On the existence of a dynamic critical point by using wet milling on (±) modafinil

This study has been carried out on the molecular compound (±) modafinil, which exhibits five pure polymorphic forms (I, III, IV, V and VI). At P = 1 atm, irrespective of temperature and without any milling energy, Form I is the stable form. Therefore, the other polymorphic forms (III, IV, V and VI) are of monotropic character. The steady states of (±) modafinil have been investigated as a function of wet milling parameters (milling intensity and water concentration). The results presented here suggest the existence of a dynamic critical point defined by Tc ≈ 40°C, Pc ≈ 1 atm, Ic ≈ k R; R=50, Xc = 2% mass percent of water, respectively the critical: mean temperature, global pressure, milling intensity proportional to R and water composition (in mass percent)

Taxonomical composition and functional analysis of biofilms sampled from a nuclear storage pool

Sampling small amounts of biofilm from harsh environments such as the biofilm present on the walls of a radioactive material storage pool offers few analytical options if taxonomic characterization and estimation of the different biomass contributions are the objectives. Although 16S/18S rRNA amplification on extracted DNA and sequencing is the most widely applied method, its reliability in terms of quantitation has been questioned as yields can be species-dependent. Here, we propose a tandem-mass spectrometry proteotyping approach consisting of acquiring peptide data and interpreting then against a generalist database without any a priori. The peptide sequence information is transformed into useful taxonomical information that allows to obtain the different biomass contributions at different taxonomical ranks. This new methodology is applied for the first time to analyze the composition of biofilms from minute quantities of material collected from a pool used to store radioactive sources in a nuclear facility. For these biofilms, we report the identification of three genera, namely Sphingomonas, Caulobacter, and Acidovorax, and their functional characterization by metaproteomics which shows that these organisms are metabolic active. Differential expression of Gene Ontology GOslim terms between the two main microorganisms highlights their metabolic specialization

« Mobi’carto » et « Mon école sous l’eau » : deux projets développés par le Master Géomatique de Cergy-Pontoise

Mobi’Carto : une application web pour visualiser l’offre de transport de la communauté d’agglomération de Cergy-Pontoise Parti du constat qu’il existe de nombreux services, sites et applications en tout genre permettant d’avoir des informations spécifiques à un mode de transport, mais qu’aucun ne donnait une vision globale des différents services (trains, bus, vélos et voitures), Mobi’Carto met en avant toute la richesse de l’offre des transports d’une communauté d’agglomération sous la forme d’u..

Evaluation of the Knowledge of Primary Care Physicians About Important Nail Diseases Before and After a Short Online Training

Introduction: Nail diseases are often diagnosed late with a potential prognostic and functional im-pact. This could be partly due to knowledge gaps among primary care physicians (PCPs). Objectives: To evaluate the knowledge about diagnosis and management of ten common/important nailconditions in a population of French PCPs and its improvement after a 31-minute online training session. Methods: We submitted 10 pre-test and post-test clinical cases and an educative online course on the diagnosis and the management of nail diseases to 138 volunteer PCPs; 73 completed the whole training path. Results: Compared to pre-test, more PCPs in the post-test required an urgent second opinion to der-matologist for pigmented melanoma (100% versus 80.3%; P <0.05) and use of inappropriate/danger-ous systemic treatment for trauma-induced nail changes was reduced after the training program (0% versus 6.8%; P <0.05).A lack of knowledge remained after training for amelanotic melanoma with an increase of mycological/bacteriological tests (9.6% versus 0%; P <0.05). Conclusions: Management of nail diseases by our panel of PCPs was suboptimal and was improved after a short online training

Multi-scale and cross-dimensional TMS mapping: A proof of principle in patients with Parkinson’s disease and deep brain stimulation

