1,099 research outputs found

    Les infractions pénales en droit médical

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    Chronique de responsabilité civile

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    Chronique de responsabilité civile

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    Decay of scalar variance in isotropic turbulence in a bounded domain

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    The decay of scalar variance in isotropic turbulence in a bounded domain is investigated. Extending the study of Touil, Bertoglio and Shao (2002; Journal of Turbulence, 03, 49) to the case of a passive scalar, the effect of the finite size of the domain on the lengthscales of turbulent eddies and scalar structures is studied by truncating the infrared range of the wavenumber spectra. Analytical arguments based on a simple model for the spectral distributions show that the decay exponent for the variance of scalar fluctuations is proportional to the ratio of the Kolmogorov constant to the Corrsin-Obukhov constant. This result is verified by closure calculations in which the Corrsin-Obukhov constant is artificially varied. Large-eddy simulations provide support to the results and give an estimation of the value of the decay exponent and of the scalar to velocity time scale ratio

    Computational Simulations for Aortic Coarctation: Representative Results From a Sampling of Patients

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    Treatments for coarctation of the aorta (CoA) can alleviate blood pressure (BP) gradients(D), but long-term morbidity still exists that can be explained by altered indices of hemodynamics and biomechanics. We introduce a technique to increase our understanding of these indices for CoA under resting and nonresting conditions, quantify their contribution to morbidity, and evaluate treatment options. Patient-specific computational fluid dynamics (CFD) models were created from imaging and BP data for one normal and four CoA patients (moderate native CoA: D12 mmHg, severe native CoA: D25 mmHg and postoperative end-to-end and end-to-side patients: D0 mmHg). Simulations incorporated vessel deformation, downstream vascular resistance and compliance. Indices including cyclic strain, time-averaged wall shear stress (TAWSS), and oscillatory shear index (OSI) were quantified. Simulations replicated resting BP and blood flow data. BP during simulated exercise for the normal patient matched reported values. Greatest exercise-induced increases in systolic BP and mean and peak DBP occurred for the moderate native CoA patient (SBP: 115 to 154 mmHg; mean and peak DBP: 31 and 73 mmHg). Cyclic strain was elevated proximal to the coarctation for native CoA patients, but reduced throughout the aorta after treatment. A greater percentage of vessels was exposed to subnormal TAWSS or elevated OSI for CoA patients. Local patterns of these indices reported to correlate with atherosclerosis in normal patients were accentuated by CoA. These results apply CFD to a range of CoA patients for the first time and provide the foundation for future progress in this area

    Computational simulations demonstrate altered wall shear stress in aortic coarctation patients previously treated by resection with end-to-end anastomosis

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    Background.  Atherosclerotic plaque in the descending thoracic aorta (dAo) is related to altered wall shear stress (WSS) for normal patients. Resection with end-to-end anastomosis (RWEA) is the gold standard for coarctation of the aorta (CoA) repair, but may lead to altered WSS indices that contribute to morbidity. Methods.  Computational fluid dynamics (CFD) models were created from imaging and blood pressure data for control subjects and age- and gender-matched CoA patients treated by RWEA (four males, two females, 15 ± 8 years). CFD analysis incorporated downstream vascular resistance and compliance to generate blood flow velocity, time-averaged WSS (TAWSS), and oscillatory shear index (OSI) results. These indices were quantified longitudinally and circumferentially in the dAo, and several visualization methods were used to highlight regions of potential hemodynamic susceptibility. Results.  The total dAo area exposed to subnormal TAWSS and OSI was similar between groups, but several statistically significant local differences were revealed. Control subjects experienced left-handed rotating patterns of TAWSS and OSI down the dAo. TAWSS was elevated in CoA patients near the site of residual narrowings and OSI was elevated distally, particularly along the left dAo wall. Differences in WSS indices between groups were negligible more than 5 dAo diameters distal to the aortic arch. Conclusions.  Localized differences in WSS indices within the dAo of CoA patients treated by RWEA suggest that plaque may form in unique locations influenced by the surgical repair. These regions can be visualized in familiar and intuitive ways allowing clinicians to track their contribution to morbidity in longitudinal studies

