Localized biliary ischemia in patients with hepatic arteriovenous malformations, a newly recognized syndrome occurring in Hereditary Hemorrhagic Telangiectasia Diagnosis and management

The clinical manifestations of hepatic arteriovenous malformations (HAVMs) were elucidated. A review of the literature was undertaken to better understand how HAVMs specifically affect the biliary system. A retrospective review of the 50 patients with HAVMs seen at the Yale University HHT Center was done, including clinical manifestation, intervention and outcome analysis. Of 50 adults with HAVM, median age was 64 (range 17-73) and 84% were female. Initially 74% were classified as Type 1, symptomatic heart failure, 16% as Type 2, portal hypertension, and 10% as Type 3, biliary abnormalities. In Type 1 conversion to Type 3 was associated with the highest mortality and in Type 3 invasive procedures precipitated rapid decline and need for transplant +/- death. Of the Type 3s, case reports of two sisters with localized biliary ischemia were presented. To our knowledge this is the first description of localized biliary HHT involvement, diagnosis and management

INTERACTIVE PLAYSCAPES: EXPLORATIVE DESIGN AND ROBOTIC FABRICATION TECHNIQUES

This research focuses on material-based practices and explorations by utilizing the carbon fiber fabric performance characteristics as a significant driver in the design and fabrication strategies. While the integrative aspects of computational design have been extensively used for the inclusion of environmental, manufacturing, or economic considerations, material information should be similarly employed as a generative driver. The paper describes and evaluates a full-scale prototype of installation for social play actuated in the heart of Beirut city, hence integrating material research with methodologies optimizing fabrication techniques for complex, performance-driven structures. The introduction of carbon fiber composites into the construction sector defines potential challenges to the design process, knowing that these components need to be light and cost-effective in their production. At the same time, advanced technologies, such as digital fabrication, need to dwell upon their limitations regarding time optimization, material restrictions, and relations between automated and manual labor. Many applications show that carbon fiber system has proven to be a novel building material to improve structures. Regarding the fabrication techniques utilized, milling is a vital process, where the material subtraction rate is one of the essential features to be established in addition to its final weight. However, factors such as shape precision and surface quality are constraining factors in the increase of material removal regarding robotic fabrication. Hence, in this work, machining strength and surface roughness are considered restricting to the optimization of machining parameters in order to obtain a maximum material removal rate

The extent of the use of Business Processes Reengineering entrance in the reform of basic education departments A field study in the first episode schools in Tartous

The research aimed to identify the extent of the use of Business processes reengineering entrance in the reform of basic education department in the first episode schools in Tartous, as well as to identify The differences between the views of respondents about extent at the use of business processes reengineering entrance in the reform of the education departments depending on the following variables (sex, scientific and educational qualification, years of experiences,and job Title). The research used Descriptive analytical method, The sample included (276) Administrative and teachers for the academic year 2016/2017. The Questionnaire consisted of (52) items. The research' conclusions are: degree of The use of entrance of business processes reengineering came moderate with a mean (1,88) and relative weight (62,67%) The result also showed no statistically significant differences between the responses of the respondents attributes to the (sex, and years of experiences), While there were statistically significant differences due to the Variables (Qualification, and Job Title). The research has offered several proposals including, for further research and studies related to reengineering of administrative processes so that addressed and number of the dimensions that are not addressed in this study such as: The use of technology and information systems

The impact of job satisfaction on improving the performance of general secondary education teachers Field Study in Tartous Governorate

 The research aimed to identify the level of job satisfaction of teachers in secondary schools in Tartous governorate, as well as their level of job performance, and to identify the impact of job satisfaction on the performance of the sample members. The descriptive approach was used. The sample included (440) teachers, ie (88.53%) of the original community of the selected schools, for the Academic year 2016/2017. In order to achieve the objective of the research, two questionnaires were designed, The first one consisted of (37) sections divided into five axes to measure job satisfaction. The second consisted of (29) items to measure the job performance. The research reached several results, most importantly: job satisfaction of the sample members came at medium level, and the axis of The nature of work) ranked first, While the axis of (work environment) ranked last. As well as job performance of the sample members came at medium degree with average of (3,31) and a relative weight (67,54). The result also shown The effect of job satisfaction on job performance of the sample members. The research presented some of conclusions and proposals, including: provide an emotive and lovely atmosphere for teachers to enable them to perform their tasks to the fullest, and improve the work environment by providing educational equipment and tools to facilitate the work of teaching, as well as conducting similar studies in other educational stages and in other governorate

Israeli necropolitics and the pursuit of health justice in Palestine.

