Assessment and diagnosis of acute limb compartment syndrome: A literature review

Background: Compartment syndrome is a collection of symptoms that signal increased pressure in the muscle compartment and results in compromised tissue perfusion. Failure to diagnose and treat the condition can result in permanent neurovascular deficit, tissue ischaemia, limb amputation and rhabdomyolysis. Aims: The aim of the review was to determine the strength of the evidence regarding risk reduction and early detection of ALCS and to identify the gaps in the evidence. Methods: Following a systematic search, literature about patient risk, risk reduction, clinical observation and compartment monitoring was identified and the methodological quality of studies was considered. Findings: Diaphyseal fractures of the tibia are the most significant risk factor for compartment syndrome followed by fracture of the distal radius. The anterior compartment of the leg and the flexor compartment of the forearm are most affected. Other factors include calcaneal fractures, male gender, age <35 years, high energy trauma, soft tissue injuries (especially in patients with bleeding disorders), open fracture, limb compression due to traction, padding and casts and surgical management of fractures. Males aged below 35 years who sustain a fracture of the lower leg or forearm should be monitored most carefully. Clinical observations, together with compartment pressure monitoring, in patients at risk appears to be the best method of diagnosing the condition. Pain out of proportion to the injury and pain on passive muscle stretch are the most effective clinical observation in conscious patients. Paresis/paralysis, parasthesia and pallor may help in diagnosis but are late signs. The sensitivity and specificity of these symptoms in diagnosing ALCS is unclear and the approach to pain assessment is not considered in detail

Taxes and Entrepreneurial Activity: Theory and Evidence for the U.S.

Entrepreneurial activity is presumed to generate important spillovers, potentially justifying tax subsidies. How does the tax law affect individual incentives? How much of an impact has it had in practice? We first show theoretically that taxes can affect the incentives to be an entrepreneur due simply to differences in tax rates on business vs. wage and salary income, due to differences in the tax treatment of losses vs. profits through a progressive rate structure and through the option to incorporate, and due to risk-sharing with the government. We then provide empirical evidence using U.S. individual tax return data that these aspects of the tax law have had large effects on actual behavior.

Cropping system to limit blast disease in upland rice

Cropping system is an essential aspect to take into account to manage blast disease (caused by the fungus Magnaporthe oryzae). In addition to the selection of resistant cultivars, studies report opportunities to limit blast incidence by managing mineral amendment (N, Si, P, etc.), cultivar mixtures or other cropping system adaptations. In Madagascar, rice is the staple crop and food. Farmers traditionally grow irrigated or rainfed lowland rice wherever possible. In the mid-1980s, CIRAD and FOFIFA launched a research program for the highlands to extend upland rice growing areas in high elevation areas of the tropics. This program was consolidated with research on cropping practices that ensure the sustainability of upland rice based cropping systems in this poor and fragile environment. New varieties where obtained, adapted for rainfed cropping up to 1800 m altitude (Dzido et al., 2004). However, farmers had to face attacks of blast disease. Due to the small genetic basis of these varieties, the fungus quickly overcame resistant or tolerant lines selected by breeders. The ways of management of blast disease are very limited in a country like Madagascar where efficient solutions are often not suitable for farmers. Observations of blast epidemics in different regions made us consider the soil as a key factor for rice susceptibility. In a first experiment, we measured the potential of our very susceptible varieties to tolerate blast when cropped in different soil conditions. During two years, we transported volcanic soil from a very fertile area close to the experimentation site and where blast pressure is much lower. We observed a decrease of blast symptoms on rice cropped on that soil compared to the soil of the experimental site, both on leaves and panicles. That decrease was bound to a significant yield increase, demonstrating the importance of plant nutrition on blast incidence. Such results confirm those obtained in 1981 by Seguy et al. Our aim was then to develop cropping systems that could influence blast incidence through an improvement of soil functions. Direct seeded mulch based (DSMB) cropping systems were first used in Madagascar to limit erosion in upland areas. During 4 years, we compared blast epidemics between a traditional cropping system with ploughing each year and a DSMB cropping system, on a midsusceptible variety specific of the highlands conditions. Two fertilisation levels were also tested in these systems: zebu manure only and manure plus additional mineral fertiliser. A significant difference between the two systems was observed, both at leaf and panicle stage. Blast incidence was reduced in DSMB cropping system and, on the contrary to the traditional cropping system, the mineral fertilisation had no effect on blast in DSMB. N fertilisation is known for a long time as an essential factor in blast management. The fact that DSMB cropping system reduced the effect of N-fertilisation made us consider N as the determinant factor of the interaction between cropping system and blast incidence. The determinants of this interaction must then be explained to enable new and durable cropping systems to be developed to manage blast epidemics, in addition to cultivar improvement. This is the objectives of the starting project GARP (ANR-Systerra) which is conducted in Bolivia, Brazil, France, and Madagascar. Its aim is to quantify the interactions between cropping system, N-nutrition and blast resistance in upland rice. Hypotheses and preliminary results of the project will be presented. (Texte intégral

