Caractérisation géomorphologique du chenal court-circuité de Poutès, haut Allier (France) : résultats préliminaires avant le démantèlement du barrage

International audienceIn the context of impact assessment related to the removal of the Poutès dam (upper Allier river, France), the geomorphology of the bypass channel was studied on the basis of geomorphological mapping and LIDAR Digital Elevation Modelling. Three major geomorphic units were identified: rapids/riffles, pools and bars. Morphometric variables were derived from the geomorphological study and were subject to a spatial analysis to identify upstream-downstream changes of the bypass channel characteristics. The study gives special attention to the size and position of rapids/riffles and pools in order to identify the impact of external controls on the spatial pattern of forms and fluvial geomorphology.Dans le cadre de l'étude d'impact liée au démantèlement du barrage de Poutès, la géomorphologie du tronçon court-circuité (TCC) a été étudiée sur la base d'une cartographie géomorphologique et de l'exploitation d'imagerie LIDAR. Trois principales unités géomorphologiques ont été identifiées : seuils/rapides, mouilles et bancs. Des variables morphométriques ont été dérivées de l'étude géomorphologique et ont fait l'objet d'une analyse spatiale afin d'identifier l'évolution amont-aval des caractéristiques du TCC. L’étude accorde une attention toute particulière aux dimensions et à la position des seuils/rapides et mouilles de manière à identifier l’incidence des contrôles externes sur l’agencement des formes et la géomorphologie fluviale

Analyse histologique des répercussions musculaires, structurales, énergétiques et microvasculaires chez des hommes et des femmes drépanocytaires

Sickle cell anemia (SCA) is a hemoglobinopathy particularly known for its hematologic, hemodynamics and vascular repercussions. Although SCA patients are exercise intolerant, no studies have looked at muscle repercussions. We assessed repercussions of sickle cell anemia on skeletal muscle and its microvasculature in men (study 1) and women (study 2) for the first time. Our results showed that men with SCA displayed an amyotrophy which can at least partly explain the decrease of BMI at the expense of lean muscle mass. We also pointed out a decrease in muscle oxidative capacities (CS, β-HAD and COx) which could result from O2 supply and utilization disorders and partly explain their exercise intolerance. Finally, a microvascular remodeling characterized by a rarefaction, a decrease in microvessel tortuosity and a microvessel weakening was also highlighted. This remodeling could contribute to maintain local blood flow and reduce risks of entrapment of sickle red blood cells in the microvasculature, hence reducing vaso-occlusive risks. Muscle repercussions on a similar female population testified of the same muscle remodeling as the one observed in men with SCA, but this latter seemed to happen at a lesser extent in women with SCA, suggesting a gender effectLa drépanocytose est une hémoglobinopathie essentiellement connue pour ses répercussions hématologiques, hémodynamiques et vasculaires chez les patients homozygotes (SCA). Bien que ces sujets présentent une intolérance à l'effort, la littérature est très pauvre concernant les répercussions musculaires de la maladie. Ce travail doctoral nous a permis de caractériser pour la première fois les répercussions structurales, énergétiques et microvasculaires du muscle d’hommes (étude 1) et de femmes (étude 2) drépanocytaires par rapport à des sujets SCT et contrôles (CON). Nos analyses histologiques et biochimiques ont mis en évidence chez les sujets SCA masculins une amyotrophie qui explique au moins en partie la diminution de l’IMC des SCA au dépend de la masse maigre. Nous avons également observé l’altération de plusieurs indices du métabolisme oxydatif (CS, β-HAD et COx) qui pourrait relever de la restriction d’approvisionnement et d’utilisation tissulaire en O2 et expliquer en partie l’intolérance à l’effort. Enfin, un remodelage microvasculaire caractérisé par une raréfaction, une moindre tortuosité et une fragilisation des microvaisseaux a également été démontré. Ce remodelage microvasculaire pourrait contribuer à limiter le risque d’enclavement des hématies falciformées et ainsi réduire les risques de vaso-occlusions. La recherche de ces différents stigmates dans le muscle de la population féminine homologue a rapporté un remodelage musculaire similaire à celui observé chez les hommes SCA, mais ce dernier semble atténué, suggérant un effet genr

