Identification of Optical Parameters for Determination of Radiance

The ‘brightness’ of coherent beams such as lasers is known as ‘radiance’ in radiometric terms. It is a concept which is rarely taken into account in laser material processing, laser system design, and for the characterization of laser beams. The typical beam parameters such as: laser power; spot size; intensity; wavelength; beam divergence and the beam propagation factor - M2, combined together are factors which determine the ‘radiance’ of lasers or energy beams in general. The concept of ‘brightness’ (‘radiance’ in particular), and how the laser beam parameters contribute to affect ‘radiance’, has not so far been reported in previous literature. Thus, we have investigated the theoretical ‘radiance’ for each parameter in relation to one another. In addition, a rather suitable empirical equation to determine the ‘radiance’ was also introduced herein, since, the existing equation for calculating ‘brightness’ do not employ the total power intensity of the beam. Based on this, we consider ‘power density’ rather than the ‘output power’ for determining radiance of a selected 1.064 μm wavelength Nd:YAG laser for a set laser processing parameter window. The analytical investigation firstly concluded that the inclusion of ‘power density’ into the equation takes in account of ‘spot size’ and ‘laser power’ to cover all laser beam parameters. Secondly, the results have shown wavelength to be the most contributory parameter to influence the radiance value followed by power density, M2, laser power and lastly the spot size of the laser beam. This was for a set-condition applied, but is generically applicable to different conditions and parameters, whereby, the same tendency would occur. This novel concept of brightness (radiance), of light sources such as a laser beam is not just useful for process control during laser material processing, but could prove to be a very effective concept for laser beam characterization, and in laser system design for enhancing the ‘brightness’ or ‘radiance’ of lasers. Also not just lasers but, the concept could be applicable for other energy beams in general.Publisher Statement: The final publication is available at Springer via http://dx.doi.org/10.1007/s12596-014-0219-

Comparison of the influence of cyclosporine and tacrolimus on the pharmacokinetics of prednisolone in adult male kidney transplant recipients

Cyclosporine has been observed to precipitate cushingoid features in kidney transplant recipients already on prednisolone. Some pharmacokinetic studies have demonstrated increased prednisolone exposure in patients on cyclosporine therapy compared with azathioprine, whereas other studies have found no difference. The objective of this study was to determine whether cyclosporine impacts on prednisolone exposure as compared with tacrolimus

Comparing peripheral venous access between obese and normal weight children

Intravenous (i.v.) access is sometimes a difficult, time-consuming, and highly frustrating procedure. Obesity is widely believed to be associated with difficult peripheral intravenous access (PIV) placement. This study examined the relationship between body mass index (BMI) and ease of venous access in children undergoing noncardiac surgical procedures.We prospectively collected data on children aged 2–18 years undergoing elective noncardiac surgery at our institution. A trained research assistant (RA) was present for PIV placement in all patients and noted the following: age, gender, ethnicity, weight, height, and BMI. We also collected data on i.v. insertion site, number of attempts, number of operators, and the number of i.v. cannula used. The main outcome variable was success or failure of i.v. placement on first attempt. Sample size calculation indicated a need for 40 obese and 40 control patients.A total of 103 (56 lean and 47 obese) patients comprised the study population. PIV cannulation was achieved on the first attempt in 55.2% while 39.6% of patients had 2–3 attempts before successful cannulation. Obese children were more likely to have failed attempt at first cannulation than lean controls ( P  < 0.001). Similarly, obese children were more likely to require two or more attempts at cannulation than lean children ( P  < 0.001).These data indicate that i.v. placement is more difficult in obese children than their lean peers and that the most likely site for successful placement in obese children after a failed attempt on the dorsum of the hand is the volar surface of the hand. Knowledge of potential sites for successful i.v. access could help to improve the success rate for i.v. placement.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/78591/1/j.1460-9592.2009.03198.x.pd

Electroencephalography microstates imbalance across the spectrum of early psychosis, autism, and mood disorders

