57 research outputs found

    Lupus Ă©rythĂ©mateux systĂ©mique Ă  dĂ©but pĂ©diatrique: Ă  propos d’un cas

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    Le lupus érythémateux systémique (LES) est une maladie systémique auto-immune d'étiologie inconnue qui touche essentiellement les femmes àl'ùge adulte. Le lupus pédiatrique est une entité rare. Nous rapportons une nouvelle observation. Il s'agissait d'un nourrisson ùgé de 7 mois quiprésentait des lésions cutanées purpuriques, une polyarthrite fébrile. Le bilan immunologique était positif (AAN et anti-ADN). Une améliorationclinique et biologique a été notée sous corticothérapie générale avec une récidive lors de la dégression du traitement

    The effect of the process on mechanical properties of polylactic acid - date palm leaf fibers composite films produced by extrusion blowing

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    Biocomposite films prepared with melt compounding and film blowing have become a new trend in plastic research to deliver more eco-friendly packages. Polylactic acid (PLA) was melt compounded with minimally processed date palm leaf fiber (DPLF) and converted into films by blown film extrusion. The compounding was done in order to enhance the film mechanical properties in one hand, and to decrease the film production cost in the other hand. In this present study, a reference PLA film and films with 1%, 2%, and 5% of DPLF (weight %) were produced with different process parameters. The spatial variations in films thickness and lay flat width indicate that the addition of DPLF up to 2% enhances the bubble stability for the tested process parameters. However, the composite with 5% DPLF shows nearly the same processability window as the neat PLA. The structural and mechanical characterizations of films suggest a reinforcing effect of the PLA matrix up to 2% of fiber (with an optimum at 1%). Larger DPLF loading leads to depressed and more anisotropic mechanical properties, related to an increased density of defects at the fiber-PLA fragile interface and to a DPLF-induced enhanced PLA thermal degradation and amorphous phase orientatio

    The ENIGMA Stroke Recovery Working Group: Big data neuroimaging to study brain–behavior relationships after stroke

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    The goal of the Enhancing Neuroimaging Genetics through Meta‐Analysis (ENIGMA) Stroke Recovery working group is to understand brain and behavior relationships using well‐powered meta‐ and mega‐analytic approaches. ENIGMA Stroke Recovery has data from over 2,100 stroke patients collected across 39 research studies and 10 countries around the world, comprising the largest multisite retrospective stroke data collaboration to date. This article outlines the efforts taken by the ENIGMA Stroke Recovery working group to develop neuroinformatics protocols and methods to manage multisite stroke brain magnetic resonance imaging, behavioral and demographics data. Specifically, the processes for scalable data intake and preprocessing, multisite data harmonization, and large‐scale stroke lesion analysis are described, and challenges unique to this type of big data collaboration in stroke research are discussed. Finally, future directions and limitations, as well as recommendations for improved data harmonization through prospective data collection and data management, are provided

    The ENIGMA Stroke Recovery Working Group: Big data neuroimaging to study brain-behavior relationships after stroke

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    The goal of the Enhancing Neuroimaging Genetics through Meta-Analysis (ENIGMA) Stroke Recovery working group is to understand brain and behavior relationships using well-powered meta- and mega-analytic approaches. ENIGMA Stroke Recovery has data from over 2,100 stroke patients collected across 39 research studies and 10 countries around the world, comprising the largest multisite retrospective stroke data collaboration to date. This article outlines the efforts taken by the ENIGMA Stroke Recovery working group to develop neuroinformatics protocols and methods to manage multisite stroke brain magnetic resonance imaging, behavioral and demographics data. Specifically, the processes for scalable data intake and preprocessing, multisite data harmonization, and large-scale stroke lesion analysis are described, and challenges unique to this type of big data collaboration in stroke research are discussed. Finally, future directions and limitations, as well as recommendations for improved data harmonization through prospective data collection and data management, are provided

    Smaller spared subcortical nuclei are associated with worse post-stroke sensorimotor outcomes in 28 cohorts worldwide

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    Up to two-thirds of stroke survivors experience persistent sensorimotor impairments. Recovery relies on the integrity of spared brain areas to compensate for damaged tissue. Deep grey matter structures play a critical role in the control and regulation of sensorimotor circuits. The goal of this work is to identify associations between volumes of spared subcortical nuclei and sensorimotor behaviour at different timepoints after stroke. We pooled high-resolution T1-weighted MRI brain scans and behavioural data in 828 individuals with unilateral stroke from 28 cohorts worldwide. Cross-sectional analyses using linear mixed-effects models related post-stroke sensorimotor behaviour to non-lesioned subcortical volumes (Bonferroni-corrected, P < 0.004). We tested subacute (≀90 days) and chronic (≄180 days) stroke subgroups separately, with exploratory analyses in early stroke (≀21 days) and across all time. Sub-analyses in chronic stroke were also performed based on class of sensorimotor deficits (impairment, activity limitations) and side of lesioned hemisphere. Worse sensorimotor behaviour was associated with a smaller ipsilesional thalamic volume in both early (n = 179; d = 0.68) and subacute (n = 274, d = 0.46) stroke. In chronic stroke (n = 404), worse sensorimotor behaviour was associated with smaller ipsilesional putamen (d = 0.52) and nucleus accumbens (d = 0.39) volumes, and a larger ipsilesional lateral ventricle (d = -0.42). Worse chronic sensorimotor impairment specifically (measured by the Fugl-Meyer Assessment; n = 256) was associated with smaller ipsilesional putamen (d = 0.72) and larger lateral ventricle (d = -0.41) volumes, while several measures of activity limitations (n = 116) showed no significant relationships. In the full cohort across all time (n = 828), sensorimotor behaviour was associated with the volumes of the ipsilesional nucleus accumbens (d = 0.23), putamen (d = 0.33), thalamus (d = 0.33) and lateral ventricle (d = -0.23). We demonstrate significant relationships between post-stroke sensorimotor behaviour and reduced volumes of deep grey matter structures that were spared by stroke, which differ by time and class of sensorimotor measure. These findings provide additional insight into how different cortico-thalamo-striatal circuits support post-stroke sensorimotor outcomes

