Gender differences in hospital mortality and use of percutaneous coronary intervention in acute myocardial infarction : microsimulation analysis of the 1999 nationwide french hospitals database.

Background— Women with acute myocardial infarction have a higher hospital mortality rate than men. This difference has been ascribed to their older age, more frequent comorbidities, and less frequent use of revascularization. The aim of this study is to assess these factors in relation to excess mortality in women. Methods and Results— All hospital admissions in France with a discharge diagnosis of acute myocardial infarction were extracted from the national payment database. Logistic regression on mortality was performed for age, comorbidities, and coronary interventions. Nonparametric microsimulation models estimated the percutaneous coronary intervention and mortality rates that women would experience if they were "treated like men." Data were analyzed from 74 389 patients hospitalized with acute myocardial infarction, 30.0% of whom were women. Women were older (75 versus 63 years of age; Pacute myocardial infarction gender; revascularization; mortality;

Optimisation de la gestion de l'énergie sur un site pétrochimique complexe

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L’impact de la supply chain sur les métiers de la logistique et des achats

International audienceCet article analyse l'impact d'une démarche supply chain sur les métiers de la logistique et des achats. Il aborde le cheminement qui a conduit les entreprises à décloisonner les fonctions, les questions que cela soulève et les conséquences sur les ressources humaines. Une étude qualitative menée auprès de 46 entreprises de secteurs variés montre que la majorité des entreprises a adopté ou est en train d'adopter le supply chain management. Il apparaît que la logistique et les achats sont des composantes clefs de la supply chain mais que le décloisonnement des fonctions n'est pas exhaustif, les achats se situant à l'extérieur de la supply chain et dépassant cette problématique. En revanche, il semble qu'il y ait un intérêt réel à conjuguer la compétence logistique et la compétence achats pour gérer la supply chain. Cet élargissement demande de développer des compétences liées au leadership pour l'animation d'équipes « trans-fonctionnelles ». La compréhension de la vision stratégique des affaires et des habilités en termes de communication sont également nécessaires

Gender Differences in Hospital Mortality and Use of Percutaneous Coronary Intervention in Acute Myocardial Infarction. Microsimulation Analysis of the 1999 Nationwide French Hospitals Database

The difference in mortality rate between men and women with acute myocardial infarction is due largely to the different age structure of these populations. However, age-adjusted hospital mortality was higher for women and was associated with a lower rate of percutaneous coronary intervention. Simulations suggest that women would derive benefit from more frequent use of percutaneous coronary intervention, although these procedures appear less protective in women than in men

Silicon on Nothing Mems Electromechanical Resonator

The very significant growth of the wireless communication industry has spawned tremendous interest in the development of high performances radio frequencies (RF) components. Micro Electro Mechanical Systems (MEMS) are good candidates to allow reconfigurable RF functions such as filters, oscillators or antennas. This paper will focus on the MEMS electromechanical resonators which show interesting performances to replace SAW filters or quartz reference oscillators, allowing smaller integrated functions with lower power consumption. The resonant frequency depends on the material properties, such as Young's modulus and density, and on the movable mechanical structure dimensions (beam length defined by photolithography). Thus, it is possible to obtain multi frequencies resonators on a wafer. The resonator performance (frequency, quality factor) strongly depends on the environment, like moisture or pressure, which imply the need for a vacuum package. This paper will present first resonator mechanisms and mechanical behaviors followed by state of the art descriptions with applications and specifications overview. Then MEMS resonator developments at STMicroelectronics including FEM analysis, technological developments and characterization are detailed.Comment: Submitted on behalf of EDA Publishing Association (http://irevues.inist.fr/EDA-Publishing

Une méthode de transformation de programmes applicable à la systolisation

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Cytotoxicity and oxidative stress induced by different metallic nanoparticles on human kidney cells

