Computational Intelligence: The Grid as a Post-Human Network

Research and design collaborative EZCT Architecture & Design Research has adopted grid computing to produce a series of furniture systems and other small-scale prototypes using genetic algorithms in combination with automated fabrication technologies. Here, cofounder Philippe Morel relates this design practice to the broader technical and social implications of various grid-computing projects, such as the online organisation Folding@Home, which utilises grid computing and distributed communities for the production and exchange of postindustrial knowledge. He argues that these ‘knowledge farms’ which create an ‘ambient factory’, are perhaps the ultimate form of social-economic production, transforming not only the evolution of design but of the communities that produce and eventually consume its products

The effect of quenching and defects size on the HCF behaviour of Boron steel

This work investigates the effect of natural and artificial surface defects and quenching on the fatigue strength of a Boron steel (22MnB5). A vast experimental campaign has been undertaken to study the high cycle fatigue behaviour and more specifically the fatigue damage mechanisms observed in quenched and untreated materials, under different loading conditions and with differents artificial defects sizes (from 25 μm to 370 μm radius). In order to test the sheet metal in shear an original test apparatus is used. The critical defect size is determined to be 100 ± 50 μm. This critical size does not appear to depend on the loading type or the microstructure of the material (i.e. ferritic–perlitic or martensitic). However, for large defects, the quenched material is more sensitive to the defect size than the untreated material. For a defect size range of 100–300 μm the slope of the Kitagawa–Takahashi diagram is approximately −1/3 and −1/6 for the quenched and untreated materials respectively. A probabilistic approach that leads naturally to a probabilistic Kitagawa type diagram is developed. This methodology can be used to explain the relationship between the influence of the heat treatment and the defect size on the fatigue behaviour of this steel

The impact of oil price variations : a DSGE Model for the Canadian Economy

Nous analysons les impacts de chocs reliés au prix du pétrole en utilisant un modèle dynamique stochastique d' équilibre général pour l'économie canadienne (DSGE). Les mouvements dans le prix du pétrole, modélisé comme une variable exogène, affectent l'économie à travers une variation de l'utilisation du capital. Les simulations du modèle suite à des chocs reliés au pétrole sont utilisée pour analyser leurs impacts sur les variables macroéconomiques. Un choc positif sur le prix mondial du pétrole augmente immédiatement la valeur du dollar canadien. Le choc crée également un effet de richesse pour les ménages canadiens et haussent leurs salaires. Bien que le choc diminue les exportations, l'effet de richesse augmente la consommation et la production de biens intermédiaires. Étant donné l'effet sur le taux de change, le choc augmente également les importations de biens

Clinical practice guidelines: Medical follow-up of patients with asthma—Adults and adolescents

