Should flow-volume loop be monitored in sleep apnea patients treated with continuous positive airway pressure?

AbstractNasal continuous positive airway pressure (nCPAP) has been widely established in the treatment of obstructive sleep apnea syndrome (OSAS). However, only few studies have evaluated long-term effects of this treatment on lung function. This study assesses the effect of nCPAP on lung function parameters and response to bronchodilators in 50 OSAS patients. Spirometry and arterial blood gas measurements were performed before starting nCPAP and after 16.8±8 months of treatment. Of the 50 study patients (55±12 years, with an apnea/hypopnea index of 47±34h−1), 15 had asthma, 13 had chronic obstructive pulmonary disease (COPD) and 22 had no obstructive airway disease (NOAD). In the entire population, significant decreases in FEF50 (from 69±38% to 61±30%, P<0.005), FEF25 (from 53±34% to 46±28%, P<0.05) and FEF25−75 (from 65±33% to 57±27%, P<0.005) were observed after treatment. No impairment of lung function was found in COPD and asthmatic patients. In contrast, lung function was changed in the NOAD group where FEF50, FEF25 and FEF25−75 as well as FEV1 and FEV1/VC ratio were significantly reduced. Moreover, bronchial hyperresponsiveness occurred in five of 22 patients of this group. These results suggest that tolerance of nCPAP should be handled by long-term follow-up of flow-volume loops

Les « niveaux de formation » à l’heure européenne. Un examen à partir de l’homologation des titres

Cet article s’inscrit dans le cadre d’une réflexion autour de la nomenclature des « niveaux de formation », interrogée par la logique de la certification et les politiques d’harmonisation européenne. Il propose un retour sur les pratiques de classement de la Commission technique d’homologation (CTH), chargée, pendant près de trente ans, d’attribuer un niveau à des titres initialement prévus dans le cadre de la formation continue. Il montre que le caractère consensuel des opérations d’attribution de niveau a été rendu possible grâce à une naturalisation des principes et de la logique classificatoire contenus dans cet outil, y compris après le choix de la CTH, en 1993, de privilégier d’autres registres et critères d’examen.This study is part of an attempt to review the nomenclature of "vocational training levels”, in the framework of the European approach to qualifications and the policies designed to harmonise qualifications between member countries. The authors suggest the need to revise the classification practices of the Technical Homologation Commission (THC), which has been responsible for almost thirty years for attributing levels to diplomas initially designed in the framework of continuing vocational training. They suggest that the consensus about the levels attributed may be due to the fact that the underlying principles and classification logics have never been challenged, even when it was decided in 1993 by the THC to change the criteria on which these assessments are based.Este artículo se inscribe en el marco de una reflexión sobre la nomenclatura de los « niveles de formación », cuestionada por la lógica de la certificación y las políticas de armonización europea. Propone un retorno a las prácticas de clasificación de la Comisión técnica de homologación (CTH), encargada durante casi treinta años de atribuir un nivel a títulos inicialmente previstos en el marco de la formación continua. Muestra que el carácter consensuado de las operaciones de atribución de nivel fue posible gracias a una naturalización de los principios y la lógica clasificatoria contenidos en este instrumento, inclusive luego de la decisión de la CTH en 1993 de privilegiar otros criterios de examen.Dieser Beitrag ist im Rahmen der Arbeiten zum Verzeichnis der „Ausbildungsniveaus“ zu sehen, die hier unter dem Gesichtspunkt der Zertifizierung und Harmonisierung von Abschlüssen auf europäischer Ebene untersucht werden. Die Autoren schlagen vor, die Klassifizierungspraktiken der Commission technique d’homologation (CTH - technischer Ausschuss für die Anerkennung von Titeln und Abschlüssen) neu zu hinterfragen. Dieser Fachausschuss war dreißig Jahre lang für die Anerkennung der ursprünglich für die berufliche Weiterbildung vergebenen Abschlüsse und Titel zuständig. Die Autoren zeigen, dass der bestehende Konsens hinsichtlich der Einstufung der Abschlüsse auf den diesem Instrument zugrunde liegenden Prinzipien sowie auf der Logik der Klassifizierung basieren, die sich auch nach 1993 nicht verändert haben, obwohl der CTH ab diesem Zeitpunkt den Akzent auf andere Anerkennungskriterien legte

