281 research outputs found
Le contrÎle d'un jet d'air rectangulaire via l'introduction de cylindres animés d'un mouvement de rotation
L'idée à l'origine de l'étude est de modifier la structure d'un écoulement pour transformer cet écoulement convectivement instable en un écoulement globalement instable. Les jets globalement instables montrent un taux
d'expansion plus élevé que les jets homogÚnes convectivement instables. Une simulation numérique a montré que le forçage, d'un jet convectivement instable, au moyen de sources de vorticité contrÎlées, conduisait à une augmentation du mélange. Notre étude vise à réaliser un montage expérimental équivalent afin de confirmer les premiers résultats observés
Repenser l'accÚs des soins de fin de vie chez les mineurs : pour une plus grande autonomie des droits et libertés fondamentaux
Au Canada, une personne souhaitant bĂ©nĂ©ficier de lâaide mĂ©dicale Ă mourir doit ĂȘtre ĂągĂ©e minimalement de 18 ans et ĂȘtre apte Ă consentir. Ăgalement, cette personne doit rencontrer les critĂšres lĂ©gaux dont ceux de souffrir physiquement ou psychologiquement dâune maladie grave et incurable laquelle se caractĂ©rise par un dĂ©clin avancĂ© et irrĂ©versible de ses capacitĂ©s. Dans la mesure oĂč les mineurs, dotĂ©s de droits et libertĂ©s individuels, peuvent eux aussi Ă©prouver des souffrances constantes et insupportables en raison dâune maladie grave et incurable, nous pouvons raisonnablement nous questionner Ă savoir pourquoi le lĂ©gislateur a choisi de fixer un Ăąge limite pour bĂ©nĂ©ficier dâun tel soin. Pour rĂ©pondre Ă cette question dĂ©licate, lâauteure analysera le cadre juridique applicable aux mineurs et aux majeurs en matiĂšre de soins de fin de vie, et ce, tant Ă lâĂ©chelle nationale quâinternationale, en sâappuyant plus particuliĂšrement sur lâexemple de la Belgique et les Pays-Bas. Ensuite, sous lâangle dâune perspective judiciaire et des droits fondamentaux existants, lâauteure proposera une esquisse de solution possible
Excellent Adherence to Antiretrovirals in HIV+ Zambian Children Is Compromised by Disrupted Routine, HIV Nondisclosure, and Paradoxical Income Effects
INTRODUCTION: A better understanding of pediatric antiretroviral therapy (ART) adherence in sub-Saharan Africa is necessary to develop interventions to sustain high levels of adherence. METHODOLOGY/PRINCIPAL FINDINGS: Adherence among 96 HIV-infected Zambian children (median age 6, interquartile range [IQR] 2,9) initiating fixed-dose combination ART was measured prospectively (median 23 months; IQR 20,26) with caregiver report, clinic and unannounced home-based pill counts, and medication event monitoring systems (MEMS). HIV-1 RNA was determined at 48 weeks. Child and caregiver characteristics, socio-demographic status, and treatment-related factors were assessed as predictors of adherence. Median adherence was 97.4% (IQR 96.1,98.4%) by visual analog scale, 94.8% (IQR 86,100%) by caregiver-reported last missed dose, 96.9% (IQR 94.5,98.2%) by clinic pill count, 93.4% (IQR 90.2,96.7%) by unannounced home-based pill count, and 94.8% (IQR 87.8,97.7%) by MEMS. At 48 weeks, 72.6% of children had HIV-1 RNA <50 copies/ml. Agreement among adherence measures was poor; only MEMS was significantly associated with viral suppression (pâ=â0.013). Predictors of poor adherence included changing residence, school attendance, lack of HIV disclosure to children aged nine to 15 years, and increasing household income. CONCLUSIONS/SIGNIFICANCE: Adherence among children taking fixed-dose combination ART in sub-Saharan Africa is high and sustained over two years. However, certain groups are at risk for treatment failure, including children with disrupted routines, no knowledge of their HIV diagnosis among older children, and relatively high household income, possibly reflecting greater social support in the setting of greater poverty
Multiple Measures Reveal Antiretroviral Adherence Successes and Challenges in HIV-Infected Ugandan Children