SummaryThe follow-up of patients with asthma should focus on asthma control (disease course over a number of weeks)→ There are 3 levels of asthma control•Acceptable:All control criteria (Table 1 below) are met•Unacceptable:One or more criteria are not met•Optimal:All control criteria are normal or, in a patient with acceptable control, the best compromise has been achieved between degree of control, acceptance of treatment and possible side effectsTable 1 Criteria defining acceptable asthma control.CriterionValue or frequency*Day-time symptoms<4 days/weekNight-time symptoms<1 night/weekPhysical activityNormalExacerbationsMild, infrequentAbsence from work or schoolNoneUse of short-acting β2-agonists<4 doses/weekFEV1 or PEF>85% of personal bestPEF diurnal variation (optional)<15%*Mean during control assessment period (1 week–3 months).FEV: forced expiratory volume; PEF: peak expiratory flow.→ Follow-up includes monitoring of treatment side effects and adherence.→ Treatment should be adjusted to level of control and current long-term therapy.•If control is unacceptable:○Check: that the disease is asthma, adherence, correct use of inhalation devices.○Look for and treat: aggravating factors, concomitant disease, specific clinical forms.○Adjust long-term therapy (see Table 2 below) in steps of 1–3 months.•If control is acceptable or optimal:○Find the minimum effective treatment to maintain at least acceptable and ideally optimal control. Each step should last 3 months.Table 2 Adjusting long-term therapy if control is unacceptable.Current therapyNew treatmentaOption 1Option 2No ICSAverage-dose ICSAverage ICS dose+AMbPatients on ICS onlyLow- or average-dose ICSAdd AMIncrease ICS dose with or without AMHigh-dose ICSAdd AMPatients on ICS and additional medication (AM)Low dose of ICS (+1 AM)Increase ICS doseAverage dose of ICS (+1 AM)Increase ICS doseAdd second AM with or without increasing ICS doseHeavy dose of ICS (+1 AM)Add second AMOral corticosteroidscHeavy dose of ICS (+2 AMs)Oral corticosteroidscAdd third AMaThe choice between options will depend on symptom frequency and respiratory function (particularly post-bronchodilator FEV1).bAdditional medication (AM) covers long-acting β2-agonists, cysteinyl-leukotriene receptor antagonists, theophylline and its derivatives (bamiphylline).cOral corticosteroids are rarely used in adolescents.→ Frequency of follow-up visits (V) and lung function tests (LFTs) according to the dose of inhaled corticosteroids (ICS) needed for acceptable control (see Table 3 below)Table 3 Frequency of follow-up visits and LFTs.ICS doseV (months)LFT (months)High33–6Low or average66–12None1212 or +Low, average and high daily dose of ICS (μg/day) in adults.Low doseAverage doseHigh doseBeclomethasonea<500500–1000>1000Budesonide<400400–800>800Fluticasone<250250–500>500aDose should be halved for QVAR® and NEXXAIR®SynopsisTitleMedical follow-up of patients with asthma—adults and adolescentsPublication dateSeptember 2004Requested byFrench National Health DirectorateProduced byAnaes—French National Agency for Accreditation and Evaluation in Healthcare (Guidelines Department)Intended forAll health professionals who manage patients with asthmaAssessment method•Systematic review of the literature (with evidence levels)•Discussion among members of an ad hoc working group•External validation by peer reviewers (see Anaes guide “Recommandations pour la pratique clinique—base méthodologique pour leur réalisation en France—1999”)ObjectivesAddress the practical aspects of long-term medical follow-up of patients with asthma (adults and adolescents only)Literature searchJanuary 1997–December 20032957 articles identified of which 696 analysedEconomic studyNoneAnaes project leader(s)Dr. Philippe Martel (Department head: Dr. Patrice Dosquet)(Literature search: Emmanuelle Blondet with the help of Maud Lefèvre (Department head: Rabia Bazi); secretarial work: Elodie Sallez)Authors of draft reportDr. Hugues Morel, chest physician, DinanDr. Nicolas Roche, chest physician, ParisCollaborations and participants•Learned societies•Steering committee•Working group (Chair: Professor Philippe Godard, chest physician/allergologist, Montpellier)•Peer reviewers(Appendix A)Internal validationAnaes Scientific Council (Referees: Professor Bruno Housset, chest physician, Créteil; Michel Paparemborde, Head of physiotherapy training college, Lille)Validated on September 2, 2004Other Anaes publications on the topicMedical follow-up is complemented by ongoing patient education, which is dealt with in the guidelines “Therapeutic education for patients with asthma—adults and adolescents” (Anaes 2001

Single port access laparoscopic right hemicolectomy

Background: Single port access (SPA) surgery is a rapidly evolving field as it combines some of the cosmetic advantage of the Natural Orifice Translumenal Endoscopic Surgery (NOTES) and allows performing surgical procedure with standard surgical instruments. We report in this paper a new technique of umbilical SPA right hemicolectomy with conventional surgical oncologic principle and technique of minimally invasive colectomy. Methods: Preliminary experience with umbilical SPA right hemicolectomy in a patient with degenerated ascending colon polyp. Results: Umbilical SPA right hemicolectomy was feasible with conventional laparoscopic instruments. Carcinologic surgical principle can be respected using this technique as pathological specimen had sufficient surgical margins (>10cm) and lymph nodes (33). Operative time was 158 min. No peroperative or postoperative complications were recorded. Conclusion: SPA right hemicolectomy is feasible and safe when performed by experienced laparoscopic surgeons. SPA right hemicolectomy may have the advantage over NOTES approach to offer the safety of laparoscopic colectomy especially for haemostasis and anastomosis. It has to be determined whether or not this approach would offer benefit to patients, except in cosmesis, compared to standard laparoscopic right hemicolectom

