Une visite guidée de la Conciergerie

L'auteur réalise un parcours à travers du Musée de la Conciergerie de París, ancienne prison du Tribunal révolutionnaire, entre mars 1793 et prairial de l'an III (mai 1795).L'autor fa un recorregut pel museu de la Conciergerie de París, antiga presó del Tribunal revolucionari, entre març de 1793 i prairial de l'any III (maig de 1795).Author make a visit throwing the Musée de la Conciergerie of Paris, older prison of the Tribunal revolutionnary between march 1793 and prairial of the third year (may 1795)

Characterizing Atmospheric Transport Pathways to Antarctica and the Remote Southern Ocean Using Radon-222

We discuss remote terrestrial influences on boundary layer air over the Southern Ocean and Antarctica, and the mechanisms by which they arise, using atmospheric radon observations as a proxy. Our primary motivation was to enhance the scientific community’s ability to understand and quantify the potential effects of pollution, nutrient or pollen transport from distant land masses to these remote, sparsely instrumented regions. Seasonal radon characteristics are discussed at 6 stations (Macquarie Island, King Sejong, Neumayer, Dumont d’Urville, Jang Bogo and Dome Concordia) using 1–4 years of continuous observations. Context is provided for differences observed between these sites by Southern Ocean radon transects between 45 and 67°S made by the Research Vessel Investigator. Synoptic transport of continental air within the marine boundary layer (MBL) dominated radon seasonal cycles in the mid-Southern Ocean site (Macquarie Island). MBL synoptic transport, tropospheric injection, and Antarctic outflow all contributed to the seasonal cycle at the sub-Antarctic site (King Sejong). Tropospheric subsidence and injection events delivered terrestrially influenced air to the Southern Ocean MBL in the vicinity of the circumpolar trough (or “Polar Front”). Katabatic outflow events from Antarctica were observed to modify trace gas and aerosol characteristics of the MBL 100–200 km off the coast. Radon seasonal cycles at coastal Antarctic sites were dominated by a combination of local radon sources in summer and subsidence of terrestrially influenced tropospheric air, whereas those on the Antarctic Plateau were primarily controlled by tropospheric subsidence. Separate characterization of long-term marine and katabatic flow air masses at Dumont d’Urville revealed monthly mean differences in summer of up to 5 ppbv in ozone and 0.3 ng m-3 in gaseous elemental mercury. These differences were largely attributed to chemical processes on the Antarctic Plateau. A comparison of our observations with some Antarctic radon simulations by global climate models over the past two decades indicated that: (i) some models overestimate synoptic transport to Antarctica in the MBL, (ii) the seasonality of the Antarctic ice sheet needs to be better represented in models, (iii) coastal Antarctic radon sources need to be taken into account, and (iv) the underestimation of radon in subsiding tropospheric air needs to be investigated

Peri-operative red blood cell transfusion in neonates and infants: NEonate and Children audiT of Anaesthesia pRactice IN Europe: A prospective European multicentre observational study

BACKGROUND: Little is known about current clinical practice concerning peri-operative red blood cell transfusion in neonates and small infants. Guidelines suggest transfusions based on haemoglobin thresholds ranging from 8.5 to 12 g dl-1, distinguishing between children from birth to day 7 (week 1), from day 8 to day 14 (week 2) or from day 15 (≥week 3) onwards. OBJECTIVE: To observe peri-operative red blood cell transfusion practice according to guidelines in relation to patient outcome. DESIGN: A multicentre observational study. SETTING: The NEonate-Children sTudy of Anaesthesia pRactice IN Europe (NECTARINE) trial recruited patients up to 60 weeks' postmenstrual age undergoing anaesthesia for surgical or diagnostic procedures from 165 centres in 31 European countries between March 2016 and January 2017. PATIENTS: The data included 5609 patients undergoing 6542 procedures. Inclusion criteria was a peri-operative red blood cell transfusion. MAIN OUTCOME MEASURES: The primary endpoint was the haemoglobin level triggering a transfusion for neonates in week 1, week 2 and week 3. Secondary endpoints were transfusion volumes, 'delta haemoglobin' (preprocedure - transfusion-triggering) and 30-day and 90-day morbidity and mortality. RESULTS: Peri-operative red blood cell transfusions were recorded during 447 procedures (6.9%). The median haemoglobin levels triggering a transfusion were 9.6 [IQR 8.7 to 10.9] g dl-1 for neonates in week 1, 9.6 [7.7 to 10.4] g dl-1 in week 2 and 8.0 [7.3 to 9.0] g dl-1 in week 3. The median transfusion volume was 17.1 [11.1 to 26.4] ml kg-1 with a median delta haemoglobin of 1.8 [0.0 to 3.6] g dl-1. Thirty-day morbidity was 47.8% with an overall mortality of 11.3%. CONCLUSIONS: Results indicate lower transfusion-triggering haemoglobin thresholds in clinical practice than suggested by current guidelines. The high morbidity and mortality of this NECTARINE sub-cohort calls for investigative action and evidence-based guidelines addressing peri-operative red blood cell transfusions strategies. TRIAL REGISTRATION: ClinicalTrials.gov, identifier: NCT02350348

Une visite guidée de la Conciergerie

L'auteur réalise un parcours à travers du Musée de la Conciergerie de París, ancienne prison du Tribunal révolutionnaire, entre mars 1793 et prairial de l'an III (mai 1795).L'autor fa un recorregut pel museu de la Conciergerie de París, antiga presó del Tribunal revolucionari, entre març de 1793 i prairial de l'any III (maig de 1795).Author make a visit throwing the Musée de la Conciergerie of Paris, older prison of the Tribunal revolutionnary between march 1793 and prairial of the third year (may 1795)