Background: Adherence to HIV antiretroviral therapy (ART) among children in developing settings is poorly understood. Methodology/Principal Findings: To understand the level, distribution, and correlates of ART adherence behavior, we prospectively determined monthly ART adherence through multiple measures and six-monthly HIV RNA levels among 121 Ugandan children aged 2â10 years for one year. Median adherence levels were 100% by three-day recall, 97.4% by 30-day visual analog scale, 97.3% by unannounced pill count/liquid formulation weights, and 96.3% by medication event monitors (MEMS). Interruptions in MEMS adherence of 48 hours were seen in 57.0% of children; 36.3% had detectable HIV RNA at one year. Only MEMS correlated significantly with HIV RNA levels (r = â0.25, p = 0.04). Multivariable regression found the following to be associated with <90% MEMS adherence: hospitalization of child (adjusted odds ratio [AOR] 3.0, 95% confidence interval [CI] 1.6â5.5; p = 0.001), liquid formulation use (AOR 1.4, 95%CI 1.0â2.0; p = 0.04), and caregiverâs alcohol use (AOR 3.1, 95%CI 1.8â5.2; p<0.0001). Childâs use of co-trimoxazole (AOR 0.5, 95%CI 0.4â0.9; p = 0.009), caregiverâs use of ART (AOR 0.6, 95%CI 0.4â0.9; p = 0.03), possible caregiver depression (AOR 0.6, 95%CI 0.4â0.8; p = 0.001), and caregiver feeling ashamed of childâs HIV status (AOR 0.5, 95%CI 0.3â0.6; p<0.0001) were protective against <90% MEMS adherence. Change in drug manufacturer (AOR 4.1, 95%CI 1.5â11.5; p = 0.009) and caregiverâs alcohol use (AOR 5.5, 95%CI 2.8â10.7; p<0.0001) were associated with 48-hour interruptions by MEMS, while second-line ART (AOR 0.3, 95%CI 0.1â0.99; p = 0.049) and increasing assets (AOR 0.7, 95%CI 0.6â0.9; p = 0.0007) were protective against these interruptions. Conclusions/Significance: Adherence success depends on a well-established medication taking routine, including caregiver support and adequate education on medication changes. Caregiver-reported depression and shame may reflect fear of poor outcomes, functioning as motivation for the child to adhere. Further research is needed to better understand and build on these key influential factors for adherence intervention development
DMTs and Covid-19 severity in MS: a pooled analysis from Italy and France
We evaluated the effect of DMTs on Covid-19 severity in patients with MS, with a pooled-analysis of two large cohorts from Italy and France. The association of baseline characteristics and DMTs with Covid-19 severity was assessed by multivariate ordinal-logistic models and pooled by a fixed-effect meta-analysis. 1066 patients with MS from Italy and 721 from France were included. In the multivariate model, anti-CD20 therapies were significantly associated (OR = 2.05, 95%CI = 1.39â3.02, p < 0.001) with Covid-19 severity, whereas interferon indicated a decreased risk (OR = 0.42, 95%CI = 0.18â0.99, p = 0.047). This pooled-analysis confirms an increased risk of severe Covid-19 in patients on anti-CD20 therapies and supports the protective role of interferon
Les droits disciplinaires des fonctions publiques : « unification », « harmonisation » ou « distanciation ». A propos de la loi du 26 avril 2016 relative à la déontologie et aux droits et obligations des fonctionnaires
The production of tt⟠, W+bb⟠and W+cc⟠is studied in the forward region of protonâproton collisions collected at a centre-of-mass energy of 8 TeV by the LHCb experiment, corresponding to an integrated luminosity of 1.98±0.02 fbâ1 . The W bosons are reconstructed in the decays WââÎœ , where â denotes muon or electron, while the b and c quarks are reconstructed as jets. All measured cross-sections are in agreement with next-to-leading-order Standard Model predictions.The production of , and is studied in the forward region of proton-proton collisions collected at a centre-of-mass energy of 8 TeV by the LHCb experiment, corresponding to an integrated luminosity of 1.98 0.02 \mbox{fb}^{-1}. The bosons are reconstructed in the decays , where denotes muon or electron, while the and quarks are reconstructed as jets. All measured cross-sections are in agreement with next-to-leading-order Standard Model predictions
Effects of eight neuropsychiatric copy number variants on human brain structure
Many copy number variants (CNVs) confer risk for the same range of neurodevelopmental symptoms and psychiatric conditions including autism and schizophrenia. Yet, to date neuroimaging studies have typically been carried out one mutation at a time, showing that CNVs have large effects on brain anatomy. Here, we aimed to characterize and quantify the distinct brain morphometry effects and latent dimensions across 8 neuropsychiatric CNVs. We analyzed T1-weighted MRI data from clinically and non-clinically ascertained CNV carriers (deletion/duplication) at the 1q21.1 (nâ=â39/28), 16p11.2 (nâ=â87/78), 22q11.2 (nâ=â75/30), and 15q11.2 (nâ=â72/76) loci as well as 1296 non-carriers (controls). Case-control contrasts of all examined genomic loci demonstrated effects on brain anatomy, with deletions and duplications showing mirror effects at the global and regional levels. Although CNVs mainly showed distinct brain patterns, principal component analysis (PCA) loaded subsets of CNVs on two latent brain dimensions, which explained 32 and 29% of the variance of the 8 Cohenâs d maps. The cingulate gyrus, insula, supplementary motor cortex, and cerebellum were identified by PCA and multi-view pattern learning as top regions contributing to latent dimension shared across subsets of CNVs. The large proportion of distinct CNV effects on brain morphology may explain the small neuroimaging effect sizes reported in polygenic psychiatric conditions. Nevertheless, latent gene brain morphology dimensions will help subgroup the rapidly expanding landscape of neuropsychiatric variants and dissect the heterogeneity of idiopathic conditions
