L’accès des entreprises au crédit bancaire

Cherbonnier Frédéric, Aubier Maud. L'accès des entreprises au crédit bancaire. In: Économie & prévision, n°177, 2007-1. pp. 121-128

Bronchial thermoplasty : a new therapeutic option for the treatment of severe, uncontrolled asthma in adults

Bronchial thermoplasty is a young yet promising treatment for severe asthma whose benefit for long-term asthma control outweighs the short-term risk of deterioration and hospitalisation in the days following the treatment. It is an innovative treatment whose clinical efficacy and safety are beginning to be better understood. Since this is a device-based therapy, the overall evaluation of risk-benefit is unlike that of pharmaceutical products; safety aspects, regulatory requirements, study design and effect size assessment may be unfamiliar. The mechanisms of action and optimal patient selection need to be addressed in further rigorous clinical and scientific studies. Bronchial thermoplasty fits in perfectly with the movement to expand personalised medicine in the field of chronic airway disorders. This is a device-based complimentary asthma treatment that must be supported and developed in order to meet the unmet needs of modern severe asthma management. The mechanisms of action and the type of patients that benefit from bronchial thermoplasty are the most important challenges for bronchial thermoplasty in the future

Weaning from Mechanical Ventilation

For most patients who require mechanical ventilation weaning and extubation is simple. In these patients a variety of strategies can be successful. In addition, sim ple criteria may predict when the patient is ready for extubation. For the small group of patients who require prolonged mechanical ventilation, however, contro versy exists about how best to remove ventilator sup port by weaning, and available data are sparse. Much of the controversy has centered on T-piece weaning ver sus intermittent mandatory ventilation. To date no con trolled study has demonstrated the superiority of either intermittent mandatory ventilation or T-piece weaning in difficult-to-wean patients. In the evolution of this con troversy, concern has developed over the potential for increased inspiratory work and expiratory resistance that may be associated with certain intermittent manda tory ventilation systems. The possibility that significant inspiratory work may occur during assist-control venti lation has also been demonstrated. Respiratory muscle weakness and fatigue is likely important in failure to wean. Other possible causes are failure of the cardiovas cular system and impaired ability of the lung to carry out gas exchange. In this article we first examine criteria and techniques for weaning short-term ventilator pa tients. We then examine criteria to begin the weaning process in prolonged ventilation patients, potential causes of failure to wean, and techniques that can be used to remove ventilator support from patients who are difficult to wean. Much literature has been devoted to techniques and criteria for weaning and extubation of patients from mechanical ventilation. For most patients who require ventilatory support, weaning and extuba tion can be easily accomplished by a variety of tech niques [1-4]. At one referral center 77.2% of all surviving patients were weaned from the ventilator within 72 hours of the onset of mechanical ventila tion, and 91% were weaned within 7 days [1]. Less than 10% of ventilated patients potentially posed problems in weaning from mechanical ventilation. Similarly, at a community hospital, few surviving patients required prolonged ventilatory support [2]. In easy-to-wean patients, Sahn and Lakshminarayan [5] described simple criteria that are predictive of successful discontinuation of ventilator support. For the small group of patients who require pro longed mechanical ventilation, however, minimal data are available. In these patients criteria to deter mine weaning ability or which measurements to follow are not clearly defined. Furthermore, no controlled trials are available to compare the differ ent weaning techniques proposed. In this article we first address routine weaning of the patient who has not required prolonged ventilator support. We then examine the difficult-to-wean patient and dis cuss criteria to begin the weaning process, poten tial causes of failure to wean, and available weaning techniques.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68923/2/10.1177_088506668800300207.pd

Planetary radio astronomy observations from Voyager-2 near Saturn

Voyager-2 planetry radio astronomy measurements obtained near Saturn are discussed. They indicate that Saturnian kilometric radiation is emitted by a strong, dayside source at auroral latitudes in the northern hemisphere and by a weaker (by more than an order of magnitude) source at complementary latitudes in the southern hemisphere. These emissions are variable both due to Saturn's rotation and, on longer time scales, probably due to influences of the solar wind and the satellite Dione. The Saturn electrostatic discharge bursts first discovered by Voyager-1 and attributed to emissions from the B-ring were again observed with the same broadband spectral properties and a 10(h)11(m) + or - 5(m) episodic recurrence period but with an occurrence frequency of only of about 30 percent of that detected with Voyager-1. During the crossing of the ring plane at a distance of 2.88 R sub S, an intense noise event is interpreted to be consequence of the impact/vaporization/ionization of charged micron-size G-ring particles distributed over a total vertical thickness of about 1500 km

A Blind Search for Magnetospheric Emissions from Planetary Companions to Nearby Solar-type Stars

This paper reports a blind search for magnetospheric emissions from planets around nearby stars. Young stars are likely to have much stronger stellar winds than the Sun, and because planetary magnetospheric emissions are powered by stellar winds, stronger stellar winds may enhance the radio luminosity of any orbiting planets. Using various stellar catalogs, we selected nearby stars (<~ 30 pc) with relatively young age estimates (< 3 Gyr). We constructed different samples from the stellar catalogs, finding between 100 and several hundred stars. We stacked images from the 74-MHz (4-m wavelength) VLA Low-frequency Sky Survey (VLSS), obtaining 3\sigma limits on planetary emission in the stacked images of between 10 and 33 mJy. These flux density limits correspond to average planetary luminosities less than 5--10 x 10^{23} erg/s. Using recent models for the scaling of stellar wind velocity, density, and magnetic field with stellar age, we estimate scaling factors for the strength of stellar winds, relative to the Sun, in our samples. The typical kinetic energy carried by the stellar winds in our samples is 15--50 times larger than that of the Sun, and the typical magnetic energy is 5--10 times larger. If we assume that every star is orbited by a Jupiter-like planet with a luminosity larger than that of the Jovian decametric radiation by the above factors, our limits on planetary luminosities from the stacking analysis are likely to be a factor of 10--100 above what would be required to detect the planets in a statistical sense. Similar statistical analyses with observations by future instruments, such as the Low Frequency Array (LOFAR) and the Long Wavelength Array (LWA), offer the promise of improvements by factors of 10--100.Comment: 11 pages; AASTeX; accepted for publication in A

Nanodust detection near 1 AU from spectral analysis of Cassini/RPWS radio data

Nanodust grains of a few nanometer in size are produced near the Sun by collisional break-up of larger grains and picked-up by the magnetized solar wind. They have so far been detected at 1 AU by only the two STEREO spacecraft. Here we analyze the spectra measured by the radio and plasma wave instrument onboard Cassini during the cruise phase close to Earth orbit; they exhibit bursty signatures similar to those observed by the same instrument in association to nanodust stream impacts on Cassini near Jupiter. The observed wave level and spectral shape reveal impacts of nanoparticles at about 300 km/s, with an average flux compatible with that observed by the radio and plasma wave instrument onboard STEREO and with the interplanetary flux models

Prospective, Single-Arm, Longitudinal Study of Biomarkers in Real-World Patients with Severe Asthma

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