IntroductionTranscranial magnetic stimulation (TMS) mapping has become a critical tool for exploratory studies of the human corticomotor (M1) organization. Here, we propose to gather existing cutting-edge TMS-EMG and TMS-EEG approaches into a combined multi-dimensional TMS mapping that considers local and whole-brain excitability changes as well as state and time-specific changes in cortical activity. We applied this multi-dimensional TMS mapping approach to patients with Parkinson’s disease (PD) with Deep brain stimulation (DBS) of the sub-thalamic nucleus (STN) ON and OFF. Our goal was to identifying one or several TMS mapping-derived markers that could provide unprecedent new insights onto the mechanisms of DBS in movement disorders.MethodsSix PD patients (1 female, mean age: 62.5 yo [59–65]) implanted with DBS-STN for 1 year, underwent a robotized sulcus-shaped TMS motor mapping to measure changes in muscle-specific corticomotor representations and a movement initiation task to probe state-dependent modulations of corticospinal excitability in the ON (using clinically relevant DBS parameters) and OFF DBS states. Cortical excitability and evoked dynamics of three cortical areas involved in the neural control of voluntary movements (M1, pre-supplementary motor area – preSMA and inferior frontal gyrus – IFG) were then mapped using TMS-EEG coupling in the ON and OFF state. Lastly, we investigated the timing and nature of the STN-to-M1 inputs using a paired pulse DBS-TMS-EEG protocol.ResultsIn our sample of patients, DBS appeared to induce fast within-area somatotopic re-arrangements of motor finger representations in M1, as revealed by mediolateral shifts of corticomuscle representations. STN-DBS improved reaction times while up-regulating corticospinal excitability, especially during endogenous motor preparation. Evoked dynamics revealed marked increases in inhibitory circuits in the IFG and M1 with DBS ON. Finally, inhibitory conditioning effects of STN single pulses on corticomotor activity were found at timings relevant for the activation of inhibitory GABAergic receptors (4 and 20 ms).ConclusionTaken together, these results suggest a predominant role of some markers in explaining beneficial DBS effects, such as a context-dependent modulation of corticospinal excitability and the recruitment of distinct inhibitory circuits, involving long-range projections from higher level motor centers and local GABAergic neuronal populations. These combined measures might help to identify discriminative features of DBS mechanisms towards deep clinical phenotyping of DBS effects in Parkinson’s Disease and in other pathological conditions

Money for writing: Screenplay development and screenwriters earnings in French cinema

The funds allocated to developing screenplays currently constitute on average 2 to 3% of the overall budget of a film in France. Producers are more than ever dependent on presenting attractive draft screenplays to find their financial partners. As a result, screenwriters undoubtedly are active economic partners of production planning, but they do not seem to receive much professional recognition for this vital role. Moreover, their earnings often fail to reflect the amount of work produced and do not reward adequately the risks taken, including the possibility that production could stop after the screenplay is written. This article investigates the place of screenplay development within the economics of French cinema. Using recently published official reports and interviews, the author identifies different types of screenwriters – freestanding screenwriters, writing teams and screenwriters co-writing with the director – and addresses their working conditions. She surveys some of the contract modalities for the remuneration of professional screenwriters. Finally, she reviews the proposals made by different professional bodies to improve the remuneration of screenwriters and reform the financing of screenwriting

Variation in Structure and Process of Care in Traumatic Brain Injury: Provider Profiles of European Neurotrauma Centers Participating in the CENTER-TBI Study.

