Risk factors associated with maternal satisfaction during childbirth: a retrospective cohort study

Résumé: Objectif: Les facteurs qui contribuent à la satisfaction maternelle de la prise en charge anesthésique pendant l'accouchement restent peu connus. L'objectif de cette étude était d'évaluer ces facteurs. Méthode: Nous avons réalisé une étude de cohorte rétrospective sur les parturientes admises entre janvier 2004 et décembre 2008. Nous avons extrait du dossier les données démographiques, les co-morbidités, les interventions anesthésiques et obstétricales réalisées, et différents éléments du vécu de l'anesthésie. La satisfaction maternelle a été mesurée au moyen d'une échelle numérique de 0 à 10 (0=pas satisfait du tout, 10=entièrement satisfait) 24h aprèsl'accouchement. Une valeur≤6 a été utilisée comme indiquant l'insatisfaction. Nous avons ainsi identifié dans une analyse multivariée les différents prédicteurs de la satisfaction maternelle, notamment la douleur, le vécu global de la technique, les délais d'attente et la présence de complications anesthésiques, obstétricales ou néonatales. Résultats: Des 15 386 parturientes admises, 10 034 avaient un dossier complet et de ce nombre, 761 (7,6 %) étaient insatisfaites de leur prise en charge. Parmi les facteurs diminuant la satisfaction, on retrouvait la grossesse à risque [rapport de cotes (RC): 0,59 et intervalle de confiance (IC) à 95 %: 0,34-1,02] et l'accouchement difficile [RC (IC95 %): 0,62 (0,52-0,74)]. La douleur, le vécu global négatif de l'intervention, le retard, la mauvaise coordination dans la prise en charge et la présence de complications diminuaient la satisfaction [RC (IC95 %): 0,07 à 0,71]; P<0,001. Conclusion: La satisfaction maternelle de l'anesthésie est largement déterminée par l'efficacité et le bon déroulement de l'intervention tant sur le plan technique qu'humain. Néanmoins d'autres facteurs tels que la bonne coordination de la prise en charge des parturientes et l'absence de complications influencent également la satisfactio

Combination of the W boson polarization measurements in top quark decays using ATLAS and CMS data at s√ = 8 TeV

The combination of measurements of the W boson polarization in top quark decays performed by the ATLAS and CMS collaborations is presented. The measurements are based on proton-proton collision data produced at the LHC at a centre-of-mass energy of 8 TeV, and corresponding to an integrated luminosity of about 20 fb−1 for each experiment. The measurements used events containing one lepton and having different jet multiplicities in the final state. The results are quoted as fractions of W bosons with longitudinal (F0), left-handed (FL), or right-handed (FR) polarizations. The resulting combined measurements of the polarization fractions are F0 = 0.693 ± 0.014 and FL = 0.315 ± 0.011. The fraction FR is calculated from the unitarity constraint to be FR = −0.008 ± 0.007. These results are in agreement with the standard model predictions at next-to-next-to-leading order in perturbative quantum chromodynamics and represent an improvement in precision of 25 (29)% for F0 (FL) with respect to the most precise single measurement. A limit on anomalous right-handed vector (VR), and left- and right-handed tensor (gL, gR) tWb couplings is set while fixing all others to their standard model values. The allowed regions are [−0.11, 0.16] for VR, [−0.08, 0.05] for gL, and [−0.04, 0.02] for gR, at 95% confidence level. Limits on the corresponding Wilson coefficients are also derived

Impact of Cytomegalovirus and Grafts versus Host Disease on the Dynamics of CD57+CD28−CD8+ T Cells After Bone Marrow Transplant

OBJECTIVES: The present study aimed to evaluate the dynamics of CD28 and CD57 expression in CD8+ T lymphocytes during cytomegalovirus viremia in bone marrow transplant recipients. METHODS: In a prospective study, blood samples were obtained once weekly once from 33 healthy volunteers and weekly from 33 patients. To evaluate the expression of CD57 and CD28 on CD8+ T lymphocytes, flow cytometry analysis was performed on blood samples for four months after bone marrow transplant, together with cytomegalovirus antigenemia assays. RESULTS: Compared to cytomegalovirus-seronegative healthy subjects, seropositive healthy subjects demonstrated a higher percentage of CD57+ and a lower percentage of CD28+ cells (p<0.05). A linear regression model demonstrated a continuous decrease in CD28+ expression and a continuous increase in CD57+ expression after bone marrow transplant. The occurrence of cytomegalovirus antigenemia was associated with a steep drop in the percentage of CD28+ cells (5.94%, p<0.01) and an increase in CD57+ lymphocytes (5.60%, p<0.01). This cytomegalovirus-dependent effect was for the most part concentrated in the allogeneic bone marrow transplant patients. The development of acute graft versus host disease, which occurred at an earlier time than antigenemia (day 26 vs. day 56 post- bone marrow transplant), also had an impact on the CD57+ subset, triggering an increase of 4.9% in CD57+ lymphocytes (p<0.05). CONCLUSION: We found continuous relative changes in the CD28+ and CD57+ subsets during the first 120 days post- bone marrow transplant, as part of immune system reconstitution and maturation. A clear correlation was observed between the expansion of the CD57+CD28-CD8+ T lymphocyte subpopulation and the occurrence of graft versus host disease and cytomegalovirus viremia

