Impact de l’évaluation de la sédation sur la durée de ventilation mécanique en réanimation pédiatrique [Impact of sedation assessment on duration of mechanical ventilation in pediatric intensive care]

French Abstract: Introduction-La sédation et l’analgésie en réanimation pédiatrique doivent assurer le confort et la sécurité des enfants ventilés. En réanimation, l’évaluation de la sédation était faite par l’échelle comportementale Comfort Behavior. L’objectif de l’étude était d’évaluer les effets de l’implémentation d’un algorithme de la sédation sur la durée de ventilation mécanique. Méthodes-Il s’agit d’une étude comparative monocentrique d’évaluation des pratiques de type avant-après, menée au niveau du service de réanimation pédiatrique de l’hôpital pédiatrique de Canastel d’Oran. L’étude comparative s’est déroulée sur deux périodes, la premièrede 2014 à 2016, sans protocole d’évaluation de la sédation et la deuxième, de 2017 à 2019, après introduction d’un protocole d’évaluation dela sédation basée sur l’échelle COMFORT-CB. Ont été inclus dans l’étude tous les enfants de moins de 15 ans, ventilés et sédatés pendant une durée égale ou supérieure à 24 heures. Pour chaque enfant, nous avons recueilli les donnéesdémographiques, lapathologie,le score de gravité, les doses moyennes d’hypnotiques et d’analgésiques, les durées de ventilation et de séjour. Résultats-Soixante et onze enfants ont été inclus dans l’étude après implémentation de l’échelle d’évaluation et 41 enfants «avant».Les pathologies pour lesquelles la sédation était indiquée étaient d’origine traumatique (32%) et neurologique (30%). Le nombre moyen d’évaluation du CB par patient et par hospitalisation était 11,8±5 dans l’étude « après». Le score CB à la phase « après» était une sédation adéquate dans (71,1%); une sédation légère (16,9%) et une sédation profonde (12%). La durée de la ventilation mécanique était significativement plus longue sans évaluation (5,9±2,9 jours versus 3,4±1,5 jours après évaluation; p=0,001).Les doses moyennes d’hypnotiques et d’analgésiques n’étaient pas significativement différentes Conclusion-l’utilisation d’une échelle d’évaluation COMFORT B a permis une diminution de la durée de la ventilation mécanique sans modifications des doses d’hypnotiques et d’analgésiques. English Abstract: Introduction-Sedation and analgesia should optimize the comfort and safety of children hospitalized In the intensive care unit (ICU).The objective of this study is to evaluate the effects of the implementation of an adaptive sedation algorithm on the duration of mechanical ventilation. Methods-: This is a monocentric comparative study of before- and-after practice evaluations,conducted in the paediatric intensive care unit of the Canastel paediatric hospital in Oran.The comparative study was conducted over two periods, the first from 2014 to 2016 without a sedation assessment protocol and the second from 2017 to 2019 after the introduction of a sedation assessment protocol based on the COMFORT-B scale. All children under 15 years of age who were ventilated and sedated for 24 hours or more were included in the study. For a child we collected demographic data, pathology, severity score, means doses of hypnotics and analgesics, ventilation and length of stay. Results-We included 71 children in the study "after" implementation of sedation scale and 41Children "before". The conditions for which sedation was indicated were traumatic (32%) and Neurological (30%).The average number of CB assessments per day was 11.8±5 "after". The CB score at the "after" phase was adequate sedation in (71.1%); mild sedation (16.9%) and deep sedation (12%). The duration of mechanical ventilation was 5,9±2,9 days without assessment versus 3,4±1,5 days after assessment. The average doses of hypnotics and analgesics were not significantly different. Conclusion-The use of a COMFORT B sedation scale allowed a reduction in the duration of mechanical ventilation with no change in the doses of hypnotics and analgesics

Impact de l’évaluation de la sédation sur la durée de ventilation mécanique en réanimation pédiatrique [Impact of sedation assessment on duration of mechanical ventilation in pediatric intensive care]