Using Low-level Telemetry in Cloud Platforms to Mitigate Latency Risks for High-Performance Computing

Latency minimization is critical to high-performance computing (HPC). Network monitoring tools that rely on out-of-band data to control latency cannot assist latency-sensitive network workloads in real time. This disclosure describes techniques that combine in-band network telemetry (INT) with the software-defined network (SDN) controller used by the cloud platform to mitigate HPC latency. INT gathers hardware-level information about buffer and queue utilization. Such information is used by the cloud SDN controller to make changes to the virtual environment. The SDN controller can directly affect decisions of the HPC master node relating to the assignment of tasks to worker nodes. The techniques leverage the deep, hardware-level information about potential latency issues signaled by buffer accumulations to inform cloud-HPC scheduling algorithms

L'Anesthésie caudale vigile pour la chirurgie herniaire chez le prématuré (expérience du CHU d'Amiens)

ntroduction: L incidence des hernies inguinales varie de 5-30% chez le prématuré. Il a été montré que les apnées et malaises postopératoires sont fréquents dans cette population (20 à 30%). Le but de cette étude est d évaluer l efficacité et les complications de l anesthésie caudale vigile chez le prématuré opéré d une hernie inguinale. Matériel et Méthode: Une étude rétrospective entre 2006 et 2009 au CHU d Amiens incluant les enfants nés avant 37 semaines d aménorrhées (SA), opérés d une hernie inguinale sous anesthésie caudale vigile a été réalisée. Le succès a été défini comme la réalisation de l acte chirurgical sans adjuvant anesthésique per opératoire. Les données sont présentées sous forme de moyenne +- SD ou sous forme de proportions. Résultats: 74 enfants ont été inclus, âgés en moyenne de 40+-3 semaines d APC pour un poids de 2760+-672 g. 69% avaient comme antécédents une détresse respiratoire néonatale, 36% une broncho dysplasie et 15% des épisodes d apnées authentifiés. Le taux de succès global de l anesthésie caudale vigile est de 81%. Le délai moyen d incision est de 25+-9 min et la durée du bloc moteur moyen est de 90+-20 min. Nous avons observé en per opératoire un épisode de désaturation dans 11% ou de bradycardie dans 7% des cas. Discussion: L anesthésie caudale vigile semble être une technique efficace pour la chirurgie herniaire du prématuré. En comparaison, la rachianesthésie vigile a un succès de 78,2% avec une durée moyenne du bloc moteur qui semble variable et imprévisible (de 45 min à 151 min).AMIENS-BU Santé (800212102) / SudocSudocFranceF

Multi-year record of atmospheric mercury at Dumont d'Urville, East Antarctic coast: continental outflow and oceanic influences

International audienceUnder the framework of the Global Mercury Observation System (GMOS) project, a 3.5-year record of atmospheric gaseous elemental mercury (Hg(0)) has been gathered at Dumont d'Urville (DDU, 66 • 40 S, 140 • 01 E, 43 m above sea level) on the East Antarctic coast. Additionally, surface snow samples were collected in February 2009 during a traverse between Concordia Station located on the East Antarctic plateau and DDU. The record of atmospheric Hg(0) at DDU reveals particularities that are not seen at other coastal sites: a gradual decrease of concentrations over the course of winter, and a daily maximum concentration around midday in summer. Additionally, total mercury concentrations in surface snow samples were particularly elevated near DDU (up to 194.4 ng L −1) as compared to measurements at other coastal Antarctic sites. These differences can be explained by the more frequent arrival of inland air masses at DDU than at other coastal sites. This confirms the influence of processes observed on the Antarctic plateau on the cycle of atmospheric mercury at a continental scale, especially in areas subject to recurrent katabatic winds. DDU is also influenced by oceanic air masses and our data suggest that the ocean plays a dual role on Hg(0) concentrations. The open ocean may represent a source of atmospheric Hg(0) in summer whereas the sea-ice surface may provide reactive halo-gens in spring that can oxidize Hg(0). This paper also discusses implications for coastal Antarctic ecosystems and for the cycle of atmospheric mercury in high southern latitudes

Estimation of optic nerve sheath diameter on an initial brain computed tomography scan can contribute prognostic information in traumatic brain injury patients.

International audienceINTRODUCTION: To evaluate the prognostic value of optic nerve sheath diameter (ONSD) measured on the initial brain computed tomography (CT) scan for intensive care unit (ICU) mortality in severe traumatic brain injury (TBI) patients. METHODS: A prospective observational study of all severe TBI patients admitted to a neurosurgical ICU (10-month period). Demographic and clinical data, and brain CT scan results were recorded. ONSD for each eye was measured on the initial CT scan. The group of ICU survivors was compared to non-survivors. Glasgow Outcome Scale (GOS) was evaluated 6 months after ICU discharge. RESULTS: 77 patients were included (age: 43 +/- 18; 81% males; mean Injury Severity Score: 35 +/- 15; ICU mortality: 28.5% [n=22]). Mean ONSD on the initial brain CT scan was 7.8 +/- 0.1 mm in non-survivors vs. 6.8 +/- 0.1 mm in survivors (p<0.001). The operative value of ONSD was a good predictor of mortality (area under the curve [AUC]: 0.805). An ONSD cut-off [greater than or equal to] 7.3 had a sensitivity of 86.4% and a specificity of 74.6% and was independently associated with mortality in this population (adjusted odds ratio [AOR] [95% confidence interval]: 22.7 [3.2-159.6], p=0.002). There was a relationship between initial ONSD values and 6-month GOS (p=0.03). CONCLUSIONS: ONSD measured on the initial brain CT scan is independently associated with ICU mortality rate (when [greater than or equal to]7.3 mm) in severe TBI patients