Abstract Background Electroencephalography (EEG) microstates translate resting-state temporal dynamics of neuronal networks throughout the brain and could constitute possible markers of psychiatric disorders. We tested the hypothesis of an increased imbalance between a predominant self-referential mode (microstate C) and a decreased attentional mode (microstate D) in psychosis, mood, and autism spectrum disorders. Methods We retrospectively included 135 subjects from an early psychosis outpatient unit, with available eyes-closed resting-state 19 electrodes EEG. Individual-level then group-level modified K-means clustering in controls provided four microstate maps that were then backfitted to all groups. Differences between microstate parameters (occurrence, coverage, and mean duration) were computed between controls and each group, and between disease groups. Results Microstate class D parameters were systematically decreased in disease groups compared with controls, with an effect size increasing along the psychosis spectrum, but also in autism. There was no difference in class C. C/D ratios of mean duration were increased only in SCZ compared with controls. Conclusions The decrease in microstate class D may be a marker of stage of psychosis, but it is not specific to it and may rather reflect a shared dimension along the schizophrenia-autism spectrum. C/D microstate imbalance may be more specific to schizophrenia

Corrections to: Use of the BOADICEA Web Application in clinical practice: appraisals by clinicians from various countries.

The article "Use of the BOADICEA Web Application in clinical practice: appraisals by clinicians from various countries" written by Anne Brédart · Jean‑Luc Kop · Antonis C. Antoniou · Alex P. Cunningham · Antoine De Pauw ·Marc Tischkowitz · Hans Ehrencrona · Sylvie Dolbeault · Léonore Robieux · Kerstin Rhiem ·Douglas F. Easton · Peter Devilee · Dominique Stoppa‑Lyonnet· Rita Schmutlzer, was originally published electronically on the publisher's internet portal (currently SpringerLink) on 16th June 2017 without open access

Phonatory effort and articulatory effort according to the voicing of oral consonants in French

Un effort phonatoire intense ou prolongé peut causer des lésions des plis vocaux et une dysphonie. L’effort correspond à la perception, par un individu, de la force qu’il déploie pour réaliser une activité, ici la phonation visant à faire vibrer périodiquement les plis vocaux pour produire la voix dans la parole. L’évaluation de cet effort doit donc reposer, au moins, sur deux mesures, l’une perceptive et l’autre physique. Pour développer de telles mesures, il est nécessaire de dissocier l’effort phonatoire de la dysphonie, d’une part, et de l’effort articulatoire, d’autre part. Nous avons réalisé des expériences chez un grand nombre de sujets sains, en faisant varier l’effort phonatoire. Nous avons comparé les consonnes voisées et non voisées, ainsi que la parole vocale modale usuelle et non usuelle, c’est-à-dire différant par l’intensité, la hauteur et la qualité de la voix. Nous avons testé une mesure d’auto-perception de l’effort dans des comparaisons de syllabes par paires : le taux de difficulté ressenti pendant la production des consonnes voisées, par rapport aux non voisées. Le score moyen s’élevait à 22 sur 36, soit 61 pourcents. Nous avons aussi adapté une mesure acoustique de l’effort phonatoire : la fréquence fondamentale relative (RFFa). Les valeurs de RFFa, notamment à l’initiation de la voyelle post-consonantique, étaient plus basses, indiquant un effort plus important, pour les consonnes voisées que pour les non voisées et pour la voix forte-aigüe-pressée que pour la voix usuelle. Ces valeurs étaient cohérentes avec les mesures aérodynamiques réalisées. Nous avons également appliqué les deux mesures développées à des patients, dont nous présentons les cas.An intense or prolonged phonatory effort can induce vocal fold lesions and dysphonia. The effort corresponds to the perception, by an individual, of the exertion to perform an activity, here the phonation aiming to create a periodic vibration the vocal folds in order to produce the voice during speech. Therefore, the evaluation of phonatory effort must rely, at least, on two measures, one perceptive and another physical. To develop such measures, it is necessary to dissociate phonatory effort from dysphonia, on the one hand, and from articulatory effort, on the other hand. We have conducted experiments in a large number of healthy subjects, by varying the phonatory effort. We compared voiced and voiceless consonants, as well as usual and unusual modal vocal speech, the last one differing in intensity, pitch, and voice quality. We tested a self-perception measurement in pair comparisons of syllables: the rate of difficulty felt during the production of the voiced consonants, compared to voiceless ones. The average score was 22 out of 36, or 61 percents. We also adapted an acoustic measure of phonatory effort: the relative fundamental frequency (RFFa). The values of RFFa, especially at the initiation of post-consonantal vowels, were lower, indicating a greater effort, for the voiced consonants than for the voiceless ones, and for the loud-high-pressed voice than for the usual voice. These values were consistent with the aerodynamic measurements we made. We also applied the two developed measures to patients and we presented their cases

