Estimating Attributable Mortality Due to Nosocomial Infections Acquired in Intensive Care Units

Background. The strength of the association between intensive care unit (ICU)-acquired nosocomial infections (NIs) and mortality might differ according to the methodological approach taken. Objective. TO assess the association between ICU-acquired NIs and mortality using the concept of population-attributable fraction (PAF) for patient deaths caused by ICU-acquired NIs in a large cohort of critically ill patients. Setting. Eleven ICUs of a French university hospital. Design. We analyzed surveillance data on ICU-acquired NIs collected prospectively during the period from 1995 through 2003. The primary outcome was mortality from ICU-acquired NI stratified by site of infection. A matched-pair, case-control study was performed. Each patient who died before ICU discharge was defined as a case patient, and each patient who survived to ICU discharge was denned as a control patient. The PAF was calculated after adjustment for confounders by use of conditional logistic regression analysis. Results. Among 8,068 ICU patients, a total of 1,725 deceased patients were successfully matched with 1,725 control Patients. The adjusted PAF due to ICU-acquired NI for patients who died before ICU discharge was 14.6% (95% confidence interval [CI], 14.4%—14.8%). Stratified by the type of infection, the PAF was 6.1% (95% CI, 5.7%-6.5%) for pulmonary infection, 3.2% (95% CI, 2.8%-3.5%) for central venous catheter infection, 1.7% (95% CI, 0.9%-2.5%) for bloodstream infection, and 0.0% (95% CI, -0.4% to 0.4%) for urinary tract infection. Conclusions. ICU-acquired NI had an important effect on mortality. However, the statistical association between ICU-acquired NI and mortality tended to be less pronounced in findings based on the PAF than in study findings based on estimates of relative risk. Therefore, the choice of methods does matter when the burden of NI needs to be assesse

Sur les routes romaines des Alpes Cottiennes. Entre Mont-Cenis et col de Larche

, . Sur les routes romaines des Alpes Cottiennes. Entre Mont-Cenis et col de Larche. Besançon : Institut des Sciences et Techniques de l'Antiquité, 2016. 0 p. (Collection « ISTA », 1376

La circulation dans les Alpes à l'époque romaine : l'exemple des Alpes Cottiennes

Traffic over the Alps in Roman times: the case of the Cottian Alps. The study addresses the role of the Mont-Genèvre road-system and Cottian Alps district during the Roman period. The idea of a vast preroman kingdom ruled by Cottius is criticized, as well as his alleged hostility to Rome. The promotion of five cities to municipal status seems to have helped the development of pastoralism and of transhumance with Italy. Commercial traffic… In the IVth and Vth centuries, the Cottian Alps appear as an element of an ‘ alpine limes’… The Roman road across the pass of Lautaret has been revisited and two other possible routes across the Petit Mont-Cenis and over the pass of La Madeleine have been explored.Les principaux axes d’une thèse de doctorat sur le rôle du système routier du Mont-Genèvre et de la province romaine des Alpes Cottiennes dans les relations transalpines sont exposés. L’idée courante que Cottius, à la tête d’un vaste royaume, aurait résisté à Rome jusqu’en 13 av. J.-C., est réfutée. La création de cinq municipes routiers a permis de désenclaver les hautes vallées avec développement de l’élevage et d’une possible transhumance avec l’Italie. Les produits transportés, le mode de transport et l’implantation des postes de la Quadragesima Galliarum sont envisagés. Aux IVe et Ve s. les Alpes Cottiennes sont un élément du “ limes alpin” et la voie du Mont-Genèvre sera le dernier lien de la Gaule avec la romanité. Les tracés des voies romaines du Mont-Genèvre et du col du Lautaret sont précisés ainsi que ceux de voies probables par le Petit Mont-Cenis et le col de Larche.Artru François. La circulation dans les Alpes à l'époque romaine : l'exemple des Alpes Cottiennes. In: Dialogues d'histoire ancienne, vol. 39, n°1, 2013. pp. 237-263