La réconciliation de la démocratie locale et de la compétitivité internationale dans le discours réformiste à Toronto : Essai d’interprétation sur le néolibéralisme normalisé

S’appuyant sur l’exemple de Toronto, cet article cherche à élucider les raisons pour lesquelles plusieurs militants ont recours au langage de la démocratie locale dans leur lutte contre le néolibéralisme. Il est très fréquent que les citoyens perçoivent les réformes urbaines légitimées au nom de la compétitivité mondiale comme une menace directe à leur qualité de vie locale. Cet antagonisme, longtemps conçu par les analystes urbains comme un conflit entre la « valeur d’usage » et la « valeur d’échange », prend toutefois une dimension particulière à Toronto avec le retour d’un régime de centre-gauche caractérisé par la synthèse de ces deux pôles qui s’expliquerait par une dynamique de normalisation du néolibéralisme.Based on the example of Toronto, this article seeks to understand why many activists use the language of local democracy in their struggle against neoliberalism. Recent urban reforms have often been legitimated as “necessary” for global competitiveness. Yet, these reforms have been perceived by residents as a direct threat to their quality of life. While this antagonism has long been analysed as the opposition between “use value” and “exchange value”, the return to power of a centre-left regime in Toronto is better characterized by a synthesis between these two poles, which exemplifies the process of normalizing neoliberalism

Performance of Three Alternative Surfacing Processes on Black Spruce Wood and Their Effects on Water-Based Coating Adhesion

Surface quality and water-based coating performance of samples prepared by oblique cutting, helical planing, and face milling were studied. Oblique cutting and helical planing generated surfaces with similar features. Samples had little subsurface damage and fibrillation, and few cell lumens were accessible on the surface to favor coating penetration. As a result, these samples had lower surface roughness and wetting properties than face-milled ones. Face-milled samples were defined by more subsurface damage, fibrillation, and open lumens that favored coating penetration. However, the pull-off strength of face-milled samples was significantly lower after accelerated weathering than the oblique-cut or helical-planed samples. Hence, oblique cutting and helical planing are suitable for preparing surfaces of black spruce prior to coating application. No correlations were detected between surface quality parameters and adhesion, which indicates that pull-off tests have to be determined to quantify coating adhesion on surfaces of this wood species

Evaluation of Four Surfacing Methods on Black Spruce Wood in Relation to Poly(Vinyl Acetate) Gluing Performance

Oblique cutting, peripheral planing, face milling, and sanding were used to surface black spruce wood prior to gluing with a two-component poly(vinyl acetate) adhesive. Surface roughness, anatomical features of surfaces, and glueline interfaces as well as the glueline shear strength before and after aging were evaluated. Oblique-cut surfaces presented no subsurface damage, little fibrillation, low roughness, thin gluelines, and little adhesive penetration. Peripheral-planed and face-milled surfaces both showed slight cell deformation and a higher level of fibrillation. The large number of cell lumens available and the fibrillation appeared to favor the penetration of adhesive as well as to increase surface roughness. Sanded surfaces were the smoothest, and their anatomical structures were the least visible of the four machining processes. These samples also showed more important subsurface damage, which limited the penetration of adhesive. For the glueline shear strength before and after weathering, no significant differences occurred among the surfacing treatments. The microscopic and topographic differences among the surfacing treatments were not sufficient to generate significant differences in glueline shear strength. Peripheral planing and face milling should be better alternatives with respect to productivity