Λ\Lambda-Returns to Scale and Individual Minimum Extrapolation Principle

This paper proposes to estimate the returns-to-scale of a production set by considering the individual return of each observed firm. Each individual returns-to-scale is estimated from the goodness of fit approach proposed by Boussemart et al. (2019). The global technology is then constructed as the intersection of all the individual technologies. We propose an axiomatic foundation by introducing the notion of $\Lambda$-returns to scale that encompasses as a special case the standard definition of $\alpha$-returns to scale (Boussemart et al., 2009). Along this line it is shown that many production models involving variable, non-increasing and non-decreasing returns-to-scale appear to be special cases of models satisfying a $\Lambda$-returns to scale assumption.Comment: 27 pages, 8 figure

Retained plastic instrument after 5 years of illegal abortion: a case report and literature review

The retained of a foreign body during a surgical procedure is defined by the forgetting of a material, left by inattention in the body of the patient during this act. It is a rare event but is responsible for high morbidity and mortality. Authors report a retained foreign body incidentally discovered during a caesarean section. The patient had performed an illegal abortion by endo-uterine instrument which was complicated by uterine perforation five years previously. She was pregnant at 37 weeks and presented to the emergency department for bleeding and diagnosed as placenta previa. The antecedent of abortion had not been informed because it is an illegal act in Madagascar. The plastic instrument was in the broad ligament in contact with the ureter and the uterine artery. Caesarean section, the removal of the catheter and postoperative recovery was uneventful. Foreign body retention remains a malpractice and the diagnosis must be made in the face of chronic pain in patients who have undergone surgery

Safety and efficacy of a 6-month home-based exercise program in patients with facioscapulohumeral muscular dystrophy

Background: Previous randomized controlled trials investigating exercise training programs in facioscapulohumeral muscular dystrophy (FSHD) patients are scarce and of short duration only. This study assessed the safety and efficacy of a 6-month home-based exercise training program on fitness, muscle, and motor function in FSHD patients. Methods: Sixteen FSHD patients were randomly assigned to training (TG) and control (CG) groups (both n = 8) in a home-based exercise intervention. Training consisted of cycling 3 times weekly for 35 minutes (combination of strength, high-intensity interval, and low-intensity aerobic) at home for 24 weeks. Patients in CG also performed an identical training program (CTG) after 24 weeks. The primary outcome was change in peak oxygen uptake (VO 2 peak) measured every 6 weeks. The principal secondary outcomes were maximal quadriceps strength (MVC) and local quadriceps endurance every 12 weeks. Other outcome measures included maximal aerobic power (MAP) and experienced fatigue every 6 weeks, 6-minute walking distance every 12 weeks, and muscle characteristics from vastus lateralis biopsies taken pre- and postintervention. Results: The compliance rate was 91% in TG. Significant improvements with training were observed in the VO 2 peak (+19%, P = 0.002) and MAP by week 6 and further to week 24. Muscle endurance, MVC, and 6-minute walking distance increased and experienced fatigue decreased. Muscle fiber cross-sectional area and citrate synthase activity increased by 34% (P = 0.008) and 46% (P = 0.003), respectively. Dystrophic pathophysiologic patterns were not exacerbated. Similar improvements were experienced by TG and CTG. Conclusions: A combined strength and interval cycling exercise-training program compatible with patients' daily professional and social activities leads to significant functional benefits without compromising muscle tissue

Epidemiological profile, maternal and neonatal issue of uterine rupture at the Befelatanana Obstetrics and Gynecology University Hospital