Single-port access prosthetic repair for primary and incisional ventral hernia: toward less parietal trauma

Background: Although still under development, single-port access (SPA) approach may be of interest in patients prone to port-side incisional hernia, ensuring absence of increased fascial incision. This forms the basis for evaluating SPA for prosthetic ventral hernia repair. We report a new SPA technique of ventral hernia repair using working-channel endoscope, standard laparoscopic instruments, and 10-mm port. Methods: Prospective experience with SPA prosthetic repair of primary and incisional ventral hernia in 52 patients for 55 ventral hernias is presented. Median (range) patient age was 46 years (26-85 years), and BMI was 28kg/m2 (20-38kg/m2). Mean fascial defect was 16.2cm2 for primary hernia (n = 23) and 48.3cm2 for incisional hernia (n = 32). Intraperitoneal composite mesh repair was achieved through single 10-mm flank port using working-channel endoscope. Meshes were fixed using absorbable tackers and transfascial stitches. Results: SPA repair of primary and incisional ventral hernia was completed in all cases without conversion to standard laparoscopy. Median (range) operative time was 54min (39-95 min). Mesh size ranged from 118 to 500cm2. No intra- or postoperative complications were recorded, except two seromas. Median (range) hospital stay was 1 day (1-5 days). One patient presented prolonged postoperative pain on mesh fixation that resolved after 3 months. No recurrence or port-site incisional hernias have been recorded at median (range) follow-up of 16 months (3-28 months). Conclusions: SPA prosthetic repair of primary and incisional ventral hernia is easily feasible according to natural exposition by pneumoperitoneum and gravity. In the present series, SPA ventral hernia repair appears to be safe for experienced SPA surgeons. It may decrease parietal trauma and scarring in patients prone to incisional hernia. SPA repair may be associated with a decrease in rate of port-site incisional hernia compared with multiport laparoscopy, but this has to be verified by randomized trial with standard laparoscopic approach on long-term follow-u

Transumbilical single-incision laparoscopic intracorporeal anastomosis for gastrojejunostomy: case report

Background: Laparoscopic gastrojejunostomy allows effective palliation and rapid recovery for the patient with limited survival due to advanced pancreatic cancer presenting with gastric outlet obstruction. Transumbilical single-incision laparoscopic surgery (SILS) offers excellent cosmetic results and may be associated with decreased postoperative pain, reduced need for analgesia, and thus accelerated recovery. The authors report the first transumbilical single-incision laparoscopic intracorporeal anastomosis for gastrojejunostomy. Methods: Preliminary experience with transumbilical single-incision, intracorporeal anastomosis for gastrojejunostomy for a patient with gastric outlet obstruction caused by advanced pancreatic cancer is reported. Results: Transumbilical single-incision laparoscopic intracorporeal anastomosis for gastrojejunostomy was performed with a linear endoscopic stapler using an omega loop. The operative time was 117min. No intra- or postoperative complications were recorded. Conclusion: Transumbilical single-incision laparoscopic intracorporeal anastomoses are feasible using the endoscopic linear stapler. Transumbilical single-incision gastrojejunostomy for gastric outlet obstruction may improve cosmetic results and allow accelerated recovery for patients with limited survival. This anastomosis technique of single-incision laparoscopic surgery for other digestive tract procedures needs further evaluatio

Calcifying Bowel Inflammation: A Case Report

We report about a previously healthy 72-year-old woman, presented with 6 days of left lower quadrant abdominal pain and constipation. There was no report of fever, melena, hematochezia or change in appetite. The physical exam demonstrated a distended abdomen with palpable left lower quadrant pain, without guarding. CT showed images compatible with a sigmoid diverticulitis and a calcification of the sigmoid colon. After antibiotic threatment, a colonoscopy was performed which revealed the presence of a shell in the sigmoid colon. Our case illustrates the need for a colonoscopy following an attack of diverticulitis to look for a cancer or rarely a foreign body