41 research outputs found
Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Distress Syndrome associated with COVID-19: An Emulated Target Trial Analysis.
RATIONALE: Whether COVID patients may benefit from extracorporeal membrane oxygenation (ECMO) compared with conventional invasive mechanical ventilation (IMV) remains unknown. OBJECTIVES: To estimate the effect of ECMO on 90-Day mortality vs IMV only Methods: Among 4,244 critically ill adult patients with COVID-19 included in a multicenter cohort study, we emulated a target trial comparing the treatment strategies of initiating ECMO vs. no ECMO within 7 days of IMV in patients with severe acute respiratory distress syndrome (PaO2/FiO2 <80 or PaCO2 ≥60 mmHg). We controlled for confounding using a multivariable Cox model based on predefined variables. MAIN RESULTS: 1,235 patients met the full eligibility criteria for the emulated trial, among whom 164 patients initiated ECMO. The ECMO strategy had a higher survival probability at Day-7 from the onset of eligibility criteria (87% vs 83%, risk difference: 4%, 95% CI 0;9%) which decreased during follow-up (survival at Day-90: 63% vs 65%, risk difference: -2%, 95% CI -10;5%). However, ECMO was associated with higher survival when performed in high-volume ECMO centers or in regions where a specific ECMO network organization was set up to handle high demand, and when initiated within the first 4 days of MV and in profoundly hypoxemic patients. CONCLUSIONS: In an emulated trial based on a nationwide COVID-19 cohort, we found differential survival over time of an ECMO compared with a no-ECMO strategy. However, ECMO was consistently associated with better outcomes when performed in high-volume centers and in regions with ECMO capacities specifically organized to handle high demand. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/)
Brucellose ostéoarticulaire sur matériel étranger (étude de trois cas et revue de la littérature)
LYON1-BU Santé (693882101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF
Logical Aspects of Computational Linguistics: 6th International Conference, LACL 2011, Montpellier, France, June 29 – July 1, 2011. Proceedings
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Well-Nestedness Properly Subsumes Strict Derivational Minimalism
Kanazawa M, Michaelis J, Salvati S, Yoshinaka R. Well-Nestedness Properly Subsumes Strict Derivational Minimalism. In: Pogodalla S, Prost J-P, eds. Logical Aspects of Computational Linguistics (LACL 2011). Lecture Notes in Computer Science. Vol 6736. Berlin, Heidelberg: Springer; 2011: 112-128
Intérêt des capteurs bon marché pour l’analyse des eaux usées - Un outil complémentaire à la gestion des stations ?
International audienc
Intérêt des capteurs bon marché pour l’analyse des eaux usées - Un outil complémentaire à la gestion des stations ?
International audienc
Intérêt des capteurs bon marché pour l’analyse des eaux usées - Un outil complémentaire à la gestion des stations ?
International audienc
Anisotropy in cyclic behavior and fatigue crack growth of IN718 processed by laser powder bed fusion
International audienceThis study aims at characterizing the role of strong anisotropy in fatigue crack growth for a superalloy processed by additive manufacturing. The choice has been made to investigate two specimens exhibiting significantly different crystallographic textures, representative of possible variations of microstructures within a real part. Both cyclic mechanical behavior and fatigue crack growth have been investigated at high temperature. As a consequence of the oriented microstructure, high levels of anisotropy of elastic and viscoplastic behaviors were observed. These behaviors have been modeled by the combination of orthotropic elasticity, a Hill's criterion and linear and non-linear kinematic hardening laws. To assess fatigue crack growth driving forces, in the context of complex crack shape, finite element analysis was proceeded taking care of 3D crack shape description. J was derived from G-θ, this method being convenient for anisotropic material. In most cases, fatigue cracks were found to grow preferentially at the vicinity of grain boundaries, regardless of the crystallographic orientation. An intrinsic fatigue crack growth rate related to this intergranular mechanism has been determined. On the other hand, mostly transgranular crack growth were observed when the loading was applied in the processing direction. In this case, the crystallographic texture appears to be the main factor governing the fatigue crack growth rate