L’hemorragie grave du peripartum en milieu de reanimation dans un centre universitaire tunisien de niveau 3: épidémiologie et facteurs de risque de mortalité maternelle

L'hémorragie grave du péripartum demeure une des causes principales de mortalité maternelle. L'objectif de notre étude était de décrire le profil épidémiologique des patientes qui ont été prises en charge en milieu de réanimation suite à une hémorragie grave du péripartum et de rechercher d'éventuels facteurs de risque de mortalité. Notre étude est rétrospective descriptive et analytique. Nous avons inclus tous les cas d'hémorragie du péripartum ayant séjourné en unité de réanimation obstétricale du centre de maternité et de néonatologie de Tunis (CMNT) au cours de la période allant de janvier 2010 à Décembre 2013. Nous avons recueilli les paramètres démographiques, obstétricaux, ceux relatifs à la prise en charge chirurgicale et réanimatoire, les scores de gravité SAPS obstétrical et APACHEII, ainsi que la morbi-mortalité. Au total nous avons colligé 322 cas sur quatre ans. La répartition annuelle des patientes ainsi que les caractéristiques démographiques et obstétricales étaient comparables dans leur globalité sur les quatre années. Les pratiques thérapeutiques étaient également comparables. Le taux global de mortalité par hémorragie dans notre unité était à 4,7%, avec un taux annuel de mortalité stable. L'analyse des facteurs de risque de mortalité par hémorragie en milieu de réanimation a montré une association statistiquement significative entre la survenue du décès et les facteurs suivants : recours aux catécholamines, survenue de sepsis, oedème pulmonaire aigu, coagulation intravasculaire disséminée, insuffisance rénale aigue avec recours à l'hémodialyse, SDRA ou TRALI, atteinte neurologique grave, défaillance multiviscérale et arrêt cardiaque récupéré

Urinary iodine level assessment during third trimester in a sample of Egyptian pregnant women and its relation to thyroid function

Background: Inadequate intakes of iodine during pregnancy may cause thyroid dysfunctions that adversely affect pregnancy outcomes. Aim of the work was to evaluate the urinary iodine level as a marker of iodine status in a sample of Egyptian pregnant women during 3rd trimester and assess its relation to thyroid functions.Methods: This cross-sectional study was conducted on 100 pregnant females at their 3rd trimester aged (18-35) years. They were divided according to their urinary iodine concentration into 3 groups; Group (I): Pregnant females with deficient iodine (<150 μg/l), Group (II): Pregnant females with adequate iodine (150-249) μg/l, Group (III): pregnant females including who have above requirements (250-499 μg/l), and excessive (≥500 μg/l). TSH, free t4, free t3, Anti-Thyroglobulin (TgAb) and anti-thyroid perioxidase (TPOAb), medium urinary Iodine concentration (UIC) by ELISA and neck U/S were performed to all participants.Results: 18% of the pregnant women in our study had iodine deficiency during 3rd trimester (UIC<150 ug/l) whereas 55% of pregnant women had excess iodine level, and adequate iodine level was observed in 27%.  Serum TSH was significantly higher in group I with deficient iodine level (p value<0.01). All pregnant women included at group I were suffering from subclinical hypothyroidism. Serum TSH and thyroid volume were inversely correlated with urinary iodine among pregnant females at 3rd trimester (p value<0.01).Conclusions: Serum TSH and thyroid volume were inversely correlated with urinary iodine level among pregnant females at 3rd trimester

Spin Fidelity for Three-qubit Greenberger-Horne-Zeilinger and W States Under Lorentz Transformations

Constructing the reduced density matrix for a system of three massive spin$-\frac{1}{2}$ particles described by a wave packet with Gaussian momentum distribution and a spin part in the form of GHZ or W state, the fidelity for the spin part of the system is investigated from the viewpoint of moving observers in the jargon of special relativity. Using a numerical approach, it turns out that by increasing the boost speed, the spin fidelity decreases and reaches to a non-zero asymptotic value that depends on the momentum distribution and the amount of momentum entanglement.Comment: 12pages, 2 figure

Relationship between sperm parameters and intracytoplasmic sperm injection outcome

Objectives: With the adventure of intracytoplasmic sperm injection (ICSI) technique, great progresses have developed in the treatment of infertility. Concentration on the properties of male's gamete has been encouraged by the increasing concerns about the causes of ICSI failure. We hence conducted this study to investigate the probable association of sperm parameters with ISCI outcome. Methods: A total of 523 couples referred to Isfahan Fertility and Sterility Center from January 2007 to June 2008 for ICSI. Semen analysis was performed before ICSI procedure according to the WHO criteria. Patients were assigned into successful ICSI (case) and failed ICSI (control) groups. Sperm parameters were then compared between the 2 groups. Results: One hundred and six patients (20) had successful ICSI results (case group) compared with 417 couples (80) with undesirable ICSI outcomes (control group). Among evaluated factors, sperm agglutination (p = 0.007), sperm concentration (p = 0.043), leukocytospermia (p = 0.026) and head abnormality of sperm (p = 0.019) showed statistically significant differences between two groups with differing ICSI results. None of the other semen parameters revealed significant differences between these two groups. Conclusion: Our study showed that some sperm parameters are associated with desirable ICSI outcome. However, it is unclear whether these associations are causal. © 2015 The Authors