French Abstract: Introduction-La sédation et l’analgésie en réanimation pédiatrique doivent assurer le confort et la sécurité des enfants ventilés. En réanimation, l’évaluation de la sédation était faite par l’échelle comportementale Comfort Behavior. L’objectif de l’étude était d’évaluer les effets de l’implémentation d’un algorithme de la sédation sur la durée de ventilation mécanique. Méthodes-Il s’agit d’une étude comparative monocentrique d’évaluation des pratiques de type avant-après, menée au niveau du service de réanimation pédiatrique de l’hôpital pédiatrique de Canastel d’Oran. L’étude comparative s’est déroulée sur deux périodes, la premièrede 2014 à 2016, sans protocole d’évaluation de la sédation et la deuxième, de 2017 à 2019, après introduction d’un protocole d’évaluation dela sédation basée sur l’échelle COMFORT-CB. Ont été inclus dans l’étude tous les enfants de moins de 15 ans, ventilés et sédatés pendant une durée égale ou supérieure à 24 heures. Pour chaque enfant, nous avons recueilli les donnéesdémographiques, lapathologie,le score de gravité, les doses moyennes d’hypnotiques et d’analgésiques, les durées de ventilation et de séjour. Résultats-Soixante et onze enfants ont été inclus dans l’étude après implémentation de l’échelle d’évaluation et 41 enfants «avant».Les pathologies pour lesquelles la sédation était indiquée étaient d’origine traumatique (32%) et neurologique (30%). Le nombre moyen d’évaluation du CB par patient et par hospitalisation était 11,8±5 dans l’étude « après». Le score CB à la phase « après» était une sédation adéquate dans (71,1%); une sédation légère (16,9%) et une sédation profonde (12%). La durée de la ventilation mécanique était significativement plus longue sans évaluation (5,9±2,9 jours versus 3,4±1,5 jours après évaluation; p=0,001).Les doses moyennes d’hypnotiques et d’analgésiques n’étaient pas significativement différentes Conclusion-l’utilisation d’une échelle d’évaluation COMFORT B a permis une diminution de la durée de la ventilation mécanique sans modifications des doses d’hypnotiques et d’analgésiques. English Abstract: Introduction-Sedation and analgesia should optimize the comfort and safety of children hospitalized In the intensive care unit (ICU).The objective of this study is to evaluate the effects of the implementation of an adaptive sedation algorithm on the duration of mechanical ventilation. Methods-: This is a monocentric comparative study of before- and-after practice evaluations,conducted in the paediatric intensive care unit of the Canastel paediatric hospital in Oran.The comparative study was conducted over two periods, the first from 2014 to 2016 without a sedation assessment protocol and the second from 2017 to 2019 after the introduction of a sedation assessment protocol based on the COMFORT-B scale. All children under 15 years of age who were ventilated and sedated for 24 hours or more were included in the study. For a child we collected demographic data, pathology, severity score, means doses of hypnotics and analgesics, ventilation and length of stay. Results-We included 71 children in the study "after" implementation of sedation scale and 41Children "before". The conditions for which sedation was indicated were traumatic (32%) and Neurological (30%).The average number of CB assessments per day was 11.8±5 "after". The CB score at the "after" phase was adequate sedation in (71.1%); mild sedation (16.9%) and deep sedation (12%). The duration of mechanical ventilation was 5,9±2,9 days without assessment versus 3,4±1,5 days after assessment. The average doses of hypnotics and analgesics were not significantly different. Conclusion-The use of a COMFORT B sedation scale allowed a reduction in the duration of mechanical ventilation with no change in the doses of hypnotics and analgesics

One Bad Apple Spoils the Bunch: Exploiting P2P Applications to Trace and Profile Tor Users

Tor is a popular low-latency anonymity network. However, Tor does not protect against the exploitation of an insecure application to reveal the IP address of, or trace, a TCP stream. In addition, because of the linkability of Tor streams sent together over a single circuit, tracing one stream sent over a circuit traces them all. Surprisingly, it is unknown whether this linkability allows in practice to trace a significant number of streams originating from secure (i.e., proxied) applications. In this paper, we show that linkability allows us to trace 193% of additional streams, including 27% of HTTP streams possibly originating from "secure" browsers. In particular, we traced 9% of Tor streams carried by our instrumented exit nodes. Using BitTorrent as the insecure application, we design two attacks tracing BitTorrent users on Tor. We run these attacks in the wild for 23 days and reveal 10,000 IP addresses of Tor users. Using these IP addresses, we then profile not only the BitTorrent downloads but also the websites visited per country of origin of Tor users. We show that BitTorrent users on Tor are over-represented in some countries as compared to BitTorrent users outside of Tor. By analyzing the type of content downloaded, we then explain the observed behaviors by the higher concentration of pornographic content downloaded at the scale of a country. Finally, we present results suggesting the existence of an underground BitTorrent ecosystem on Tor

Villoglandular papillary adenocarcinoma of the uterine cervix with lymph node metastasis - A case report and review of the literature