Traffic over the Alps in Roam times : the case of Cottian Alps

L’étude vise à apprécier l’importance exacte du système routier du Mont-Genèvre et de l’entité administrative des Alpes Cottiennes dans les relations transalpines à l’époque romaine. Une première partie, sorte d’introduction à la circulation alpine dans l’Antiquité, envisage successivement les sources documentaires, en particulier la Table de Peutinger, les nouvelles données paléoenvironnementales, l’exploitation du trafic comme élément fondateur du découpage territorial préromain, la part du mythe et des connaissances réelles dans l’image des Alpes chez les Romains et, enfin, les conditions pratiques de déplacement dans le massif alpin. Tout au long des cinq siècles de domination romaine sont analysées les relations entre les évènements politico-militaires, la géographie administrative et le réseau viaire de la région étudiée. Le passage du royaume indigène indépendant à la préfecture romaine est revu à partir d’une remise en question de l’idée d’un vaste royaume préexistant à la conquête augustéenne et de la prétendue hostilité initiale de Cottius envers Rome. Parmi les arguments qui plaident pour une alliance de Cottius et d’Auguste vue comme un préliminaire à la conquête alpine et non comme son dernier acte, l’accent est mis sur le degré avancé de romanisation des Cottii, de la cité de Suse et de la voie du Mont-Genèvre. Le témoignage d’Ammien Marcellin sur la résistance du roi de Suse est récusé et le passage de Pline sur ‘les douze cités cottiennes qui ne furent pas hostiles’ interprété en faisant l’hypothèse de deux états successifs de la préfecture de Cottius.Il est montré ensuite comment, au cours des cinq siècles qui ont suivi la création de la préfecture, la voie du Mont-Genèvre demeura la voie transalpine la plus commode et, sans doute, la plus utilisée de toutes les Alpes occidentales. L’effet déterminant du développement du réseau routier cottien sur la municipalisation, la romanisation et l’économie des hautes vallées est mis en relief. La possibilité du passage de l’activité d’élevage de montagne à un stade productiviste basé sur la pratique de la transhumance est envisagée. Parmi les aspects du trafic transalpin sont abordées la place primordiale du cursus publicus, l’organisation douanière de la région et l’arrière-plan religieux des déplacements en montagne. La mise en évidence d’un véritable ‘système routier du Mont-Genèvre’, aménagé à partir de l’époque préfectorale, s’appuie sur l’étude de la carte archéologique et sur une prospection de terrain. Celle-ci a porté d’abord sur la voie du Mont-Genèvre, révélant pour le secteur durancien un tracé différent de celui envisagé par les rares études antérieures. De nombreux arguments sont rassemblés en faveur de l’existence d’une voie romaine franchissant le col du Petit Mont-Cenis et conduisant au limes rhénan. En ce qui concerne la voie qui empruntait probablement le col de Larche, le tracé proposé franchit sans grande difficulté le prétendu obstacle de la basse vallée de l’Ubaye. Deux autres voies du système du Mont-Genèvre ont été étudiées en détails. Sur la voie du col du Lautaret sont apportés quelques éléments nouveaux, en particulier dans la zone de la Porte Romaine de Bons et dans celle de la section taillée près de Bourg d’Oisans. Quant à la voie tracée sur la Table de Peutinger entre Luc-en-Diois et le Mont-Genèvre, elle fait l’objet d’un examen graphique sur le document et de reconnaissances sur le terrain, sans réussir à démontrer la réalité de cette liaison.The study addresses the Mont-Genèvre road and the Cottian Alps district as playing a major rôle in the transalpine traffic during the Roman period. A general chapter upon alpine circulation in the Antiquity reviews the following subjects: recent paleoclimatic data, control of an itinerary in the genesis of preroman tribes’ settlement, actual knowledge of Alps by Romans, and practical traveling conditions through mountains.Relationships between politico-military events, territorial limits and road network are analysed along five centuries of Roman presence. The idea of a vast preroman kingdom ruled by Cottius is not shared. The transition from independence to the status of roman prefecture is viewed as a preliminary decision of August and not as a final event of the Alps conquest. Ammianus alleged hostility of Cottius to Rome, but his testimony has to be rejected. Pline’s allusion to the twelve cottian cities which were not hostile is explained by supposing an early transitory state of the prefecture.It is explained how the development of the road network allowed promotion of some cities to municipal status, favoured romanisation and boosted the economy of high valleys. An intensification of pastoralism through the practice of transhumance is suggested. Related aspects of the alpine traffic, as cursus publicus, Quadragesima Galliarum and religious beliefs of travellers are examined. Evidences for the existence of a ‘Mont-Genèvre roads system’, constructed since the time of the prefecture, are derived from archaeological registries and local exploration. Concerning the road of the Durance valley, within cottian frontiers, it appears to follow a quite different course from the one proposed until now. Arguments are gathered favouring the existence of a roman road running across the Petit Mont-Cenis and leading to the Rhenan limes. The road which very likely runs over the col de Larche (or de la Madeleine) and through the Ubaye valley appears to join easily the Durance valley contrary to some previous opinions. Two other routes of the Mont-Genèvre system are studied in detail. One crosses the col du Lautaret and its two remaining sections are carefully examined, namely the Porte Romaine de Bons and the rock-cutted segment near Bourg d’Oisans. The second road, between Luc-en-Diois and the Mont-Genèvre, appears only on the Tabula Peutingeriana. Graphical examination of the drawing and local investigation does not allow a definitive conclusion upon the reality of this route

La circulation dans les Alpes à l'époque romaine : l'exemple des Alpes Cottiennes