A hybrid approach of anfis—artificial bee colony algorithm for intelligent modeling and optimization of plasma arc cutting on monel™ 400 alloy

This paper focusses on a hybrid approach based on genetic algorithm (GA) and an adaptive neuro fuzzy inference system (ANFIS) for modeling the correlation between plasma arc cutting (PAC) parameters and the response characteristics of machined Monel 400 alloy sheets. PAC experiments are performed based on box-behnken design methodology by considering cutting speed, gas pressure, arc current, and stand-off distance as input parameters, and surface roughness (Ra), kerf width (kw), and micro hardness (mh) as response characteristics. GA is efficaciously utilized as the training algorithm to optimize the ANFIS parameters. The training, testing errors, and statistical validation parameter results indicated that the ANFIS learned by GA outperforms in the forecasting of PAC responses compared with the results of multiple linear regression models. Besides that, to obtain the optimal combination PAC parameters, multi-response optimization was performed using a trained ANFIS network coupled with an artificial bee colony algorithm (ABC). The superlative responses, such as Ra of 1.5387 µm, kw of 1.2034 mm, and mh of 176.08, are used to forecast the optimum cutting conditions, such as a cutting speed of 2330.39 mm/min, gas pressure of 3.84 bar, arc current of 45 A, and stand-off distance of 2.01 mm, respectively. Furthermore, the ABC predicted results are validated by conducting confirmatory experiments, and it was found that the error between the predicted and the actual results are lower than 6.38%, indicating the adoptability of the proposed ABC in optimizing real-world complex machining processes

Demonstration of the Complementarity of One- and Two-Photon Interference

The visibilities of second-order (single-photon) and fourth-order (two-photon) interference have been observed in a Young's double-slit experiment using light generated by spontaneous parametric down-conversion and a photon-counting intensified CCD camera. Coherence and entanglement underlie one-and two-photon interference, respectively. As the effective source size is increased, coherence is diminished while entanglement is enhanced, so that the visibility of single-photon interference decreases while that of two-photon interference increases. This is the first experimental demonstration of the complementarity between single- and two-photon interference (coherence and entanglement) in the spatial domain.Comment: 21 pages, 7 figure

Conditional Reverse Tet-Transactivator Mouse Strains for the Efficient Induction of TRE-Regulated Transgenes in Mice

Tetracycline or doxycycline (dox)-regulated control of genetic elements allows inducible, reversible and tissue specific regulation of gene expression in mice. This approach provides a means to investigate protein function in specific cell lineages and at defined periods of development and disease. Efficient and stable regulation of cDNAs or non-coding elements (e.g. shRNAs) downstream of the tetracycline-regulated element (TRE) requires the robust expression of a tet-transactivator protein, commonly the reverse tet-transactivator, rtTA. Most rtTA strains rely on tissue specific promoters that often do not provide sufficient rtTA levels for optimal inducible expression. Here we describe the generation of two mouse strains that enable Cre-dependent, robust expression of rtTA3, providing tissue-restricted and consistent induction of TRE-controlled transgenes. We show that these transgenic strains can be effectively combined with established mouse models of disease, including both Cre/LoxP-based approaches and non Cre-dependent disease models. The integration of these new tools with established mouse models promises the development of more flexible genetic systems to uncover the mechanisms of development and disease pathogenesis

DETECTING MULTIPATH EFFECTS ON SMARTPHONE GNSS MEASUREMENTS USING CMCD AND ELEVATION-DEPENDENT SNR SELECTION TECHNIQUE

Regarding increasing smartphone receivers' usage in science and industry, they must improve their positioning algorithms to increase positioning accuracy and location-based software's productivity. For this goal, various studies have been presented to remove or adjust the errors in the GNSS signal received by smartphones. Nevertheless, so far, no study has been conducted to investigate the effect of the multipath effect on smartphone observations. Various algorithms have been performed to study the effect of multipath, from detecting and removing this effect by correcting errors in the signal processing step to weighting the measurements to reduce the effect of multipath on the observations in the positioning step.In this article, an attempt has been made to compare the results of two different algorithms, CMCD and Selection Signal, based on SNR elevation-dependent in detecting the effect of multipath on smartphones to check their performance for detecting measurements contaminated with multipath.</p

Automated quantification of steatosis: agreement with stereological point counting

Background: Steatosis is routinely assessed histologically in clinical practice and research. Automated image analysis can reduce the effort of quantifying steatosis. Since reproducibility is essential for practical use, we have evaluated different analysis methods in terms of their agreement with stereological point counting (SPC) performed by a hepatologist. Methods: The evaluation was based on a large and representative data set of 970 histological images from human patients with different liver diseases. Three of the evaluated methods were built on previously published approaches. One method incorporated a new approach to improve the robustness to image variability. Results: The new method showed the strongest agreement with the expert. At 20× resolution, it reproduced steatosis area fractions with a mean absolute error of 0.011 for absent or mild steatosis and 0.036 for moderate or severe steatosis. At 10× resolution, it was more accurate than and twice as fast as all other methods at 20× resolution. When compared with SPC performed by two additional human observers, its error was substantially lower than one and only slightly above the other observer. Conclusions: The results suggest that the new method can be a suitable automated replacement for SPC. Before further improvements can be verified, it is necessary to thoroughly assess the variability of SPC between human observers