De « l’excellence » territoriale en général et en particulier. Les campus des métiers et des qualifications de l’action « Territoires d’innovation pédagogique »

Introduction Créé dans le cadre de la Loi d’orientation et de programmation pour la refondation de l’École de la République du 8 juillet 2013, le campus des métiers et des qualifications (CMQ) est un label qui, selon la définition du ministère de l’Éducation nationale, « permet d'identifier, sur un territoire donné, un réseau d'acteurs qui interviennent en partenariat pour développer une large gamme de formations professionnelles, technologiques et générales, relevant de l'enseignement second..

Improved coining force calculations through incorporation of key process parameters

Among the sheet forming processes, coining is a specific operation which makes it possible to correct shape defects or to perform thickness reductions in the parts. This operation often requires a very high force which is likely to have an impact on the functioning of the tool or the press. It is therefore important that the coining forces be evaluated accurately, but this is not allowed by the existing analytical calculation formulas. The objective of this study is to improve the accuracy of the calculation of the coining forces via the adaptation of an existing formula. Such adaptation was carried out based on a study of the influence of the flat coining parameters. To that end, a series of experimental measurements was performed. An instrumented force measuring setup made it possible to measure the maximum coining force. Several parameters were analysed, including the coining ratio and the sheet thickness. Numerical simulations were carried out at the same time, in order to understand the influence of certain parameters on the coining force. 2D numerical models were developed using the Forge NXT2 software. The simulations and the experimental tests were analysed and the results revealed the influential phenomena which have to be taken into account in the analytical formula, in particular the coining surface and the friction. In order to study the friction more thoroughly, ring compression tests were performed so as to determine the friction coefficients, based on the Coulomb’s law limited to Tresca. This type of test is representative of the stresses undergone by the metal during the coining operation. Finally, a new calculation formula is proposed, in order to integrate the coining surface and friction more accurately

Association studies using random and "candidate" microsatellite loci in two infectious goat diseases

We established a set of 30 microsatellites of Bovidae origin for use in a biodiversity study in Swiss and Creole goats. Additional microsatellites located within or next to "candidate" genes of interest, such as cytokine genes (IL4, INF-gamma) and MHC class II genes (DRB, DYA) were tested in the caprine species in order to detect possible associations with two infectious caprine diseases. Microsatellite analysis was undertaken using automated sequencers (ABI373 & 3100). In the first study, a total of 82 unrelated Creole goats, 37 resistant and 45 susceptible to Heartwater disease (Cowdriosis) were analysed. In this study, the two microsatellite loci DRBP1 (MHCII) and BOBT24 (IL4) were positively associated with disease susceptibility, demonstrating a corrected P-value of 0.002 and 0.005, respectively. In a second investigation, we tested 36 goats, naturally infected with the nematode parasite Trichostrongylus colubriformis. These animals were divided into a "low" and "high" excreting group on the basis of two independently recorded fecal egg counts. For this nematode resistance study, we detected a significant association of one of the alleles of the microsatellite locus SPS113 with "low" excretion (resistance). The MHC class II locus DYA (P19), was weakly associated with susceptibility in both diseases (Pc = 0.05). In future experiments, we will extend the sample size in order to verify the described associations

Adult nephron-specific MR-deficient mice develop a severe renal PHA-1 phenotype

Aldosterone is the main mineralocorticoid hormone controlling sodium balance, fluid homeostasis, and blood pressure by regulating sodium reabsorption in the aldosterone-sensitive distal nephron (ASDN). Germline loss-of-function mutations of the mineralocorticoid receptor (MR) in humans and in mice lead to the "renal" form of type 1 pseudohypoaldosteronism (PHA-1), a case of aldosterone resistance characterized by salt wasting, dehydration, failure to thrive, hyperkalemia, and metabolic acidosis. To investigate the importance of MR in adult epithelial cells, we generated nephron-specific MR knockout mice (MR$^{Pax8/LC1}$) using a doxycycline-inducible system. Under standard diet, MR$^{Pax8/LC1}$ mice exhibit inability to gain weight and significant weight loss compared to control mice. Interestingly, despite failure to thrive, MR$^{Pax8/LC1}$ mice survive but develop a severe PHA-1 phenotype with higher urinary Na^+ levels, decreased plasma Na(+), hyperkalemia, and higher levels of plasma aldosterone. This phenotype further worsens and becomes lethal under a sodium-deficient diet. Na^+/Cl^- co-transporter (NCC) protein expression and its phosphorylated form are downregulated in the MR$^{Pax8/LC1}$ knockouts, as well as the αENaC protein expression level, whereas the expression of glucocorticoid receptor (GR) is increased. A diet rich in Na^+ and low in K^+ does not restore plasma aldosterone to control levels but is sufficient to restore body weight, plasma, and urinary electrolytes. In conclusion, MR deletion along the nephron fully recapitulates the features of severe human PHA-1. ENaC protein expression is dependent on MR activity. Suppression of NCC under hyperkalemia predominates in a hypovolemic state