INTRODUCTION: The strength of evidence underpinning care and treatment recommendations in traumatic brain injury (TBI) is low. Comparative effectiveness research (CER) has been proposed as a framework to provide evidence for optimal care for TBI patients. The first step in CER is to map the existing variation. The aim of current study is to quantify variation in general structural and process characteristics among centers participating in the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. METHODS: We designed a set of 11 provider profiling questionnaires with 321 questions about various aspects of TBI care, chosen based on literature and expert opinion. After pilot testing, questionnaires were disseminated to 71 centers from 20 countries participating in the CENTER-TBI study. Reliability of questionnaires was estimated by calculating a concordance rate among 5% duplicate questions. RESULTS: All 71 centers completed the questionnaires. Median concordance rate among duplicate questions was 0.85. The majority of centers were academic hospitals (n = 65, 92%), designated as a level I trauma center (n = 48, 68%) and situated in an urban location (n = 70, 99%). The availability of facilities for neuro-trauma care varied across centers; e.g. 40 (57%) had a dedicated neuro-intensive care unit (ICU), 36 (51%) had an in-hospital rehabilitation unit and the organization of the ICU was closed in 64% (n = 45) of the centers. In addition, we found wide variation in processes of care, such as the ICU admission policy and intracranial pressure monitoring policy among centers. CONCLUSION: Even among high-volume, specialized neurotrauma centers there is substantial variation in structures and processes of TBI care. This variation provides an opportunity to study effectiveness of specific aspects of TBI care and to identify best practices with CER approaches

Analyse et optimisation du processus d'attribution des ponts de chargement de la cimenterie d'Obourg (LafargeHolcim)

Ce mémoire porte sur l’analyse et l’optimisation des règles d’attribution des ponts de chargement de la cimenterie d’Obourg (LafargeHolcim). LafargeHolcim se positionne comme un des leaders mondiaux dans le secteur des matériaux de construction. L’objectif de ce mémoire est de proposer des alternatives à la politique actuelle d’attribution des ponts de chargement de façon à réduire le temps d’attente et le temps passé sur site par les camions venant charger du ciment. Ceci permettrait une réduction des coûts liés à l’attente des camions ainsi qu’une amélioration du service au client. Après une présentation de la multinationale, les contraintes et les enjeux de la situation ainsi que les caractéristiques et le fonctionnement de la cimenterie d’Obourg sont exposés. Ensuite, il a été procédé à une analyse des données historiques. A partir de là, le processus de chargement actuel a été modélisé à l’aide d’Anylogic. Enfin, les différentes alternatives développées au regard des caractéristiques de la cimenterie d’Obourg ont également été modélisées et analysées au travers de multiples simulations. Ces deux dernières parties constituent le cœur du mémoire.Master [120] en Ingénieur de gestion, Université catholique de Louvain, 201

La bibliothérapie en médecine générale : quels freins à son utilisation ?

La bibliothérapie est une thérapie encore trop peu utilisée en Belgique et ce malgré des preuves de son efficacité dans la prise en charge de pathologies fréquentes en médecine générale. Cet article, basé sur mon TFE, vise à mettre en évidence les freins à son utilisation ainsi que des pistes d’action.Bibliotherapy is a therapy that is still uncommon in Belgium, despite evidence of its effectiveness in the management of pathologies that are common in general medicine. This article, based on my thesis, aims to highlight the obstacles to its use as well as courses of action

Prise en charge des patients drépanocytaires sévères en réanimation pédiatrique polyvalente au CHU de Strasbourg:Thèse présentée pour le diplôme d'État de docteur en médecine. Diplôme d'État mention pédiatrie

