Évolution des structures deltaïques du delta de la rivière Natashquan, Québec

Le delta de la rivière Natashquan (Côte-Nord du Saint-Laurent) offre un exemple typique de construction de structures deltaïques (lobes) dans un contexte de régression, sous la dépendance des processus hydrodynamiques fluvial et marin. Actuellement, depuis la migration de l'embouchure de la rivière, un des lobes du delta est partiellement en voie d'érosion et de fossilisation. La structure du substratum (bouclier cristallin précambrien et roches sédimentaires paléozoïques) détermine la morphologie et le drainage préglaciaires de la région. Les glaciations du Pleistocene ont creusé des vallées en auge. La transgression de la Mer de Goldthwait, liée au relèvement glacioisostatique, donne la morphologie actuelle de la région (paléolignes de rivage, delta). Le delta multilobé, encore partiellement submergé, est limité au large par une ligne de cuestas submergée. Une étude géophysique et sédimentologique décrit les sédiments recouvrant le substratum. Le prisme sableux deltaïque progresse sur des sédiments argilosilteux prédeltaïques de la Mer de Goldthwait. La pente du front du delta varie de 0,5° est à 10° ouest. La structure interne du lobe montre plusieurs unités complexes de couches frontales tronquées, reposant sur des couches basâtes; les couches sommitales érodées sont absentes. Les effets combinés des processus fluvial et marin entraînent une progradation rapide d'un large volume de sédiments à l'ouest avec des couches frontales très inclinées (8°) provoquant des mouvements gravitaires.Natashquan River delta (north shore of the St. Lawrence River) provides a typical example of deltaic structure (lobes) construction, in a regressive context, controlled by fluvial and marine hydrodynamics processes. At the present, since the mouth of the river has migrated, one deltaic lobe is partly eroded and being fossilized. The structure of the bedrock (Precambrian crystalline shield and Lower Paleozoic sedimentary rocks) controls pre-glacial morphology and drainage of the region. Pleistocene glaciations formed U-shaped valleys. Postglacial high sea levels (Goldthwait Sea) and isostatic rebound created present morphology of the region (relict shorelines, delta). Part of the delta is still submerged and forms a deltaic fan (multilobate) which extends offshore as far as a line of submerged cuestas. Geophysical profiles and sampling provide a good understanding of the sedimentary blanket overlying bedrock. The deltaic sand body progrades on predeltaic silty-clay sediments of the Goldthwait Sea. The delta front slope varies from 0.5° east to 10° west. Internal structure of the lobe shows many complex units of truncated foresets, resting on bottomsets; topsets are eroded and absent. Combined effects of fluvial and waves processes result in rapid progradation of a large volume of sediments to the west with steep foresets (8°) causing sediment flow and avalanching.El delta del no Natashquan (Costa-Norte del San-Lorenzo) es un ejemplo tipico de construcciôn de estructuras deltaicas (lôbulos) contemporâneas en un medio regresivo, controlada por procesos hidrodinâmicos fluviales y maritimos. Actualmente, luego de la migraciôn de la desembocadura del n'o, uno de los lôbulos se erosiona parcialmente y esta fosilizando. La estructura del lecho rocoso (Escudo cristalino Precambriano y rocas sedimentarias Paleozoicas), contrôla la morfologia y el drenaje preglacial de la region. Las glaciaciones del Pleistoceno han cavado valles en forma de U. La transgression del mar de Goldthwait, junto con el levantamiento glacio-isostâtico, dan la mortoligia actual de la region (paleolineas costeras, delta). El delta multilobulado, aûn parcialmente sumergido, esta limitado a Io largo por una linea de cuestas sumergidas. Un estudio geofisico y sedimentodolôgico describe los sedimentos que recubren el lecho rocoso. El prisma arenoso deltâico avanza sobre los sedimentos arcillo-limosos predeltâicos del mar de Goldthwait. La pendiente del trente del delta varia entre 0,5° Este y 10° Oeste. La estructura interna del lôbulo muestra varias unidades complejas de capas frontales seccionadas, que reposan sobre las capas de fondo, mientras que las capas superiores han sido erosionadas. Los efectos combinados de los procesos fluviales y marinos conllevan un aumento ràpido de un volumen significativo de sedimentos hacia el oeste formando capas frontales inclinadas (8°) provocando deslizamientos