Clinical empathy : role and determinants in the care of severe chronic diseases

Ces 15 dernières années, la recherche sur l'empathie clinique dans le contexte de la médecine somatique s'est développée de manière significative. Cette empathie clinique est donc de mieux en mieux cernée : élaboration de différentes modélisations et identification de ses bénéfices. Aujourd'hui, il reste certains challenges à relever, et notamment celui d'améliorer et de préserver l'empathie clinique au fil de la formation et de la pratique médicales tout en protégeant le bien-être des médecins. Ce travail de thèse a pour objectif de définir l'empathie clinique dans le cadre des maladies chroniques graves : son processus, ses déterminants, ses conséquences et les ressources nécessaires. Ce travail propose trois études successives portant sur des patients (N=15) et des médecins hospitaliers (N=235) selon un design mixte, recueils de données quantitatifs et qualitatifs associés à des analyses de données quantitatives. Ces études cherchent à définir l'empathie, identifier et tester ses antécédents et conséquences, en explorant les vécus des médecins et des patients. Par ailleurs, une quatrième étude longitudinale dite pilote a été mise en place. Les résultats ont mis en évidence la spécificité de l'empathie à une clinique spécifique, ont souligné sa nature majoritairement cognitive et comportementale et son rôle primordial dans la clinique et le bien-être des patients et des médecins. Ce travail propose ainsi une définition empirique qui concilie et enrichit les précédentes tout en développant la connaissance des déterminants de cette compétence clinique dans le cas spécifique des maladies chroniques graves. L'empathie clinique résulte de nombreux éléments tant individuels que situationnels ou encore interindividuels. Alors le développement de l'empathie des médecins auprès des personnes atteintes de maladies chroniques graves ne peut être considéré sans développer des recommandations à destination des institutions, des programmes de formation, et des dispositifs de soutien individuel et collectif.Over the last 15 years, research on clinical empathy in somatic medicine has increased significantly. This clinical empathy is therefore becoming better understood, which shows by the appearance of various models and benefits on patients and physicians. Today, the challenge is to improve and to maintain clinical empathy through medical training and practice while protecting the well-being of physicians. This thesis' aim is to define clinical empathy in the context of serious chronic diseases: its process, its determinants, its consequences and the resources it needs. This work proposes three sequential studies involving patients (N = 15) and hospital doctors (N = 233). The design is mixed between qualitative and quantitative data and methods. These studies seek to define empathy, identify and test its antecedents and its consequences, exploring both the experiences of physicians and patients. Furthermore, a fourth study, a pilot one, has been conducted. Empathy appears as specific to a clinic. The results emphasize its cognitive and behavioral facets. Clinical empathy has a key role in patients' care and wellbeing but also in physicians' wellbeing. This work proposes an empirical definition that reconciles and enriches the preceding ones. It gives the opportunity to develop knowledge of empathy's determinants in the specific case of serious chronic diseases. Clinical empathy is the result of many individual, situational and inter-individual elements. Therefore, the development of doctors' empathy with patients with severe chronic diseases cannot be considered without developing recommendations to institutions, training programs, and individual and collective supports