17 research outputs found
Understanding Factors Associated With Psychomotor Subtypes of Delirium in Older Inpatients With Dementia
First continental underground electric railway, Budapest 1896
International audienceIn 1871, a municipal commission in charge of city planning in Budapest introduced an urban development plan based on a concentric annular structure and several large radials. Another element of the plan was the attractive Andra ´ssy Avenue linking the inner city to the city park (Va ´rosliget). In 1893, the Siemens & Halske Company developed a project for a shallowly buried railway that was to extend the entire length of the new avenue. The 3690 m long line, inaugurated in 1896, was mainland Europe's first underground electric railway, preceded only by London's underground (1890). In the early 1970s, complete restructuring was carried out because of increases in traffic and construction of the underground network. The short surface segment on the inside of the park was taken out of service, the segment between the two stations was buried and the line was extended to the current terminus, beyond the outer boulevard. The subway was then entirely refurbished in 1994-1996. This paper highlights the particular adaptive capacities of the small M1 line, which remains, after more than a century and despite the singular nature of the initial project, perfectly integrated in Budapest's transport system.Le premier chemin de fer électrique souterrain du continent et son contexte urbain, Budapest 1867-189
Designing a ground-breaking structure. Notes on the cast-iron/wrought-iron dome of the former Halle au Blé, 1809–1813
International audienceBélanger and F. Brunet, the cast-iron and wrought-iron framework covering the former Paris wheat market was built in 1809-13 in order to replace the wooden structure designed by Legrand and Molinos in 1782-83 and destroyed by fire in 1802. Validated by the central administration, it was the first, largediameter dome entirely built with iron elements. How was this structure able to persist as a model when its design was partly founded on empirical considerations or uncertain knowledge acquired through the construction of the first cast-iron bridges? Indeed, the sizing of the elements was based on embryonic theoretical considerations, the development of which was only completed subsequently, permitting the proper resolution of the problem of elastic curved beams. In this paper, we shall attempt to reconstitute the theoretical aspects underpinning the design of this unique structure, built well before iron framework reached an autonomous technical form
Guide de conception d'une infrastructure de recharge des VE pour la gare-pôle d'échangePrincipes / Bases pour le dimensionnement / Réglementation
Guide de conception d'une infrastructure de recharge des VE pour la gare-pôle d'échangePrincipes / Bases pour le dimensionnement / Réglementatio
Guide de conception d'une infrastructure de recharge des VE pour la gare-pôle d'échangePrincipes / Bases pour le dimensionnement / Réglementation
Guide de conception d'une infrastructure de recharge des VE pour la gare-pôle d'échangePrincipes / Bases pour le dimensionnement / Réglementatio
New Signage System for Improving Pedestrian Flow on Single-Exit Metro Stations: Focus on Paris Metro Line 4 Historical Stations
International audienceFor a number of years now, the use of the Metro is steadily augmenting, making it more and more difficult to ensure traffic regularity (due to a variety of technical problems, increases in exiting/boarding time and passenger accidents), which determines a loss in the system"s energy efficiency and the increase of traction current expenses. In disadvantageous conditions, such as those found in historical stations having only one access to each platform (present notably along the north-south line 4, opened roughly a century ago) and where the movements of passengers can be disorderly, it seems possible to ameliorate the quality of spaces and the overall service through well-focused low-impact improvements. In this paper, a new signage system with a view to improving flow management and providing better information to passengers is proposed. We focus on a particular moment of the voyage, namely the platform-train exchange, in the case of stations with one single exit that have, still today, a cul-de-sac at one end. Without neglecting the architectural aspects and comfort of the passengers, the objective of the proposal is controlling the regularity of traffic and optimising the resulting electricity consumption. The effectiveness of the signage system is validated via an in-house developed numerical tool allowing to explore the impact of the signage system on the modalities and times of the train-platform exchange. The analysis and comparison of several variations have upheld the validity of the improvements hypothesis in its entirety
Role of serotonin in cocaine effects in mice with reduced dopamine transporter function
The mesolimbic dopaminergic system, especially the nucleus accumbens, has received attention for its involvement in the reinforcing and addictive properties of cocaine and other drugs of abuse. It is generally accepted that the ability of cocaine to inhibit the dopamine transporter (DAT) is directly related to its reinforcing actions. However, mice with a genetic deletion of the DAT (DAT-KO mice) still experience the rewarding effects of cocaine. These behavioral findings suggest that there is an alternate site for cocaine reinforcement. We demonstrate here that modulation of the serotonergic system in the ventral tegmental area, where the mesolimbic dopamine system originates, is a target of cocaine action. The ultimate effect of this serotonin mechanism in animal models with sustained elevations of dopamine may be a feed-forward enhancement of dopamine levels in the nucleus accumbens
Lung Ultrasonography for the Diagnosis of SARS-CoV-2 Pneumonia in the Emergency Department.
"Delirium Day": A nationwide point prevalence study of delirium in older hospitalized patients using an easy standardized diagnostic tool
Background: To date, delirium prevalence in adult acute hospital populations has been estimated generally from pooled findings of single-center studies and/or among specific patient populations. Furthermore, the number of participants in these studies has not exceeded a few hundred. To overcome these limitations, we have determined, in a multicenter study, the prevalence of delirium over a single day among a large population of patients admitted to acute and rehabilitation hospital wards in Italy. Methods: This is a point prevalence study (called "Delirium Day") including 1867 older patients (aged 65 years or more) across 108 acute and 12 rehabilitation wards in Italian hospitals. Delirium was assessed on the same day in all patients using the 4AT, a validated and briefly administered tool which does not require training. We also collected data regarding motoric subtypes of delirium, functional and nutritional status, dementia, comorbidity, medications, feeding tubes, peripheral venous and urinary catheters, and physical restraints. Results: The mean sample age was 82.0 ± 7.5 years (58 % female). Overall, 429 patients (22.9 %) had delirium. Hypoactive was the commonest subtype (132/344 patients, 38.5 %), followed by mixed, hyperactive, and nonmotoric delirium. The prevalence was highest in Neurology (28.5 %) and Geriatrics (24.7 %), lowest in Rehabilitation (14.0 %), and intermediate in Orthopedic (20.6 %) and Internal Medicine wards (21.4 %). In a multivariable logistic regression, age (odds ratio [OR] 1.03, 95 % confidence interval [CI] 1.01-1.05), Activities of Daily Living dependence (OR 1.19, 95 % CI 1.12-1.27), dementia (OR 3.25, 95 % CI 2.41-4.38), malnutrition (OR 2.01, 95 % CI 1.29-3.14), and use of antipsychotics (OR 2.03, 95 % CI 1.45-2.82), feeding tubes (OR 2.51, 95 % CI 1.11-5.66), peripheral venous catheters (OR 1.41, 95 % CI 1.06-1.87), urinary catheters (OR 1.73, 95 % CI 1.30-2.29), and physical restraints (OR 1.84, 95 % CI 1.40-2.40) were associated with delirium. Admission to Neurology wards was also associated with delirium (OR 2.00, 95 % CI 1.29-3.14), while admission to other settings was not. Conclusions: Delirium occurred in more than one out of five patients in acute and rehabilitation hospital wards. Prevalence was highest in Neurology and lowest in Rehabilitation divisions. The "Delirium Day" project might become a useful method to assess delirium across hospital settings and a benchmarking platform for future surveys