Villoglandular papillary adenocarcinoma was first described by Young and Scully in 1989 as a distinct entity with the histological features of exophytic growth proliferation, villous and papillary architecture and mild to moderate nuclear atypia. We report one case of villoglandular papillary adenocarcinoma (VGPA) of the uterine cervix with lymph node metastasis and reviewed the clinicopathological features of six other cases reported in the literature. Our patient is the seventh similar reported cases. They ranged in age from 29 to 54 (mean, 41) years. Five had lymphovascular invasion. All except our patient were treated with radical hysterectomy and radiotherapy. She was followed-up for 7 months and unfortunately died due to chest infectio

Profil glucido-lipidique et risque cardiovasculaire chez les diabétiques de type 2

AbstractBackground-Diabetes is a real health public problem because of its many potential complications,particularly the cardiovascular ones.The aim of this work was to describe the clinicaland biological profile in type 2 diabetic population, then to study the relationship betweenglycemic control and lipid abnormalities with micro and macro vascular complications.Methods - It was about a retrospective study of 341 type 2 diabetes patients’ with an averageage of 60.1 ± 11.71 years.The IBM® SPSS statistics 20.0 software was used for analyzing data.Only significant associations (p ≤ 5%) were retained.Results -An HbA1c level ≥7% was observed in 82,5% of patients, More than 60% have dyslipidemia.52,8% of them have an LDLc level ≤ 1 g/l, and 64,4% have a Non-HDLc level >1g/l.Sixty-six percent of patients have high blood pressure. The macrovascular disorders wereobserved on 30,9% of patients and microvascular ones on 66,8% of them (p = 0.0001).Thelogistic regression analysis showed that HbA1c was the most significant biological parameter(p=0,008).while for micro-vascular complications, high blood pressure was the only associatedfactor (p = 0.03). For ischemic heart disease, dyslipidemia and high blood pressurewere the most associated factors.Conclusion - this study showed a high frequency of micro and macrovascular complications,lipid abnormalities and a very poor glycemic control. The elevation of HbA1clevel, the high blood pressure and dyslipidemia are the most associated factors with ahigh cardiovascular risk. RésuméIntroduction-Le diabète est un véritable problème de santé publique du fait deses nombreuses complications potentielles, notamment cardiovasculaires. Notreobjectif était de décrire le profil clinico-biologique chez une population de diabétiquetype 2 et d’étudier la relation entre l’équilibre glycémique et les anomalieslipidiques avec les complications micro et macroangiopathiques.Matériels et méthodes -Nous avons mené une étude rétrospective portant sur 341 patientsdiabétiques type 2.Les données ont été analysées par le logiciel IBM® SPSS statistics20.0. Seules, les associations significatives (p ≤ 5%) étaient retenues.Résultats - quatre-vingt deux pourcent et demi des patients ont un taux d’HbA1c ≥7 %.Plus de 60 % ont une dyslipidémie. Cinquante deux pourcent des patients ont un taux duLDLc ≤ 1 g/l, et 64,4 % ont un taux du Non-HDLc >1g/l. Environ 66 % des patients ont unehypertension artérielle. quarante pourcent des patients ont présenté une macroangiopathieet 66,8 % une microangiopathie (p=0,0001). L’analyse par régression logistique,a montré que l’HbA1c est le paramètre biologique le plus associé aux complicationsmacroangiopathiques (p=0,008), alors que pour les complications micro-angiopathiques,l’HTA était le seul facteur associé (p = 0,03). Pour la cardiopathie ischémique, la dyslipidémieet l’HTA étaient les facteurs les plus associés.Conclusion -Notre étude a montré une fréquence élevée des complications microet macroangiopathiques et des anomalies lipidiques, ainsi qu’un très mauvais équilibreglycémique. L’HbA1c, la dyslipidémie et l’HTA sont les facteurs les plus associés au risquecardiovasculaire

Accidents exposing blood to the staff of a hospital and university establishment in Algeria: Assessment and risk factors

Background: Accidents exposing to blood AEB represent real public health problem in healthcare establishments. The objective of our study was to estimate the frequency of AEB As at our establishment as well as the risk factors that determine their occurrence. Patients and Methods: A cross-sectional descriptive survey was conducted at a hospital university establishment over period from October 16 to December 3, 2018. The survey concerned accident exposing blood to the staff of our establishment. Data entry and analysis was carried out using Epi-Info software. Results: A clear predominance of women was noted (79.2%) among the study population with a Sex ratio equal to 0.26. The average age was 27.7 ± 6.2 years.The frequency of exposure to AEB among hospital staff was 48.5%. Needlestick injuries were the most common accident (88.3%), followed by splashing blood or body fluids (51.7%), and cutting with a sharp object (10.0%). Among the risk factors significantly associated with the occurrence of AEB, we can cite the medical profession (OR = 3.94; p<0.001), the surgical specialty (OR = 3.3; p <0.01), the male sex (OR = 3.7; p <0.01). Likewise, risk of AEB increased significantly with age (p <0.01) and professional seniority (p <0.02). Keywords: Accidents exposing blood; hospital staff; Algeria

