370 research outputs found
A Z_3-graded generalization of supermatrices
We introduce Z_3-graded objects which are the generalization of the more
familiar Z_2-graded objects that are used in supersymmetric theories and in
many models of non-commutative geometry. First, we introduce the Z_3-graded
Grassmann algebra, and we use this object to construct the Z_3-matrices, which
are the generalizations of the supermatrices. Then, we generalize the concepts
of supertrace and superdeterminant
Hypersymmetry: a Z_3-graded generalization of supersymmetry
We propose a generalization of non-commutative geometry and gauge theories
based on ternary Z_3-graded structures. In the new algebraic structures we
define, we leave all products of two entities free, imposing relations on
ternary products only. These relations reflect the action of the Z_3-group,
which may be either trivial, i.e. abc=bca=cab, generalizing the usual
commutativity, or non-trivial, i.e. abc=jbca, with j=e^{(2\pi i)/3}. The usual
Z_2-graded structures such as Grassmann, Lie and Clifford algebras are
generalized to the Z_3-graded case. Certain suggestions concerning the eventual
use of these new structures in physics of elementary particles are exposed
Emergency surgery for splenic flexure cancer: results of the SFC Study Group database
Colectomía; Mortalidad; Carcinoma del ángulo esplénicoColectomia; Mortalitat; Carcinoma de l'angle esplènicColectomy; Mortality; Splenic flexure carcinomaBackground
The effectiveness of surgical treatment for splenic flexure carcinomas (SFCs) in emergency settings remains unexplored. This study aims to compare the perioperative and long-term outcomes of different alternatives for emergency SFC resection.
Method
This multicenter retrospective study was based on the SFC Study Group database. For the present analysis, SFC patients were selected if they had received emergency surgical resection with curative intent between 2000 and 2018. Extended right colectomy (ERC), left colectomy (LC), and segmental left colectomy (SLC) were evaluated and compared.
Results
The study sample was composed of 90 SFC patients who underwent emergency ERC (n = 55, 61.1%), LC (n = 18, 20%), or SLC (n = 17, 18.9%). Bowel obstruction was the most frequent indication for surgery (n = 75, 83.3%), and an open approach was chosen in 81.1% of the patients. A higher incidence of postoperative complications was observed in the ERC group (70.9%) than in the LC (44.4%) and SLC groups (47.1%), with a significant procedure-related difference for severe postoperative complications (Dindo-Clavien ≥ III; adjusted odds ratio for ERC vs. LC:7.23; 95% CI 1.51-34.66; p = 0.013). Anastomotic leakage occurred in 8 (11.2%) patients, with no differences between the groups (p = 0.902). R0 resection was achieved in 98.9% of the procedures, and ≥ 12 lymph nodes were retrieved in 92.2% of patients. Overall and disease-free survival rates at 5 years were similar between the groups and were significantly associated with stage pT4 and the presence of synchronous metastases.
Conclusion
In the emergency setting, ERC and open surgery are the most frequently performed procedures. ERC is associated with increased odds of severe postoperative complications when compared to more conservative SFC resections. Nonetheless, all the alternatives seem to provide similar pathologic and long-term outcomes, supporting the oncological safety of more conservative resections for emergency SFCs.No authors received funding or resources in relation to this article
La médiation humaniste, pour ‘faire société’ dans la prise en charge des différends
This paper is the work of a collective, and contains multidisciplinary reflexions on a humanistic practice of mediation that was pioneered in France in 1984, and refined over 30 years of practical experience and thousands of completed mediations. This kind of mediation focuses its efforts less on the specific area of dispute, and more on the transformation of human and social relationships, thereby justifying the qualifier ‘humanistic’. The exchanges established between the mediants, made possible and facilitated by the mediator, have the core objective of rebuilding a lasting and peaceable relationship.Humanistic mediation is shown to be a tool for personal, ontological transformation – a way of supporting the deep aspirations and values which everyone needs in order to live. In social interaction it enables common ground (‘commons’) to emerge which forms the basis of a new mode of sharing; it introduces a process that is humanizing and mutually nurturing while still respecting differences. Humanistic mediation is rooted in the trans-modern beginnings of our ongoing societal transformation. By reintroducing a sense of existential solidarity which is founded more on sharing than on exchange, it offers itself as an educational tool for peace, using a civilizing pedagogy to create a humanism for our times.The process is laid out in three sequential phases, which take into account the emotions of the mediants. With often