Observation of the B0 â Ï0Ï0 decay from an amplitude analysis of B0 â (Ï+Ïâ)(Ï+Ïâ) decays
Protonâproton collision data recorded in 2011 and 2012 by the LHCb experiment, corresponding to an integrated luminosity of 3.0 fbâ1 , are analysed to search for the charmless B0âÏ0Ï0 decay. More than 600 B0â(Ï+Ïâ)(Ï+Ïâ) signal decays are selected and used to perform an amplitude analysis, under the assumption of no CP violation in the decay, from which the B0âÏ0Ï0 decay is observed for the first time with 7.1 standard deviations significance. The fraction of B0âÏ0Ï0 decays yielding a longitudinally polarised final state is measured to be fL=0.745â0.058+0.048(stat)±0.034(syst) . The B0âÏ0Ï0 branching fraction, using the B0âÏKâ(892)0 decay as reference, is also reported as B(B0âÏ0Ï0)=(0.94±0.17(stat)±0.09(syst)±0.06(BF))Ă10â6
Measurement of the (eta c)(1S) production cross-section in proton-proton collisions via the decay (eta c)(1S) -> p(p)over-bar
The production of the state in proton-proton collisions is probed via its decay to the final state with the LHCb detector, in the rapidity range GeV/c. The cross-section for prompt production of mesons relative to the prompt cross-section is measured, for the first time, to be at a centre-of-mass energy TeV using data corresponding to an integrated luminosity of 0.7 fb, and at TeV using 2.0 fb. The uncertainties quoted are, in order, statistical, systematic, and that on the ratio of branching fractions of the and decays to the final state. In addition, the inclusive branching fraction of -hadron decays into mesons is measured, for the first time, to be , where the third uncertainty includes also the uncertainty on the inclusive branching fraction from -hadron decays. The difference between the and meson masses is determined to be MeV/c.The production of the state in proton-proton collisions is probed via its decay to the final state with the LHCb detector, in the rapidity range . The cross-section for prompt production of mesons relative to the prompt cross-section is measured, for the first time, to be at a centre-of-mass energy using data corresponding to an integrated luminosity of 0.7Â fb , and at using 2.0Â fb . The uncertainties quoted are, in order, statistical, systematic, and that on the ratio of branching fractions of the and decays to the final state. In addition, the inclusive branching fraction of -hadron decays into mesons is measured, for the first time, to be , where the third uncertainty includes also the uncertainty on the inclusive branching fraction from -hadron decays. The difference between the and meson masses is determined to be .The production of the state in proton-proton collisions is probed via its decay to the final state with the LHCb detector, in the rapidity range GeV/c. The cross-section for prompt production of mesons relative to the prompt cross-section is measured, for the first time, to be at a centre-of-mass energy TeV using data corresponding to an integrated luminosity of 0.7 fb, and at TeV using 2.0 fb. The uncertainties quoted are, in order, statistical, systematic, and that on the ratio of branching fractions of the and decays to the final state. In addition, the inclusive branching fraction of -hadron decays into mesons is measured, for the first time, to be , where the third uncertainty includes also the uncertainty on the inclusive branching fraction from -hadron decays. The difference between the and meson masses is determined to be MeV/c
A study of CP violation in B-+/- -> DK +/- and B-+/- -> D pi(+/-) decays with D -> (KSK +/-)-K-0 pi(-/+) final states
A first study of CP violation in the decay modes and , where labels a or meson and labels a or meson, is performed. The analysis uses the LHCb data set collected in collisions, corresponding to an integrated luminosity of 3 fb. The analysis is sensitive to the CP-violating CKM phase through seven observables: one charge asymmetry in each of the four modes and three ratios of the charge-integrated yields. The results are consistent with measurements of using other decay modes
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