Background: Uterine rupture is an obstetric emergency. It involves the life of the mother and the fetus. The main objective of this study was to describe the epidemiological-clinical profile of uterine rupture in Befelatanana Obstetrics and Gynecology University Hospital from January 2016 to April 2018.Methods: This is a retrospective and descriptive study conducted from January 1, 2016 to April 30, 2018 at the Befelatanana Hospital Centre of Gynecology-Obstetrics. All pregnant patients with uterine rupture were included.Results: We recorded 35 cases of uterine rupture in 13184 deliveries with a prevalence of 2.65%. The average age was 27.69±6.21 years old. More than half of the pregnant women attended at least four prenatal care consultations. Uterine rupture occurred after a vaginal delivery attempt outside the centre in 62.86%. There were 77.14% cases occurring on non-scarred uterus and 14.29% on mechanical dystocia. A case of fetal macrosomia has been reported. There were 28.57% maternal deaths and 51.43% perinatal deaths, half of which were fetal deaths in utero and the other half were early neonatal deaths.Conclusions: Uterine rupture remains high in Madagascar. Quality antenatal care and training of the personal would be needed

Suivi gynécologique par les médecins généralistes libéraux des Pyrénées-Atlantiques (état des lieux, freins objectifs et subjectifs)

BORDEAUX2-BU Santé (330632101) / SudocSudocFranceF

Histology analyses of structural, energetics and microvascular repercussions of skeletal muscle in men and women with sickle cell anemia

La drépanocytose est une hémoglobinopathie essentiellement connue pour ses répercussions hématologiques, hémodynamiques et vasculaires chez les patients homozygotes (SCA). Bien que ces sujets présentent une intolérance à l'effort, la littérature est très pauvre concernant les répercussions musculaires de la maladie. Ce travail doctoral nous a permis de caractériser pour la première fois les répercussions structurales, énergétiques et microvasculaires du muscle d’hommes (étude 1) et de femmes (étude 2) drépanocytaires par rapport à des sujets SCT et contrôles (CON). Nos analyses histologiques et biochimiques ont mis en évidence chez les sujets SCA masculins une amyotrophie qui explique au moins en partie la diminution de l’IMC des SCA au dépend de la masse maigre. Nous avons également observé l’altération de plusieurs indices du métabolisme oxydatif (CS, β-HAD et COx) qui pourrait relever de la restriction d’approvisionnement et d’utilisation tissulaire en O2 et expliquer en partie l’intolérance à l’effort. Enfin, un remodelage microvasculaire caractérisé par une raréfaction, une moindre tortuosité et une fragilisation des microvaisseaux a également été démontré. Ce remodelage microvasculaire pourrait contribuer à limiter le risque d’enclavement des hématies falciformées et ainsi réduire les risques de vaso-occlusions. La recherche de ces différents stigmates dans le muscle de la population féminine homologue a rapporté un remodelage musculaire similaire à celui observé chez les hommes SCA, mais ce dernier semble atténué, suggérant un effet genreSickle cell anemia (SCA) is a hemoglobinopathy particularly known for its hematologic, hemodynamics and vascular repercussions. Although SCA patients are exercise intolerant, no studies have looked at muscle repercussions. We assessed repercussions of sickle cell anemia on skeletal muscle and its microvasculature in men (study 1) and women (study 2) for the first time. Our results showed that men with SCA displayed an amyotrophy which can at least partly explain the decrease of BMI at the expense of lean muscle mass. We also pointed out a decrease in muscle oxidative capacities (CS, β-HAD and COx) which could result from O2 supply and utilization disorders and partly explain their exercise intolerance. Finally, a microvascular remodeling characterized by a rarefaction, a decrease in microvessel tortuosity and a microvessel weakening was also highlighted. This remodeling could contribute to maintain local blood flow and reduce risks of entrapment of sickle red blood cells in the microvasculature, hence reducing vaso-occlusive risks. Muscle repercussions on a similar female population testified of the same muscle remodeling as the one observed in men with SCA, but this latter seemed to happen at a lesser extent in women with SCA, suggesting a gender effec