Médecine (Pédiatrie)La drépanocytose, ou anémie à cellules falciformes, est une maladie génétique héréditaire, autosomique récessive, qui affecte l'hémoglobine des globules rouges, aboutissant à la formation d'hémoglobine S (HbS). Cette dernière est responsable de la falciformation et de la diminution de la déformabilité du globule rouge à l'état désoxygéné. Selon l'OMS, 300 000 enfants naissent dans le monde chaque année avec une anomalie majeure de l'hémoglobine. La mortalité pédiatrique a quasiment disparu, mais la maladie est encore grevée d'une morbidité importante. Dans ce contexte, nous avons réalisé un état des lieux de la prise en charge des patients drépanocytaires sévères hospitalisés en Réanimation Pédiatrique Polyvalente à Strasbourg entre 2012 et 2022. Il s'agit donc d'une étude observationnelle descriptive rétrospective et monocentrique dans laquelle nous avons pu inclure 34 patients dont 15 filles (44,1%) et 19 garçons (55,9%) d'âge médian 7 ans. Le principal motif d'admission en réanimation était le syndrome thoracique aigu (22 patients, 64,7%). Parmi les 34 patients, 26 d'entre eux (76%) ont nécessité une ventilation, tous ont bénéficié d'une antibiothérapie probabiliste et d'une antalgie adaptée. Vingt-six patients (76,5%) ont nécessité une transfusion de CGR, associée pour 14 d'entre eux à un échange transfusionnel. Cinq patients ont bénéficié d'un échange transfusionnel seul malgré une Hb<9/dL. Il y a eu une majorité d'échange automatisé (12/19 soit 63,2%). Les faibles effectifs de notre étude ne nous ont pas permis de mettre en évidence des facteurs prédictifs de sévérité de la maladie. Enfin, l'analyse en sous-groupe visait à comparer l'échange transfusionnel manuel et automatisé tous motifs d'hospitalisation confondus puis dans le sous-groupe des STA. Le faible nombre de patients et le déséquilibre numérique entre les groupes ne nous a pas permis de réaliser de test statistique. Néanmoins, il semble que les patients ayant bénéficié d'un échange automatisé aient une durée d'hospitalisation totale plus courte avec une meilleure efficacité sur la diminution du taux d'hémoglobine S malgré un délai de réalisation plus long. En conclusion, la prise en charge de ces patients drépanocytaires concorde aux dernières recommandations HAS de 2005 à l'exception d'une utilisation excessive des échanges transfusionnels dans certaines situations comme le STA alors que la transfusion sanguine doit être la première étape si l'Hb < 9 g/dL et en l'absence de défaillance d'organe. De même, l'indication de l'échange manuel semble pouvoir être optimisée et ainsi l'échange automatisé privilégié.Sickle cell anemia is an inherited, autosomal recessive genetic disorder that affects the hemoglobin in red blood cells, resulting in the formation of hemoglobin S (HbS). HbS is responsible for sickle cell disease and reduced deformability of the red blood cell in the deoxygenated state. According to the WHO, 300,000 children are born worldwide each year with a major hemoglobin anomaly. Pediatric mortality has virtually disappeared, but the disease still carries a significant morbidity. In this context, we conducted a review of the management of severe sickle cell patients hospitalized in the Pediatric Intensive Care Unit in Strasbourg between 2012 and 2022. This was a single-center, retrospective, descriptive observational study in which we were able to include 34 patients, including 15 girls (44.1%) and 19 boys (55.9%) with a median age of 7 years. The main reason for admission to intensive care was acute chest syndrome (22 patients, 64.7%). Of the 34 patients, 26 (76%) required ventilation, all of whom received probabilistic antibiotic therapy and appropriate analgesia. Twenty-six patients (76.5%) required blood transfusion, 14 of them associated with erythro-exchange. Five patients benefited from eryhtro-exchange alone, despite an Hb<9/dL. The majority of eerythro-xchange were automated (12/19 or 63.2%). The small numbers in our study did not allow us to identify predictive factors of disease severity. Finally, a sub-group analysis was carried out to compare manual and automated erythro-exchange. The small number of patients and the numerical imbalance between groups prevented us from carrying out a statistical test. Nonetheless, it appears that patients who received automated exchange had a shorter total hospital stay, with greater efficacy in reducing hemoglobin S levels, despite a longer delay.In conclusion, the management of these sickle cell patients is in line with the latest HAS recommendations from 2005, with the exception of excessive use of erythro-exchange in certain situations such as ACS, whereas blood transfusion should be the first step if Hb < 9 g/dL and in the absence of organ failure. Similarly, the indication for manual exchange could be optimized, and automated exchange favored.Thèses et écrits académique