Calibration and validation of the STICS crop model for managing wheat irrigation in the semi-arid Marrakech/Al Haouz Plain

In the first part of this work, the shoot growth module and grain yield of the STICS crop model were calibrated and validated by using field data which was collected from irrigated winter wheat fields in the Haouz plain near Marrakech. The calibration was performed on the thermal units between the four phenological stages that control the dynamics of leaf area index and the thermal unit between emergence and the beginning of grain filling. The plant phenology was calibrated for three fields monitored during the 2002/03 season. Evaluation of the grain yields and the temporal evolution of leaf area index were done for six validation fields during 2003/04. The results showed the significant accuracy of the model in simulating these variables, and also indicated that the plants mainly suffered from lack of nitrogen. The results in the second part show the potential of crop modeling to schedule irrigation water, on the assumption that the plants were growing under optimal conditions of fertilization. In this case, the model was used to manage the time of irrigation according to a threshold for water deficit. Various simulations displayed logical trends in the relationship between the grain yield and both the amount and timing of irrigation water. These results were finally compared with those obtained from real irrigation practices. For the particular climate of 2003/04, the comparison showed that 70 mm and 40 mm of water could be saved in case of early and late sowing, respectively

C‐reactive protein assessment to predict early septic complications after laparoscopic bowel resection for endometriosis: a diagnostic study

International audienceObjective To assess the predictive value of C-reactive protein (CRP) level for early septic complications after laparoscopic bowel resection for endometriosis. Design Retrospective study using data prospectively recorded in the CIRENDO database. Setting University tertiary referral centre. Population Three hundred and three women managed by segmental resection or disc excision for colorectal endometriosis in 40 consecutive months. Methods C-reactive protein was routinely measured at postoperative days 4, 5, and 6. Bowel fistula, pelvic abscess, and pelvic infected haematoma were prospectively recorded. Main outcome measures A receiver operating characteristic (ROC) curve was built to assess the best cut off CRP value to predict early septic complications. Results The incidence of bowel fistula and pelvic abscess/infected hematoma were 2 and 7.9%, respectively. The CRP cut-off value of 100 mg/l at postoperative day 4 predicts early septic pelvic complications (sensitivity, specificity, positive and negative predictive values of, respectively, 76, 83, 30.2, and 90.4%), and the area under the curve was 0.85 (95% CI 0.78–0.92). Conclusion Postoperative CRP monitoring is useful in the prediction of early septic pelvic complications following bowel endometriosis surgery, with possible impact on the management of postoperative outcomes and hospitalisation stay

The impact of training on productivity and wages : evidence from British panel data

It is standard in the literature on training to use wages as a sufficient statistic for productivity. But there are many reasons why wages and productivity may diverge. This paper is part of a smaller literature on the effects of work-related training on direct measures of productivity. We construct a panel of British industries between 1983 and 1996 containing training, productivity and wages. Using a variety of econometric estimation techniques (including system GMM) we find that training is associated with significantly higher productivity. Raising the proportion of workers trained in an industry by one percentage point (say from the average of 10% to 11%) is associated with an increase in value added per worker of about 0.6% and an increase in wages of about 0.3%. Furthermore, we find that the magnitude of the impact of training on wages is only half as large as the impact of training on productivity, implying that the existing literature has underestimated the importance of training. We also show evidence using complementary datasets (e.g. from individuals) that is suggestive of externalities of training and imperfect competition

Lymphomatoid papulosis associated with chronic lymphocytic leukaemia/small lymphocytic lymphoma: three cases

International audienc

Extracorporeal membrane oxygenation network organisation and clinical outcomes during the COVID-19 pandemic in greater paris, france. a multicentre cohort study

Background: In the Île-de-France region (henceforth termed Greater Paris), extracorporeal membrane oxygenation (ECMO) for severe acute respiratory distress syndrome (ARDS) was considered early in the COVID-19 pandemic. We report ECMO network organisation and outcomes during the first wave of the pandemic. Methods In this multicentre cohort study, we present an analysis of all adult patients with laboratory-confirmed SARS-CoV-2 infection and severe ARDS requiring ECMO who were admitted to 17 Greater Paris intensive care units between March 8 and June 3, 2020. Central regulation for ECMO indications and pooling of resources were organised for the Greater Paris intensive care units, with six mobile ECMO teams available for the region. Details of complications (including ECMO-related complications, renal replacement therapy, and pulmonary embolism), clinical outcomes, survival status at 90 days after ECMO initiation, and causes of death are reported. Multivariable analysis was used to identify pre-ECMO variables independently associated with 90-day survival after ECMO. Findings The 302 patients included who underwent ECMO had a median age of 52 years (IQR 45−58) and Simplified Acute Physiology Score-II of 40 (31−56), and 235 (78%) of whom were men. 165 (55%) were transferred after cannulation by a mobile ECMO team. Before ECMO, 285 (94%) patients were prone positioned, median driving pressure was 18 cm H2O (14−21), and median ratio of the partial pressure of arterial oxygen to the fraction of inspired oxygen was 61 mm Hg (IQR 54−70). During ECMO, 115 (43%) of 270 patients had a major bleeding event, 27 of whom had intracranial haemorrhage; 130 (43%) of 301 patients received renal replacement therapy; and 53 (18%) of 294 had a pulmonary embolism. 138 (46%) patients were alive 90 days after ECMO. The most common causes of death were multiorgan failure (53 [18%] patients) and septic shock (47 [16%] patients). Shorter time between intubation and ECMO (odds ratio 0·91 [95% CI 0·84−0·99] per day decrease), younger age (2·89 [1·41−5·93] for ≤48 years and 2·01 [1·01−3·99] for 49–56 years vs ≥57 years), lower pre-ECMO renal component of the Sequential Organ Failure Assessment score (0·67, 0·55−0·83 per point increase), and treatment in centres managing at least 30 venovenous ECMO cases annually (2·98 [1·46–6·04]) were independently associated with improved 90-day survival. There was no significant difference in survival between patients who had mobile and on-site ECMO initiation. Interpretation Beyond associations with similar factors to those reported on ECMO for non-COVID-19 ARDS, 90-day survival among ECMO-assisted patients with COVID-19 was strongly associated with a centre's experience in venovenous ECMO during the previous year. Early ECMO management in centres with a high venovenous ECMO case volume should be advocated, by applying centralisation and regulation of ECMO indications, which should also help to prevent a shortage of resources