Traffic over the Alps in Roman times: the case of the Cottian Alps. The study addresses the role of the Mont-Genèvre road-system and Cottian Alps district during the Roman period. The idea of a vast preroman kingdom ruled by Cottius is criticized, as well as his alleged hostility to Rome. The promotion of five cities to municipal status seems to have helped the development of pastoralism and of transhumance with Italy. Commercial traffic… In the IVth and Vth centuries, the Cottian Alps appear as an element of an ‘ alpine limes’… The Roman road across the pass of Lautaret has been revisited and two other possible routes across the Petit Mont-Cenis and over the pass of La Madeleine have been explored.Les principaux axes d’une thèse de doctorat sur le rôle du système routier du Mont-Genèvre et de la province romaine des Alpes Cottiennes dans les relations transalpines sont exposés. L’idée courante que Cottius, à la tête d’un vaste royaume, aurait résisté à Rome jusqu’en 13 av. J.-C., est réfutée. La création de cinq municipes routiers a permis de désenclaver les hautes vallées avec développement de l’élevage et d’une possible transhumance avec l’Italie. Les produits transportés, le mode de transport et l’implantation des postes de la Quadragesima Galliarum sont envisagés. Aux IVe et Ve s. les Alpes Cottiennes sont un élément du “ limes alpin” et la voie du Mont-Genèvre sera le dernier lien de la Gaule avec la romanité. Les tracés des voies romaines du Mont-Genèvre et du col du Lautaret sont précisés ainsi que ceux de voies probables par le Petit Mont-Cenis et le col de Larche.Artru François. La circulation dans les Alpes à l'époque romaine : l'exemple des Alpes Cottiennes. In: Dialogues d'histoire ancienne, vol. 39, n°1, 2013. pp. 237-263

Variations of Ultraviolet Lines for C N and O in the Ap-Stars HD18296 and HD25823

International audienceFrom the rotational variation of UV resonance lines of carbon, nitrogen, and oxygen, we study the irregular distribution of these elements upon the surface of two magnetic Ap stars: HD 18296 (21 Per) and HD25823 (41 Tau)

Variation of oxygen lines in magnetic AP stars

International audienceThe red lines of the OI multiplet at λ=7773A are observed at high resolution and their rotational variation is recorded for a sample of nine magnetic Ap stars. These lines are found to be weaker than for normal A stars. The irregular distribution of oxygen on the stellar surface is connected to the magnetic geometry for the stars HD 25823 (41 Tau), HD 74521 (49 Cnc), HD 112185 (ɛ UMa), HD 112413 (α^2 CVn), and HD 125248 (CS Vir). For four of these stars, it is clearly established that oxygen is concentrated around a magnetic polar region. The interpretation of the observed trends adds new constraints to the theory of radiative diffusion of oxygen in Ap stars

Radiative accelerations on carbon, nitrogen and oxygen

International audienceRadiative accelerations acting on the elements carbon, nitrogen and oxygen are calculated over a large range of plasma parameters which covers the conditions of A-F star envelopes. The theoretical atomic data available from the OPACITY project (OP) have been extensively used to perform a detailed computation of radiative accelerations including the contribution of lines and photoionization for all ions of C, N and O. The present calculations apply the method developed in a recent related paper. It includes several improvements by comparison with the usual approximations adopted previously, in particular concerning the background opacity, the pressure broadening of lines, and the distribution of radiative acceleration between adjacent ions after photoabsorption. Results are presented for models of stellar envelopes with effective temperatures ranging between 6700 and 10000K. For each of the elements C, N, and O, the variation of the radiative acceleration through the envelope is obtained for 19 different abundances. A parameterization of these results is attempted, using a simple formula which gives the radiative acceleration, as a function of only two parameters for each ion. These parameters do not depend on plasma conditions. A greater accuracy of about 0.2 dex is possible by simple interpolation in the available tables of results. The radiative accelerations obtained for C, N, and O are used to estimate the equilibrium abundances of these elements in A and F-type stars, and the comparison with available observed abundances is discussed

Improving the Fagacées growth model with an expanded common beech (Fagus sylvatica L.) data series from France and Germany

International audienceKey message: The Fagacées growth model was originally designed for application in the Northern half of France. It is a robust model with potential applicability to a larger area, though this potential has not yet been verified. We added new data to the original parameterization data set and our results show that the Fagacées formalism can be generalized. Context :The Fagacées growth and yield model was designed for the management of pure even-aged stands of European beech and served as a prototype to build models for other tree species. Aims: The objective of this study was to improve the growth components of the Fagacées model with additional data from NorthWestern France to SouthWestern Germany. Material and methods: Our model was calibrated on several forest inventory data sets. The first one (F) is the original data set that was used to elaborate the equations in the Fagacées model. The second one (F+) is the original data set extended with additional measurements on the same sites and on new sites in Northern France. The third (G) adds complementary data from a forest network in Southwestern Germany. The last one (A) is the aggregate of all these data sets. Results: Fitting the original model equations on the extended F+ dataset led us to modify the equation for stand basal area increment. This new equation also fit the German dataset well. The other equations could be applied to all datasets, some with the same parameter values and some after recalibrating according to the dataset. Conclusion: We conclude that the general form of the model's equations is appropriate for application to other regions, but that a recalibration of the equations is preferable in order to reflect local conditions. The advantage of our approach is that fewer data are required to recalibrate an existing equation than to establish an entirely new one