We abhor the continuation and acceleration of the Israeli state's systemic violence against the Palestinian people. We reassert that resolution of the settler colonial root causes of violence in Palestine is central to the pursuit of justice and peace. The moral foundations of global health and medical practice require us to prioritise and foreground oppressed realities, and to practise epistemic resistance. Framing Palestinian violence on October 7 as provocation and Israeli violence as response is ahistoric and indicates indifference to the everyday violence experienced by Palestinians. The Israeli state practises both fast violence against Palestinians, while simultaneously creating the conditions for their ‘slow death’. The systematic targeting and destruction of the health system and healthcare workers in Gaza has been central to Israel's military strategy, while many Israeli officials have expressed clear genocidal intent. The occupation of Palestine demonstrates the horrors of Israeli necropolitics, which leads to the creation of 'death-worlds' in which people survive and resist in perpetual proximity to death

Mise en oeuvre de procédés de contacts nanométriques pour des dispositifs photovoltaïque à base de silicium

The use of point contacts has made the Passivated Emitter and Rear Cell design one of the most efficient monocrystalline-silicon photovoltaic cell designs in production. The main feature of such solar cell is that the rear surface is partially contacted by periodic openings in a dielectric film that provides surface passivation. However, a trade-off between ohmic losses and surface recombination is found. Due to the technology used to locally open the contacts in the passivation layer, the distance between neighboring contacts is on the order of hundreds of microns, introducing a significant series resistance.In this work, I explore the possibility and potential advantages of using nanoscale contact openings with a pitch between 300 nm to 10 µm. Analytic and numerical simulations done during the course of this thesis have shown that such nanoscale contacts would result in negligible ohmic losses while still keeping the surface recombination velocity Seff,rear at an acceptable level, as long as the recombination velocity at the contact (Scont) is in the range from 103-105 cm/s. To achieve such contacts in a potentially cost-reducing way, my experimental work has focused on the use of polystyrene nanospheres as a sacrificial mask.The thesis is therefore divided into three sections. The first section develops and explores processes to enable the formation of such contacts using various nanosphere dispersion, thin-film deposition, and layer etching processes. The second section describes a test device using a thin-film amorphous silicon NIP diode to explore the electrical properties of the point contacts. Finally, the third section considers the application of such point contacts on crystalline silicon by exploring localized doping through the nanoholes formed.In the first section, I have explored using polystyrene nanoparticles (NPs) as a patterning mask. The first two tested NPs deposition techniques (spray-coating, spin-coating) give poorly controlled distributions of nanospheres on the surface, but with very low values of coverage. The third tested NPs deposition technique (floating transfer technique) provided a closely-packed monolayer of NPs on the surface; this process was more repeatable but necessitated an additional O2 plasma step to reduce the coverage area of the sphere. This was performed using matrix distributed electron cyclotron resonance (MD-ECR) in order to etch the NPs by performing a detailed study.The NPs have been used in two ways; by using them as a direct deposition mask or by depositing a secondary etching mask layer on top of them.In the second section of this thesis, I have tested the nanoholes as electrical point-contacts in thin-film a-Si:H devices. For low-diffusion length technologies such as thin-film silicon, the distance between contacts must be in the order of few hundred nanometers. Using spin coated 100 nm NPs of polystyrene as a sacrificial deposition mask, I could form randomly spaced contacts with an average spacing of a few hundred nanometers. A set of NIP a-Si:H solar cells, using RF-PECVD, have been deposited on the back reflector substrates formed with metallic layers covered with dielectrics having nanoholes. Their electrical characteristics were compared to the same cells done with and without a complete dielectric layer. These structures allowed me to verify that good electrical contact through the nanoholes was possible, but no enhanced performance was observed.In the third section of this thesis, I investigate the use of such nanoholes in crystalline silicon technology by the formation of passivated contacts through the nanoholes. Boron doping by both thermal diffusion and ion implantation techniques were investigated. A thermally grown oxide layer with holes was used as the doping barrier. These samples were characterized, after removing the oxide layer, by secondary electron microscopy (SEM) and conductive probe atomic force microscopy (CP-AFM).Au cours de cette thèse, j’ai étudié la possibilité et les avantages d’utiliser des contacts nanométriques au-dessous de 1 µm. Des simulations analytiques et numériques ont montré que ces contacts nanométriques sont avantageux pour les cellules en silicium cristallin comme ils peuvent entrainer une résistance ohmique négligeable. Mon travail expérimental était focalisé sur le développement de ces contacts en utilisant des nanoparticules de polystyrène comme un masque. En utilisant la technique de floating transfert pour déposer les nanosphères, une monocouche dense de nanoparticules s’est formée. Cela nécessite une gravure par plasma de O2 afin de réduire la zone de couverture des NPs. Cette gravure était faite et étudiée en utilisant la technique de plasmas matriciels distribués à résonance cyclotronique électronique (MD-ECR). Une variété de techniques de créations de trous nanométriques était développée et testée dans des structures de couches minces et silicium cristallin. Des trous nanométriques étaient formés dans la couche de passivation, de SiO2 thermique, du silicium cristallin pour former des contacts nanométriques dopés. Un dopage local de bore était fait, à travers ces trous nanométriques par diffusion thermique et implantation ionique. En faisant la diffusion, le dopage local était observé par CP-AFM en mesurant des courbes de courant-tension à l’intérieur et à l’extérieur des zones dopées et en détectant des cellules solaires nanométriques. Par contre le processus de dopage local par implantation ionique a besoin d’être améliorer afin d’obtenir un résultat similaire à celui de diffusion