    ASSESSMENT OF URINARY HYDROXYPYRIDINIUM CROSS-LINKS MEASUREMENT IN OSTEOARTHRITIS

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    The aim of this study is to re-evaluate urinary collagen cross-links, previously proposed as markers of osteoarthritis (OA). The urinary excretion of collagen cross-links, pyridinoline (PYD) and deoxypyridinoline (DPD), was measured using high-performance liquid chromatography (HPLC) in 114 patients with OA, 19 patients with rheumatoid arthritis (RA) and 40 healthy subjects. An increase in PYD and DPD, expressed per millimole of creatinine, was confirmed in RA. However, PYD and DPD in patients with hip OA, knee OA and polyOA were similar, and did not differ from controls. In patients with radiographic end-stage OA, PYD and DPD were significantly higher than in patients with an early OA, but not significantly higher than in controls. The PYD/DPD ratio did not vary with the OA stage. Thus, urinary collagen cross-links are not elevated in OA, but could reflect bone sclerosis and/or erosion in late O

    Is the Shroud of Turin in Relation to the Old Jerusalem Historical Earthquake?

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    Phillips and Hedges suggested, in the scientific magazine Nature (1989), that neutron radiation could be liable of a wrong radiocarbon dating, while proton radiation could be responsible of the Shroud body image formation. On the other hand, no plausible physical reason has been proposed so far to explain the radiation source origin, and its effects on the linen fibres. However, some recent studies, carried out by the first author and his Team at the Laboratory of Fracture Mechanics of the Politecnico di Torino, found that it is possible to generate neutron emissions from very brittle rock specimens in compression through piezonuclear fission reactions. Analogously, neutron flux increments, in correspondence to seismic activity, should be a result of the same reactions. A group of Russian scientists measured a neutron flux exceeding the background level by three orders of magnitude in correspondence to rather appreciable earthquakes (4th degree in Richter Scale). The authors consider the possibility that neutron emissions by earthquakes could have induced the image formation on Shroud linen fibres, trough thermal neutron capture by Nitrogen nuclei, and provided a wrong radiocarbon dating due to an increment in C(14,6)content. Let us consider that, although the calculated integral flux of 10^13 neutrons per square centimetre is 10 times greater than the cancer therapy dose, nevertheless it is100 times smaller than the lethal dose.Comment: 13 pages, 1 figur

    Derivation of fluid dynamics from kinetic theory with the 14--moment approximation

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    We review the traditional derivation of the fluid-dynamical equations from kinetic theory according to Israel and Stewart. We show that their procedure to close the fluid-dynamical equations of motion is not unique. Their approach contains two approximations, the first being the so-called 14-moment approximation to truncate the single-particle distribution function. The second consists in the choice of equations of motion for the dissipative currents. Israel and Stewart used the second moment of the Boltzmann equation, but this is not the only possible choice. In fact, there are infinitely many moments of the Boltzmann equation which can serve as equations of motion for the dissipative currents. All resulting equations of motion have the same form, but the transport coefficients are different in each case.Comment: 15 pages, 3 figures, typos fixed and discussions added; EPJA: Topical issue on "Relativistic Hydro- and Thermodynamics

    Numerical simulation of blood flow and pressure drop in the pulmonary arterial and venous circulation

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    A novel multiscale mathematical and computational model of the pulmonary circulation is presented and used to analyse both arterial and venous pressure and flow. This work is a major advance over previous studies by Olufsen et al. (Ann Biomed Eng 28:1281–1299, 2012) which only considered the arterial circulation. For the first three generations of vessels within the pulmonary circulation, geometry is specified from patient-specific measurements obtained using magnetic resonance imaging (MRI). Blood flow and pressure in the larger arteries and veins are predicted using a nonlinear, cross-sectional-area-averaged system of equations for a Newtonian fluid in an elastic tube. Inflow into the main pulmonary artery is obtained from MRI measurements, while pressure entering the left atrium from the main pulmonary vein is kept constant at the normal mean value of 2 mmHg. Each terminal vessel in the network of ‘large’ arteries is connected to its corresponding terminal vein via a network of vessels representing the vascular bed of smaller arteries and veins. We develop and implement an algorithm to calculate the admittance of each vascular bed, using bifurcating structured trees and recursion. The structured-tree models take into account the geometry and material properties of the ‘smaller’ arteries and veins of radii ≥ 50 μ m. We study the effects on flow and pressure associated with three classes of pulmonary hypertension expressed via stiffening of larger and smaller vessels, and vascular rarefaction. The results of simulating these pathological conditions are in agreement with clinical observations, showing that the model has potential for assisting with diagnosis and treatment for circulatory diseases within the lung
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