<p>Abstract</p> <p>Background</p> <p>Some manufactured nanoparticles are metal-based and have a wide variety of applications in electronic, engineering and medicine. Until now, many studies have described the potential toxicity of NPs on pulmonary target, while little attention has been paid to kidney which is considered to be a secondary target organ. The objective of this study, on human renal culture cells, was to assess the toxicity profile of metallic nanoparticles (TiO₂, ZnO and CdS) usable in industrial production. Comparative studies were conducted, to identify whether particle properties impact cytotoxicity by altering the intracellular oxidative status.</p> <p>Results</p> <p>Nanoparticles were first characterized by size, surface charge, dispersion and solubility. Cytotoxicity of NPs was then evaluated in IP15 (glomerular mesangial) and HK-2 (epithelial proximal) cell lines. ZnO and CdS NPs significantly increased the cell mortality, in a dose-dependent manner. Cytotoxic effects were correlated with the physicochemical properties of NPs tested and the cell type used. Analysis of reactive oxygen species and intracellular levels of reduced and oxidized glutathione revealed that particles induced stress according to their composition, size and solubility. Protein involved in oxidative stress such as NF-κb was activated with ZnO and CdS nanoparticles. Such effects were not observed with TiO₂nanoparticles.</p> <p>Conclusion</p> <p>On glomerular and tubular human renal cells, ZnO and CdS nanoparticles exerted cytotoxic effects that were correlated with metal composition, particle scale and metal solubility. ROS production and oxidative stress induction clearly indicated their nephrotoxic potential.</p

Qualification sanitaire des troupeaux, représentations du risque selon les acteurs et les disciplines

La qualification sanitaire vise à établir de manière objective et fiable le statut sanitaire d'un animal ou d'un ensemble d'animaux au regard d'une maladie infectieuse. Concevoir une qualification sanitaire repose sur des connaissances biologiques concernant l'agent pathogène, ses voies de transmission et les moyens de détection de la maladie. Les modèles mathématiques et les outils statistiques et probabilistes permettent d'intégrer ces connaissances tout en prenant en compte l'incertitude et la variabilité des données biologiques. Les sciences humaines apportent un éclairage sur les enjeux, les perceptions et les logiques des individus et des collectifs, afin d'étudier la demande et l'acceptabilité de la qualification sanitaire. Chaque discipline apporte ainsi son point de vue sur la notion de risque sous-jacente à la démarche de qualification. Cette approche interdisciplinaire nécessite une coconstruction de la recherche, qui doit dépasser les différences culturelles et épistémologiques entre disciplines. Elle n'obéit pas à un seul type de rationalité, scientifique ou juridico-administrative ; elle mobilise nécessairement des connaissances savantes et des savoirs empiriques et dépend de nombreuses décisions pouvant engendrer convergences ou contradictions. (Résumé d'auteur

Disease characteristics, effectiveness, and safety of vestronidase alfa for the treatment of patients with mucopolysaccharidosis VII in a novel, longitudinal, multicenter disease monitoring program

Background: Mucopolysaccharidosis VII (MPS VII) is an ultra-rare, autosomal recessive, debilitating, progressive lysosomal storage disease caused by reduced activity of β-glucuronidase (GUS) enzyme. Vestronidase alfa (recombinant human GUS) intravenous enzyme replacement therapy is an approved treatment for patients with MPS VII. Methods: This disease monitoring program (DMP) is an ongoing, multicenter observational study collecting standardized real-world data from patients with MPS VII (N ≈ 50 planned) treated with vestronidase alfa or any other management approach. Data are monitored and recorded in compliance with Good Clinical Practice guidelines and planned interim analyses of captured data are performed annually. Here we summarize the safety and efficacy outcomes as of 17 November 2022. Results: As of the data cutoff date, 35 patients were enrolled: 28 in the Treated Group and seven in the Untreated Group. Mean (SD) age at MPS VII diagnosis was 4.5 (4.0) years (range, 0.0 to 12.4 years), and mean (SD) age at DMP enrollment was 13.9 (11.1) years (range, 1.5 to 50.2 years). Ten patients (29%) had a history of nonimmune hydrops fetalis. In the 23 patients who initiated treatment prior to DMP enrollment, substantial changes in mean excretion from initial baseline to DMP enrollment were observed for the three urinary glycosaminoglycans (uGAGs): dermatan sulfate (DS), -84%; chondroitin sulfate (CS), -55%; heparan sulfate (HS), -42%. Also in this group, mean reduction from initial baseline to months 6, 12, and 24 were maintained for uGAG DS (-84%, -87%, -89%, respectively), CS (-70%, -71%, -76%, respectively), and HS (+ 3%, -32%, and − 41%, respectively). All adverse events (AEs) were consistent with the known vestronidase alfa safety profile. No patients discontinued vestronidase alfa. One patient died. Conclusions: To date, the DMP has collected invaluable MPS VII disease characteristic data. The benefit-risk profile of vestronidase alfa remains unchanged and favorable for its use in the treatment of pediatric and adult patients with MPS VII. Reductions in DS and CS uGAG demonstrate effectiveness of vestronidase alfa to Month 24. Enrollment is ongoing.</p