A Hybrid no Frost Refrigeration System Using a Membrane Based Desiccant System

International audienceFrosting is a major problem in refrigeration systems and its accumulation on the evaporator of a vaporcompression cycle deteriorates the coil’s performance. In some applications, frost is avoided bydehumidifying the air using solid desiccant wheels which are regenerated usually through electrical meanscausing high energy consumption. Thus the use of liquid desiccants that offer easier energy integrationallows proposing a hybrid system where the desiccant regeneration is done by the waste thermal energyfrom the condenser of the compression cycle. The system’s dehumidifier consists mainly of a membranebased heat and mass exchanger necessary to prevent the escarpment of the desiccant solution droplets tothe air avoiding corrosion problems. This paper proposes a model of such a membrane exchanger to derivesensitivity analysis of the key design parameters. Three architectures are studied where in the firstarchitecture the desiccant solution only dehumidifies the air while the evaporator does the entire cooling. Inthe second architecture the desiccant simultaneously cools and dehumidifies the air and here the evaporatorof the vapor compression cycle is used only to cool the desiccant. The third is where the desiccantdehumidifies and only pre-cools the air while the evaporator cools the air in cascade

PTEN R130Q Papillary Tumor of the Pineal Region (PTPR) with Chromosome 10 Loss Successfully Treated with Everolimus: A Case Report

Papillary tumors of the pineal region (PTPR) can be observed among adults with poor prognosis and high recurrence rates. Standards of therapy involve total surgical excision along with radiation therapy, with no promising prospects for primary adjuvant chemotherapy, as long-term treatment options have not been explored. Chromosome 10 loss is characteristic of PTPR, and PTEN gene alterations are frequently encountered in a wide range of human cancers and may be treated with mTORC1 inhibitors such as everolimus. In parallel, there are no reports of treating PTPR with everolimus alone as a monopharmacotherapy. We report the case of a patient diagnosed with PTPR (grade III) characterized by a PTEN R130Q alteration with chromosome 10 loss that was treated with everolimus pharmacotherapy alone, resulting in an asymptomatic course and tumor regression, a rare yet notable phenomenon not described in the literature so far with potential to alter the management approach to patients with PTPR