Follicular growth and ovulation in the queen

The queen is a seasonally polyoestrus, induced ovulator. Due to the limited follicular size, clinical follow-up of terminal follicular growth is difficult in this species. In this study, ovarian ultrasonography has been performed during 9 anovulatory cycles and 12 ovulatory cycles. Follicles appeared as well-defined anechoic circular zones. Mean estrus duration was 7.4 days. On the first day of behavioural estral modifications, 4.8 ± 0.2 follicles (2-7 per female) of 2.3 ± 0.01 mm mean diameter were present on the ovaries. Follicular growth continues at a rate of 0.2 ± 0.04 mm per day. At least one follicle of the cohort reaches a diameter greater than 3.0 mm. Maximal follicular growth was reached 3.8 ± 0.3 days after the onset of estrus and the diameter of the largest follicle was 3.5 ± 0.04 mm. In the absence of ovulation, follicular diameter decreased from 0.1 ± 0.01 mm per day until the end of estrus. The first day after the end of behavioural estrus, the diameter of the largest follicle of each cohort was 2.7 ± 0.05 mm. When ovulation was mechanically induced, it began 23 to 28 hours after vaginal stimulations and lasted 10 hours. It was visualized by anechoic images disparition. No correlation has been observed between follicular development and either vaginal smear characteristics, or time spent from the onset of estrus. Ultrasonography revealed to be the more reliable technique to examine the follicular development and its main interest is the determination of the optimal time for ovulation induction before artificial insemination.La chatte est une femelle à polyoestrus saisonnier et à ovulation provoquée. Compte tenu de la faible taille des follicules, le suivi clinique de la croissance folliculaire terminale est difficile dans cette espèce. Les ovaires ont été observés au cours de 9 cycles anovulatoires et 12 cycles ovulatoires grâce à un échographe de très haute résolution. Les follicules apparaissent sous forme de zones circulaires anéchogènes bien délimitées. Les chaleurs durent en moyenne 7,4 jours. Le premier jour d'apparition des manifestations comportementales de l'œstrus, 4,8 ± 0,2 follicules (entre 2 et 7 par chatte) sont présents avec un diamètre moyen de 2,3 ± 0,01 mm. La croissance des follicules se poursuit ensuite à raison de 0,2 ± 0,04 mm par jour. Au moins un follicule de la cohorte atteint un diamètre supérieur à 3 mm. La croissance folliculaire maximale est atteinte 3,8 ± 0,3 jours en moyenne après le début des chaleurs; le diamètre du plus gros follicule est de 3,5 ± 0,04 mm. En l'absence d'ovulation, le diamètre folliculaire diminue d'en moyenne 0,1 ± 0,01 mm par jour jusqu'à la fin des chaleurs. Le premier jour d'arrêt des manifestations comportementales, le diamètre du plus gros follicule de chaque cohorte est de 2,7 ± 0,05 mm. Lorsqu'elle est induite par stimulation vaginale, l'ovulation débute 23 à 28 heures après la première stimulation et s'étale sur environ 10 heures. Elle se traduit par la disparition des images anéchogènes. Cette étude montre que le stade de croissance folliculaire ne peut être relié ni aux caractéristiques du frottis vaginal ni à la durée écoulée depuis le début des manifestations comportementales. L'échographie semble être la technique la plus fiable pour déterminer le stade de croissance folliculaire et donc décider du moment optimal d'induction de l'ovulation en vue de l'insémination