Independence in activities after injury in humanitarian settings : assessment, change over time and associated factors

Background: Injury represents a significant burden in humanitarian settings, overwhelming the limited trauma care resources. Trauma care in these settings mainly focuses on saving lives and limbs, and not on recovery in daily activities. Rehabilitation, including physiotherapy, is often delayed and not systematic. Moreover, the lack of adequate measures of recovery of independence in activities limits the understanding of patients’ needs beyond survival. This thesis aimed at assessing recovery over the first six months after an acute orthopedic, visceral, and/or skin injury in different humanitarian settings, first revising and evaluating a measure of independence in activities, the Activity Independence Measure–Trauma (AIM-T). Methods: The three studies were conducted in eight health facilities supported or run by Médecins Sans Frontières in humanitarian settings, located in Burundi, Central African Republic, Cameroon, Iraq, Haiti, and Yemen. Study I used routine clinical data to run an inter-item correlation matrix and assess floor and ceiling effects of the initial AIM-T (AIMT1), aiming for a shortened version (AIM-T2). Then, the adequacy of the AIM-T2 was evaluated through semi-structured interviews with patients and healthcare professionals (HCPs), informing additional revisions for AIM-T3. Study II evaluated the construct validity and reliability of the AIM-T3. Study III assessed recovery at four time points (hospital admission, discharge, three and six months after injury), with different measures of recovery, including the AIM-T3. Factors associated with independence in activities (AIMT3) were identified using multivariable logistic regressions for each of three time points (i.e., discharge, three and six months). Results: In Study I (n=635), the identified redundant AIM-T1 items were removed, leading to AIM-T2. All remaining items were considered adequate by the 60 patients and 23 HCPs interviewed. Some items were revised to improve the adequacy of the content, and one item added to provide AIM-T3. In Study II (n=195), the AIM-T3 construct validity was supported, and inter-rater reliability was found to be good to excellent within a subset of 77 patients. In Study III (n=554), patients improved in all aspects of recovery across the four time points. Factors significantly associated with increased independence at one or several time points were age, type and location of injury, baseline independence and trauma care interventions, including early inpatient physiotherapy. Conclusions: The AIM-T was considered adequate to assess independence in activities after acute injury in humanitarian settings, and its validity and reliability were supported. The AIM-T has thus potential for use as an indicator of recovery in humanitarian settings. Regarding recovery, most patients still experience difficulties at six months. The association of early physiotherapy with better recovery of independence suggests that physiotherapy may be beneficial and may potentially be a modifiable factor to enhance recovery in humanitarian settings

Flexible fiber batteries for applications in smart textiles

Here we discuss two alternative approaches for building flexible batteries for applications in smart textiles. The first approach uses well-studied inorganic electrochemistry (Al-NaOCl galvanic cell) and innovative packaging in order to produce batteries in a slender and flexible fiber form that can be further weaved directly into the textiles. During fabrication process the battery electrodes are co-drawn within a microstructured polymer fiber, which is later filled with liquid electrolyte. The second approach describes Li-ion chemistry within solid polymer electrolytes that are used to build a fully solid and soft rechargeable battery that can be furthermore stitched onto a textile, or integrated as stripes during weaving process

Corpus et catégorisation. Perspective linguistique sur les genres en néo-égyptien

Le corpus néo-égyptien a suscité - et suscite encore – un large intérêt, sans toutefois attacher suffisamment d’attention à la définition du corpus. Dans bon nombre d’études, l’appellation « néo-égyptien » a longtemps été réservée aux textes de la pratique censés refléter au mieux la langue parlée. À vrai dire, si l’étude du néo-égyptien a suscité un certain engouement dans le milieu égyptologique, deux perspectives ont généralement été envisagées : une vision englobante : l’étude du néo-égyptien se fait à partir d’un corpus étendu, sans aucune restriction particulière et sans prêter attention aux genres des textes, à la diachronie ou à l’état de langue employé ; une vision restrictive : l’étude du néo-égyptien s’appuie sur un corpus réduit, en tenant compte de critères préalablement définis comme la diachronie, le lieu géographique ou le genre (littéraire >< non littéraire). Quelques études ont également été consacrées à un genre de texte particulier. Une étude manquait donc encore ; aucun travail de recherche n’avait envisagé l’étude du corpus néo-égyptien selon une perspective diachronique large, sans restriction entre textes littéraires et non littéraires, et en tenant compte des genres. Dans ma thèse, j’ai donc proposé de définir le corpus néo-égyptien comme suit : il s’agit d’un ensemble de textes s’inscrivant dans différents genres dans lesquels s’actualisent différents registres d’expression. Dès lors, la définition du corpus néo-égyptien passait nécessairement par la définition des genres et des registres d’expression employés au sein de ce corpus. On le sait, chaque texte s’inscrit dans un genre qui va imposer des règles/normes codifiant ce genre. Ce sont ces normes, ces règles qu’il s’agissait de mettre en avant. Je me suis donc attelée à définir ces genres, c’est-à-dire mettre en évidence les critères qui les définissent, spécifier les fonctionnements propres aux différents genres afin d’établir leur « carte d’identité ». C’est la base de données Ramsès qui a servi de corpus de référence à mon étude. À chacun des textes a été attribué un genre a priori. Il est vite apparu que dans l’examen des normes imposées par le genre, de nombreux critères pouvaient être mobilisés, toutefois, j’ai décidé de concentrer mes recherches sur quatre critères de définition : la phraséologie, la diplomatique (particulièrement, les formules d’incipit et d’explicit), le répertoire, l’emploi de l’encre rouge. L’examen de ces 4 critères a donc permis de mettre en évidence quelques-unes des normes codifiant les différents genres et, par la même occasion, d’assurer la pertinence de la classification proposée