Modelling of micro-sources for security studies

International audienceThe interconnection of small, modular generation and storage technologies at the MV and LV distribution level have the potential to significantly impact power system performance. In this paper models of the main micro-generation sources are described. In particular, the models of Microturbines, Fuel Cells, Photovoltaic Systems and Wind Turbines, are described. In addition basic models of their power electronic interfaces are given. The integration of the above models in a steady state and dynamic simulation tool, which is developed in the framework of the EU funded MICROGRIDS project, will provide a simulation test platform, which will be necessary to define and evaluate the developed operational and control strategies

The CAMOMILE Collaborative Annotation Platform for Multi-modal, Multi-lingual and Multi-media Documents

International audienceIn this paper, we describe the organization and the implementation of the CAMOMILE collaborative annotation framework for multimodal, multimedia, multilingual (3M) data. Given the versatile nature of the analysis which can be performed on 3M data, the structure of the server was kept intentionally simple in order to preserve its genericity, relying on standard Web technologies. Layers of annotations, defined as data associated to a media fragment from the corpus, are stored in a database and can be managed through standard interfaces with authentication. Interfaces tailored specifically to the needed task can then be developed in an agile way, relying on simple but reliable services for the management of the centralized annotations. We then present our implementation of an active learning scenario for person annotation in video, relying on the CAMOMILE server; during a dry run experiment, the manual annotation of 716 speech segments was thus propagated to 3504 labeled tracks. The code of the CAMOMILE framework is distributed in open source

To-many or to-one? All-in-one! Efficient purely functional multi-maps with type-heterogeneous hash-tries

An immutable multi-map is a many-to-many map data structure with expected fast insert and lookup operations. This data structure is used for applications processing graphs or many-to-many relations as applied in compilers, runtimes of programming languages, or in static analysis of object-oriented systems. Collection data structures are assumed to carefully balance execution time of operations with memory consumption characteristics and need to scale gracefully from a few elements to multiple gigabytes at least. When processing larger in-memory data sets the overhead of the data structure encoding itself becomes a memory usage bottleneck, dominating the overall performance. In this paper we propose AXIOM, a novel hash-trie data structure that allows for a highly efficient and type-safe multi-map encoding by distinguishing inlined values of singleton sets from nested sets of multi-mappings

Techniques&charlie

Frédéric Joulian Après l’assassinat des dessinateurs de Charlie Hebdo par des intégristes et les jours de tristesse, de colère ou de communion collective que nous venons de vivre, il nous a semblé important de ne pas nous taire, sous prétexte de science et d’objectivité. Une revue n’existe vraiment que par les hommes et les femmes qui l’animent, et, même si la nôtre est consacrée aux rapports sociaux aux techniques et aux objets, elle ne peut se faire sans engagement, sans empathie, sans réf..

Stellar Evolution at Low Metallicity

Massive stars played a key role in the early evolution of the Universe. They formed with the first halos and started the re-ionisation. It is therefore very important to understand their evolution. In this review, we first recall the effect of metallicity (Z) on the evolution of massive stars. We then describe the strong impact of rotation induced mixing and mass loss at very low Z. The strong mixing leads to a significant production of primary nitrogen 14, carbon 13 and neon 22. Mass loss during the red supergiant stage allows the production of Wolf-Rayet stars, type Ib,c supernovae and possibly gamma-ray bursts (GRBs) down to almost Z=0 for stars more massive than 60 solar masses. Galactic chemical evolution models calculated with models of rotating stars better reproduce the early evolution of N/O, C/O and C12/C13. Finally, the impact of magnetic fields is discussed in the context of GRBs.Comment: 12 pages, 7 figures, "Massive Stars as Cosmic Engines" Conference proceedings (IAU Symp 250), F. Bresolin, P.A. Crowther, J. Puls Ed