2,810 research outputs found
Prior conceptions of integration and coordination as modulators of an innovation's adoption: the case of a pilot project targeting the implementation of a services' integration device in France
Implementing an evidence-based integration model in France to maintain independence: Project and Research on Integration of Services to Maintain the Autonomy (PRISMA)
Scintigraphie isotopique couplée au scanner : intérêt dans le diagnostic de dysfonctionnement de pompe à baclofène
Is there a way to measure implementation of integration in different countries? The case of the PRISMA implementation qualitative methodology
Experimental study of a fast gas-particle separator
A horizontal rapid gas-particle separator dedicated to the Fluid Catalytic Cracking process was tested on a small scale cold Circulating Fluidized Bed. Air (density 1.2 kg/m3, dynamic viscosity 1.8×10-5 Pa.s) and typical FCC particles (density 1400 kg/m3, mean diameter 70 mm) are used. The inlet gas velocity is kept constant at 7.3 m/s while the inlet solid loading and the separator dipleg back pressure range from 0 to 16 kg/kg and 100 to 500 Pa, respectively. Solid collection efficiency and pressure drop are studied. A model based on cyclone concepts is proposed. The solid collection efficiency increases with the inlet solid loading and reaches an asymptotic value close to 95 % when the inlet loading is above 5 kg/kg. Two flow regimes are observed in the separator dipleg through the range of inlet solid loadings, related to the available flow section modification and the interstitial gas entrainment. At constant gas collection efficiency, the separator pressure drop is maximum under single-phase flow conditions and reaches a minimum when the inlet solid loading is close to 2.5. The pressure drop increases again for higher inlet solid loading. The final modeling allows good prediction of the separator operation for all inlet solid loading conditions when the gas collection efficiency is at 100 %
Dark Matter Directionality Detection performance of the Micromegas-based TPC-MIMAC detector
Directional Dark Matter Detection (DDMD) can open a new signature for Weakly
Massive Interacting Particles (WIMPs) Dark Matter. The directional signature
provides in addition, an unique way to overcome the neutron and neutrino
backgrounds. In order to get the directional signature, the DDM detectors
should be sensitive to low nuclear energy recoils in the keV range and have an
angular resolution better than . We have performed experiments with
low energy () ion beam facilities to measure the angular
distribution of nuclear recoil tracks in a MIMAC detector prototype. In this
paper, we study angular spreads with respect to the electron drift direction
( incident angle) of Fluorine nuclear tracks in this low energy
range, and show nuclear recoil angle reconstruction produced by a monoenergetic
neutron field experiment. We find that a high-gain systematic effect leads to a
high angular resolution along the electron drift direction. The measured
angular distribution is impacted by diffusion, and space charge or ion feedback
effects, which can be corrected for by an asymmetry factor observed in the
flash-ADC profile. The estimated angular resolution of the incident
ion is better than at keV kinetic energy and agrees with the
simulations within %. The distributions from the nuclear recoils have been
compared with simulated results based on a modified Garfield++ code. Our study
shows that protons would be a more adapted target than heavier nuclei for DDMD
of light WIMPs. We demonstrate that directional signature from the Galactic
halo origin of a Dark Matter WIMP signal is experimentally achievable, with a
deep understanding of the operating conditions of a low pressure detector with
its diffusion mechanism.Comment: 19 pages, 12 figure
A proposal for a high performance -camera based on liquid Xenon converter and gaseous photomultiplier for PET
présenté par D. Ther
Apport de la TEP-FDG dans le staging initial des cancers du sein localement avancés traités par chimiothérapie néo-adjuvante
L’atteinte ganglionnaire axillaire et la présence de métastases à distance sont des facteurs pronostiques majeurs dans la prise en charge du cancer du sein. L’objectif de notre travail a été d’évaluer les performances de la TEP-FDG dans le bilan initial de cancers du sein localement avancés (CSLA) traités par chimiothérapie néo-adjuvante (CNA) et chirurgie, et de comparer les données de la TEP préthérapeutique à celles de l’histologie du curage réalisé après CNA (classification de Sataloff). Cette étude rétrospective a concerné 89 patientes porteuses d’un CSLA, explorées avant mise en route de la CNA par une TEP en complément du bilan d’extension standard (BS). Toutes les patientes ont bénéficié après CNA d’une tumorectomie/mastectomie et d’un curage axillaire. Une atteinte axillaire a été retrouvée chez 58 patientes (65 %) par la TEP et 39 patientes (44 %) par le BS. Comparées à l’histologie du curage axillaire post-CNA, les sensibilité et spécificité de la TEP ont été calculées à 80 % et 63 %. La TEP a révélé une atteinte ganglionnaire extra-axillaire, non suspectée par le BS, chez 25 patientes (28 %). Des lésions métastatiques méconnues par le BS ont été découvertes au niveau osseux chez deux patientes et pulmonaire chez une patiente. Un cas de faux-positif TEP hépatique a été observé (adénomatose). Cette étude confirme l’intérêt de la TEP dans le staging initial des CSLA, notamment au niveau ganglionnaire extra-axillaire. Au niveau axillaire, une TEP positive suggère fortement une atteinte métastatique ; les cas d’interprétation douteuse incitant à réaliser en complément une cytoponction échoguidée
Rapid cognitive decline, one-year institutional admission and one-year mortality: Analysis of the ability to predict and inter-tool agreement of four validated clinical frailty indexes in the safes cohort
Objectives: To evaluate the predictive ability of four clinical frailty indexes as regards one-year rapid cognitive decline (RCD — defined as the loss of at least 3 points on the MMSE score), and one-year institutional admission (IA) and mortality respectively; and to measure their agreement for identifying groups at risk of these severe outcomes. Design: One-year follow-up and multicentre study of old patients participating in the SAFEs cohort study. Setting: Nine university hospitals in France. Participants: 1,306 patients aged 75 or older (mean age 85±6 years; 65% female) hospitalized in medical divisions through an Emergency department. Measurements: Four frailty indexes (Winograd; Rockwood; Donini; and Schoevaerdts) reflecting the multidimensionality of the frailty concept, using an ordinal scoring system able to discriminate different grades of frailty, and constructed based on the accumulation of identified deficits after comprehensive geriatric assessment conducted during the first week of hospital stay, were used to categorize participants into three different grades of frailty: Gl — not frail; G2 — moderately frail; and G3 — severely frail. Comparisons between groups were performed using Fisher's exact test. Agreement between indexes was evaluated using Cohen's Kappa coefficient. Results: All patients were classified as frail by at least one of the four indexes. The Winograd and Rockwood indexes mainly classified subjects as G2 (85% and 96%), and the Donini and Schoevaerdts indexes mainly as G3 (71% and 67%). Among the SAFEs cohort population, 250, 1047 and 1,306 subjects were eligible for analyses of predictability for RCD, 1-year IA and 1-year mortality respectively. At 1 year, 84 subjects (34%) experienced RCD, 377 (36%) were admitted into an institutional setting, and 445 (34%) had died With the Rockwood index, all subjects who expenenced RCD were classified in G2; and in G2 and G3 when the Donini and Schoevaerdts indexes were used No significant difference was found between frailty grade and RCD, whereas frailty grade was significantly associated with an increased risk of IA and death, whatever the frailty index considered. Agreement between the different indexes of frailty was poor with Kappa coefficients ranging from −0.02 to 0.15. Conclusion: These findings confirm the poor clinimetric properties of these current indexes to measure frailty, underlining the fact that further work is needed to develop a better and more widely-accepted definition of frailty and therefore a better understanding of its pathophysiolog
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