spectacular results, the process leads to a pivotal moment that allows the energy of the conflict to be redirected. The role and attitude of the mediator are precisely defined. The relationship between mediation and institutions such as justice and education is discussed. Humanistic mediation takes its place in the evolution of a justice that both repairs and restores.Cet article est la réflexion pluridisciplinaire d’un collectif sur une pratique humaniste de la médiation, introduite de façon pionnière en 1984 et affinée au cours de 30 ans d’expérience et de milliers de médiations réalisées. Ce type de médiation concentre ses efforts moins sur le différend que sur la transformation des rapports humains et sociaux, justifiant ainsi le qualificatif humaniste. Les échanges instaurés entre les médiants, rendus possibles et facilités par le médiateur, ont pour objectif essentiel de reconstruire une relation pacifiée et durable.La médiation humaniste se révèle un outil ontologique de transformation personnelle prenant appui sur les aspirations profondes et les valeurs dont chacun a besoin pour vivre. Socialement, elle permet l’émergence de communs sur lesquels fonder un nouveau mode de partage, introduisant un processus de fécondation mutuelle et d’humanisation réciproque, dans le respect des différences. La médiation humaniste s’inscrit dans les prémices trans-modernes de la transformation sociétale en cours. Réintroduisant le sens d’une solidarité existentielle, fondée plus sur le partage que sur l’échange, elle se présente comme un outil d’éducation à la paix, pédagogique et civilisateur, pour un humanisme de notre temps.Le déroulement en est explicité en trois phases successives prenant en compte les émotions des médiants et aboutissant à un retournement souvent spectaculaire qui permet de réorienter l’énergie du conflit. Le rôle et la posture du médiateur sont précisés.Le rapport aux institutions Justice et Education est discuté. La médiation humaniste s’inscrit dans une démarche de justice réparatrice et restauratrice
Optimisation de l'assemblage bois béton collé pour construire durable : identification des mécanismes d'endommagement induits par des chargements hydriques
Site web : http://imagerie-gc.univ-bpclermont.fr/La mixité bois-béton est une solution intéressante dans le domaine des ouvrages d'art pour la réalisation de ponts, et dans le domaine du bâtiment dans la confection de planchers mixtes bois-béton. Le laboratoire Navier travaille depuis plusieurs années au développement du procédé par collage appliqué aux structures mixtes bois-béton. En effet, cette technique d'assemblage permet d'assurer une connexion quasi-parfaite entre le bois et le béton, contrairement aux techniques d'assemblage usuelles (connecteurs métalliques). Les travaux présentés ici concernent plus spécifiquement les résultats obtenus grâce aux techniques de corrélation d'images 2D qui ont permis de mettre en avant les mécanismes d'endommagement au niveau de l'interface collée. Les protocoles expérimentaux sont en particulier discutés en lien avec les processus de transfert d'eau analysés par imagerie par résonance magnétique
Prevalence and correlates of prescription opioid residue injection
Abstract: BACKGROUND: There is growing evidence of intravenous administration of prescription opioids (POs) in several countries. Preparation of POs for injection may leave residues in containers and filters used by people who inject drugs and may lead to adverse health outcomes if they are injected. METHODS: This exploratory study used cross-sectional data from the COSMO study, a prospective cohort of out-of-treatment cocaine users carried out in Montréal (Canada) between October 2010 and August 2015. For this analysis, only one visit per participant was selected, that is, the first time the participant reported PO injection during the study. The outcome of interest, "injection of PO residues", was defined as having injected PO residues from a filter and/or a container in the last month. Correlates of this outcome were identified using logistic regression analyses. RESULTS: Of the 122 participants who reported PO injection during the study period, 41.8% had injected PO residues. Reporting an unstable source of income (AOR=4.26; 95% CI: 1.03-17.69), a recent overdose (AOR=5.45; 95% CI: 1.50-19.88) and a preponderant use of opiates (mostly opiate use versus other drugs excluding alcohol and cannabis) (AOR=2.46; 95% CI: 1.08-5.63) increased the risk of PO residue injection. The odds of reporting PO residue injection rose by 7% per unit increase in the score of psychological distress (AOR=1.07 per unit increase; 95% CI: 1.01-1.12). CONCLUSIONS: The findings of this study suggest that PO residue injection is associated with markers of vulnerability. Further investigation is needed in order to better understand this understudied drug injection practice
Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis
BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London
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