A modified Doyle-Fuller-Newman model enables the macroscale physical simulation of dual-ion batteries

Dual-ion batteries are being considered a feasible approach for electrochemical energy storage. In this battery technology both cations and anions are involved in the redox reactions, respectively, at the anode and the cathode. However, the participation of both ions in the redox reactions means that enough salt must be added in the electrolyte to ensure proper battery functioning, which present a limiting factor in battery design. Herein, a modified version of the standard pseudo-2D Doyle-Fuller-Newman model is proposed to account for the different redox reactions that occur in dual-ion batteries and simulate the variation of average salt concentration in the electrolyte during charging and discharging. The model has been validated against galvanostatic cycling and electrochemical impedance spectroscopy experimental data from dual-ion batteries based on poly(2,2,6,6-tetramethyl-1-piperidinyloxy methacrylate) (PTMA). Such a model can be helpful to design practical dual-ion batteries that respect the constraints imposed by their working mechanism and maximize the obtainable capacity and energy density

Practical Cell Design for PTMA-Based Organic Batteries: an Experimental and Modeling Study

Poly(2,2,6,6-tetramethyl-1-piperidinyloxy methacrylate) (PTMA) is one of the most promising organic cathode materials thanks to its relatively high redox potential, good rate performance, and cycling stability. However, being a p-type material, PTMA-based batteries pose additional challenges compared to conventional lithium-ion systems due to the involvement of anions in the redox process. This study presents a comprehensive approach to optimize such batteries, addressing challenges in electrode design, scalability, and cost. Experimental results at a laboratory scale demonstrate high active mass loadings of PTMA electrodes (up to 9.65 mg cm$^{–2}$), achieving theoretical areal capacities that exceed 1 mAh cm$^{–2}$. Detailed physics-based simulations and cost and performance analysis clarify the critical role of the electrolyte and the impact of the anion amount in the PTMA redox process, highlighting the benefits and the drawbacks of using highly concentrated electrolytes. The cost and energy density of lithium metal batteries with such high mass loading PTMA cathodes were simulated, finding that their performance is inferior to batteries based on inorganic cathodes even in the most optimistic conditions. In general, this work emphasizes the importance of considering a broader perspective beyond the lab scale and highlights the challenges in upscaling to realistic battery configurations

Kinked silicon nanowires-enabled interweaving electrode configuration for lithium-ion batteries

A tri-dimensional interweaving kinked silicon nanowires (k-SiNWs) assembly, with a Ni current collector co-integrated, is evaluated as electrode configuration for lithium ion batteries. The large-scale fabrication of k-SiNWs is based on a procedure for continuous metal assisted chemical etching of Si, supported by a chemical peeling step that enables the reuse of the Si substrate. The kinks are triggered by a simple, repetitive etch-quench sequence in a HF and H2O2-based etchant. We find that the inter-locking frameworks of k-SiNWs and multi-walled carbon nanotubes exhibit beneficial mechanical properties with a foam-like behavior amplified by the kinks and a suitable porosity for a minimal electrode deformation upon Li insertion. In addition, ionic liquid electrolyte systems associated with the integrated Ni current collector repress the detrimental effects related to the Si-Li alloying reaction, enabling high cycling stability with 80% capacity retention (1695 mAh/gSi) after 100 cycles. Areal capacities of 2.42 mAh/cm2 (1276 mAh/gelectrode) can be achieved at the maximum evaluated thickness (corresponding to 1.3 mgSi/cm2). This work emphasizes the versatility of the metal assisted chemical etching for the synthesis of advanced Si nanostructures for high performance lithium ion battery electrodes