical model of CM structures for pushover analysis is proposed with basis on a wide-column approach that employs an adaptive shear load-displacement constitutive relation. The proposed method is compared with a discrete element model that represents explicitly the confinements-masonry interaction, against the experimental results obtained in a quasi-static test of a full-scale tridimensional CM structure. The accuracy of the predictions from both methods is very satisfactory, allowing to capture the base shear-displacement envelope and also the damage patterns of the structure, thus, demonstrating the ability of the methods to be used in performance-based seismic assessment and design of CM buildings.The first author acknowledges the financial support from the Portuguese Foundation for Science and Technology (FCT) through the Ph.D. Grant SFRH/BD/41221/2007

Mobile clinical teams for stroke and neurological handicaps in the community: A pilot project in the Île-de-France area

IntroductionIn December 2013 the Regional Health Agency in Île-de-France (Paris city and surrounding districts) started an experimental project of mobile clinical teams for post-acute care and rehabilitation of serious neurological conditions such as stroke. This pilot project was organized in 8 departments. The goal was to coordinate health and social services in order to facilitate home transitions and home living maintenance for persons with disabilities, while enhancing persons’ independence.Material/patients and methodsIn this communication, we compare the organizations of these teams: their part-time team members as specialists in geriatrics or Physical Medicine and Rehabilitation, social workers, occupational therapists and secretaries; their intervention types and places (in acute or post-acute care, or in the community); the methods of referral to the teams; the tools used for evaluation, functioning and communication. Since one year, monthly global meetings of the teams have led to an harmonization of these tools and to a useful sharing of experiences.ResultsAs most teams have been fully functional since September 2014, a synthesis of 6 months of activity can be drawn. The number of patients managed by each team was between 9 and 40. Main reasons for referral to the teams were assistance in the transition from hospital to home, help in home living maintenance, functional evaluations, and administrative assistance. The teams performed between 3 and 32 home visits.DiscussionThrough this first experiment, the added value of these mobile teams was highlighted. The multidisciplinary analysis of individual situations, which combines a functional approach to a social support, gives a comprehensive insight into the neurological handicap and its challenges at home and in the community. The acquired knowledge enables the teams to improve the management of recent stroke in preparing home transitions and to take into account the complexity of stroke-related disabilities at all ages. The limits of the interventions of these teams are related to the large geographical territories which need to be addressed, to the incomplete knowledge of care and residential possibilities, and sometimes to an under-evaluation of the medical work time required

Human Immunodeficiency Virus Type 1 Group O Infection in France: Clinical Features and Immunovirological Response to Antiretrovirals

International audienc

Human immunodeficiency virus continuum of care in 11 european union countries at the end of 2016 overall and by key population: Have we made progress?

Background. High uptake of antiretroviral treatment (ART) is essential to reduce human immunodeficiency virus (HIV) transmission and related mortality; however, gaps in care exist. We aimed to construct the continuum of HIV care (CoC) in 2016 in 11 European Union (EU) countries, overall and by key population and sex. To estimate progress toward the Joint United Nations Programme on HIV/AIDS (UNAIDS) 90-90-90 target, we compared 2016 to 2013 estimates for the same countries, representing 73% of the population in the region. Methods. A CoC with the following 4 stages was constructed: number of people living with HIV (PLHIV); proportion of PLHIV diagnosed; proportion of those diagnosed who ever initiated ART; and proportion of those ever treated who achieved viral suppression at their last visit. Results. We estimated that 87% of PLHIV were diagnosed; 92% of those diagnosed had ever initiated ART; and 91% of those ever on ART, or 73% of all PLHIV, were virally suppressed. Corresponding figures for men having sex with men were: 86%, 93%, 93%, 74%; for people who inject drugs: 94%, 88%, 85%, 70%; and for heterosexuals: 86%, 92%, 91%, 72%. The proportion suppressed of all PLHIV ranged from 59% to 86% across countries. Conclusions. The EU is close to the 90-90-90 target and achieved the UNAIDS target of 73% of all PLHIV virally suppressed, significant progress since 2013 when 60% of all PLHIV were virally suppressed. Strengthening of testing programs and treatment support, along with prevention interventions, are needed to achieve HIV epidemic control. © The Author(s) 2020

Human immunodeficiency virus continuum of care in 11 european union countries at the end of 2016 overall and by key population: Have we made progress?

Background. High uptake of antiretroviral treatment (ART) is essential to reduce human immunodeficiency virus (HIV) transmission and related mortality; however, gaps in care exist. We aimed to construct the continuum of HIV care (CoC) in 2016 in 11 European Union (EU) countries, overall and by key population and sex. To estimate progress toward the Joint United Nations Programme on HIV/AIDS (UNAIDS) 90-90-90 target, we compared 2016 to 2013 estimates for the same countries, representing 73% of the population in the region. Methods. A CoC with the following 4 stages was constructed: number of people living with HIV (PLHIV); proportion of PLHIV diagnosed; proportion of those diagnosed who ever initiated ART; and proportion of those ever treated who achieved viral suppression at their last visit. Results. We estimated that 87% of PLHIV were diagnosed; 92% of those diagnosed had ever initiated ART; and 91% of those ever on ART, or 73% of all PLHIV, were virally suppressed. Corresponding figures for men having sex with men were: 86%, 93%, 93%, 74%; for people who inject drugs: 94%, 88%, 85%, 70%; and for heterosexuals: 86%, 92%, 91%, 72%. The proportion suppressed of all PLHIV ranged from 59% to 86% across countries. Conclusions. The EU is close to the 90-90-90 target and achieved the UNAIDS target of 73% of all PLHIV virally suppressed, significant progress since 2013 when 60% of all PLHIV were virally suppressed. Strengthening of testing programs and treatment support, along with prevention interventions, are needed to achieve HIV epidemic control