Biosorption Study of Zn(Ii), Cu(Ii), Pb(Ii) And Cd(Ii) Ions by Palm Leaves Activated Carbon

The aim of the present study is to investigate the efficiency of palm leaves activated carbon on the removal of lead (Pb), zinc (Zn), copper (Cu), and cadmium (Cd) from the aqueous solution. The effect of various process parameters such as pH (2 – 10), initial metal ion concentration (50 – 1000 mg/L), particle size (125, 500, 800 μm), and temperature (303, 313, 323 K) was studied using batch adsorption technique. Thermodynamic parameters were also evaluated. The maximum metal ion removal efficiency of 94.5, 94.1, 87.4, and 90.7% for Pb, Cd, Zn, and Cu, respectively, was reached at an optimum pH of 5, biosorbent dosage of 1.0 g, and initial metal ion concentration of 50 ppm. The Freundlich adsorption isotherm model best described the removal of metal ions on palm leaves activated carbon with high correlation coefficients (0.98 – 1.00). The adsorption process was found to be favorable since the intensity of adsorption, n lies within 1 to 10. The adsorption capacity values were 40.0, 38.3, 38.0, and 40.00 mg/g for lead (Pb), zinc (Zn), copper (Cu), and cadmium (Cd), respectively. The metal ion adsorption was also found to be endothermic in nature. The efficiency was increased with an increase in temperature implying the process should be performed at a controlled temperatur

Unintended Memorization and Timing Attacks in Named Entity Recognition Models

Named entity recognition models (NER), are widely used for identifying named entities (e.g., individuals, locations, and other information) in text documents. Machine learning based NER models are increasingly being applied in privacy-sensitive applications that need automatic and scalable identification of sensitive information to redact text for data sharing. In this paper, we study the setting when NER models are available as a black-box service for identifying sensitive information in user documents and show that these models are vulnerable to membership inference on their training datasets. With updated pre-trained NER models from spaCy, we demonstrate two distinct membership attacks on these models. Our first attack capitalizes on unintended memorization in the NER's underlying neural network, a phenomenon NNs are known to be vulnerable to. Our second attack leverages a timing side-channel to target NER models that maintain vocabularies constructed from the training data. We show that different functional paths of words within the training dataset in contrast to words not previously seen have measurable differences in execution time. Revealing membership status of training samples has clear privacy implications, e.g., in text redaction, sensitive words or phrases to be found and removed, are at risk of being detected in the training dataset. Our experimental evaluation includes the redaction of both password and health data, presenting both security risks and privacy/regulatory issues. This is exacerbated by results that show memorization with only a single phrase. We achieved 70% AUC in our first attack on a text redaction use-case. We also show overwhelming success in the timing attack with 99.23% AUC. Finally we discuss potential mitigation approaches to realize the safe use of NER models in light of the privacy and security implications of membership inference attacks.Comment: This is the full version of the paper with the same title accepted for publication in the Proceedings of the 23rd Privacy Enhancing Technologies Symposium, PETS 202

Low-cost colorimetric setup for concentration measurement of manganese ions based on optical absorbance

This study presents a cost-effective setup for measuring the concentration of Mn2+ ions using colorimetry. The current method involves a calibration curve created with expensive and large commercial laboratory-based instruments, limiting its use in financially constrained situations. To address this issue, the study proposes a low-cost setup consisting of a light-emitting diode and photodiode that utilizes colorimetric and absorbance effects for Mn2+ concentration measurement. Mn2+ colorimetric samples were prepared using the 1-(2-pyridylazo)-2-naphthol (PAN) method with concentrations ranging from 0.2 to 1.0 mg/L. The samples were tested using the proposed setup, followed by a spectrophotometry test to determine the optimal configuration for the setup. The validity of the setup was confirmed by measuring the voltage and calculating the optical absorbance, which exhibited a good correlation with the concentration, consistent with the initial expectation. The correlation coefficient for voltage and absorbance against Mn2+ concentration was found to be 0.9976 and 0.9987, respectively, indicating good linearity and suitability as a calibration curve for Mn2+ detection and measurement. Consequently, the study’s objectives were successfully achieved, and the proposed setup is considered a viable platform for more complex applications, such as real-time monitoring activities