    Chronic stroke sensorimotor impairment is related to smaller hippocampal volumes: an ENIGMA analysis

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    Background Persistent sensorimotor impairments after stroke can negatively impact quality of life. The hippocampus is vulnerable to poststroke secondary degeneration and is involved in sensorimotor behavior but has not been widely studied within the context of poststroke upper‐limb sensorimotor impairment. We investigated associations between non‐lesioned hippocampal volume and upper limb sensorimotor impairment in people with chronic stroke, hypothesizing that smaller ipsilesional hippocampal volumes would be associated with greater sensorimotor impairment. Methods and Results Cross‐sectional T1‐weighted magnetic resonance images of the brain were pooled from 357 participants with chronic stroke from 18 research cohorts of the ENIGMA (Enhancing NeuoImaging Genetics through Meta‐Analysis) Stroke Recovery Working Group. Sensorimotor impairment was estimated from the FMA‐UE (Fugl‐Meyer Assessment of Upper Extremity). Robust mixed‐effects linear models were used to test associations between poststroke sensorimotor impairment and hippocampal volumes (ipsilesional and contralesional separately; Bonferroni‐corrected, P<0.025), controlling for age, sex, lesion volume, and lesioned hemisphere. In exploratory analyses, we tested for a sensorimotor impairment and sex interaction and relationships between lesion volume, sensorimotor damage, and hippocampal volume. Greater sensorimotor impairment was significantly associated with ipsilesional (P=0.005; ÎČ=0.16) but not contralesional (P=0.96; ÎČ=0.003) hippocampal volume, independent of lesion volume and other covariates (P=0.001; ÎČ=0.26). Women showed progressively worsening sensorimotor impairment with smaller ipsilesional (P=0.008; ÎČ=−0.26) and contralesional (P=0.006; ÎČ=−0.27) hippocampal volumes compared with men. Hippocampal volume was associated with lesion size (P<0.001; ÎČ=−0.21) and extent of sensorimotor damage (P=0.003; ÎČ=−0.15). Conclusions The present study identifies novel associations between chronic poststroke sensorimotor impairment and ipsilesional hippocampal volume that are not caused by lesion size and may be stronger in women

    Association of Brain Age, Lesion Volume, and Functional Outcome in Patients With Stroke

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    BACKGROUND AND OBJECTIVES: Functional outcomes after stroke are strongly related to focal injury measures. However, the role of global brain health is less clear. In this study, we examined the impact of brain age, a measure of neurobiological aging derived from whole-brain structural neuroimaging, on poststroke outcomes, with a focus on sensorimotor performance. We hypothesized that more lesion damage would result in older brain age, which would in turn be associated with poorer outcomes. Related, we expected that brain age would mediate the relationship between lesion damage and outcomes. Finally, we hypothesized that structural brain resilience, which we define in the context of stroke as younger brain age given matched lesion damage, would differentiate people with good vs poor outcomes. METHODS: We conducted a cross-sectional observational study using a multisite dataset of 3-dimensional brain structural MRIs and clinical measures from the ENIGMA Stroke Recovery. Brain age was calculated from 77 neuroanatomical features using a ridge regression model trained and validated on 4,314 healthy controls. We performed a 3-step mediation analysis with robust mixed-effects linear regression models to examine relationships between brain age, lesion damage, and stroke outcomes. We used propensity score matching and logistic regression to examine whether brain resilience predicts good vs poor outcomes in patients with matched lesion damage. RESULTS: We examined 963 patients across 38 cohorts. Greater lesion damage was associated with older brain age (ÎČ = 0.21; 95% CI 0.04-0.38, DISCUSSION: We provide evidence that younger brain age is associated with superior poststroke outcomes and modifies the impact of focal damage. The inclusion of imaging-based assessments of brain age and brain resilience may improve the prediction of poststroke outcomes compared with focal injury measures alone, opening new possibilities for potential therapeutic targets

    Accounting Regulations and IFRS Adoption in Francophone North African Countries: The Experience of Algeria, Morocco, and Tunisia

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    This paper traces the historical developments of accounting regulations in Algeria, Morocco, and Tunisia and uses institutional theory to identify factors affecting International Financial Reporting Standards (IFRS) adoption as the national accounting standards in these countries. We find that the extent of convergence with IFRS in Algeria is higher compared to Morocco and Tunisia. This has been mostly due to greater foreign investor flows from Western countries in Algeria during the last decade, the dominant position of international Big-4 audit firms, and strong trade relationship of Algeria with the European Union (EU) compared with Morocco and Tunisia. We discuss the main challenges faced by these three countries in converging toward IFRS. These are underdeveloped equity markets, switching from French fiscal-oriented accounting systems to Anglo-Saxon accounting systems, and are characterized by lack of knowledge of principles-based IFRS by local professional accountants. Moreover, the convergence with IFRS in these countries is confronted by the prevailing small and medium-sized firms in the economic environment, difficulty in fair-value measurement in these settings, and the cost of convergence for companies. Our study has policy implications for those countries sharing similarities with these settings and have undertaken steps to implement IFRS
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