The Perspectives of Patients with Chronic Diseases and Their Caregivers on Self-Management Interventions : A Scoping Review of Reviews

Self-management (SM) interventions are supportive interventions systematically provided by healthcare professionals, peers, or laypersons to increase the skills and confidence of patients in their ability to manage chronic diseases. We had two objectives: (1) to summarise the preferences and experiences of patients and their caregivers (informal caregivers and healthcare professionals) with SM in four chronic diseases and (2) to identify and describe the relevant outcomes for SM interventions from these perspectives. We conducted a mixed-methods scoping review of reviews. We searched three databases until December 2020 for quantitative, qualitative, or mixed-methods reviews exploring patients' and caregivers' preferences or experiences with SM in type 2 diabetes mellitus (T2DM), obesity, chronic obstructive pulmonary disease (COPD), and heart failure (HF). Quantitative data were narratively synthesised, and qualitative data followed a three-step descriptive thematic synthesis. Identified themes were categorised into outcomes or modifiable factors of SM interventions. We included 148 reviews covering T2DM (n = 53 [35.8%]), obesity (n = 20 [13.5%]), COPD (n = 32 [21.6%]), HF (n = 38 [25.7%]), and those with more than one disease (n = 5 [3.4%]). We identified 12 main themes. Eight described the process of SM (disease progression, SM behaviours, social support, interaction with healthcare professionals, access to healthcare, costs for patients, culturally defined roles and perceptions, and health knowledge), and four described their experiences with SM interventions (the perceived benefit of the intervention, individualised care, sense of community with peers, and usability of equipment). Most themes and subthemes were categorised as outcomes of SM interventions. The process of SM shaped the perspectives of patients and their caregivers on SM interventions. Their perspectives were influenced by the perceived benefit of the intervention, the sense of community with peers, the intervention's usability, and the level of individualised care. Our findings can inform the selection of patient-important outcomes, decision-making processes, including the formulation of recommendations, and the design and implementation of SM interventions

Self-management interventions for adults living with obesity to improve patient-relevant outcomes : An evidence map

To conduct an evidence map on self-management interventions and patient-relevant outcomes for adults living with overweight/obesity. Following Arksey and O'Malley methodology, we searched in five electronical databases including randomized controlled trials (RCTs) on SMIs for overweight/obesity. We used the terms "self-management", "adult" and "obesity" for content. Two independent reviewers assessed eligible references; one reviewer extracted data, a second checked accuracy. We identified 497 RCTs (58% US, 20% Europe) including 99,741 (median 112, range 11-5145) adults living with overweight/obesity. Most research evaluated clinical outcomes (617, 55%) and behaviors adherence (255, 23%). Empowerment skills, quality of life and satisfaction were less targeted (8%, 7%, 0.2%, respectively). The most frequent techniques included sharing information (858, 99%), goal setting (619, 72%) and self-monitoring training (614, 71%), provided face-to-face (386, 45%) or in combination with remote techniques (256, 30%). Emotional management, social support and shared-decision were less frequent (18%, 26%, 4%). Socio-economic status, minorities or health literacy were seldom reported. There is a need of widening the scope of research by focusing on outcomes important to patients, assessing emotional/social/share-decision support, exploring remote techniques and including vulnerable populations

Genome-wide association study identifies six new loci influencing pulse pressure and mean arterial pressure.

Numerous genetic loci have been associated with systolic blood pressure (SBP) and diastolic blood pressure (DBP) in Europeans. We now report genome-wide association studies of pulse pressure (PP) and mean arterial pressure (MAP). In discovery (N = 74,064) and follow-up studies (N = 48,607), we identified at genome-wide significance (P = 2.7 × 10(-8) to P = 2.3 × 10(-13)) four new PP loci (at 4q12 near CHIC2, 7q22.3 near PIK3CG, 8q24.12 in NOV and 11q24.3 near ADAMTS8), two new MAP loci (3p21.31 in MAP4 and 10q25.3 near ADRB1) and one locus associated with both of these traits (2q24.3 near FIGN) that has also recently been associated with SBP in east Asians. For three of the new PP loci, the estimated effect for SBP was opposite of that for DBP, in contrast to the majority of common SBP- and DBP-associated variants, which show concordant effects on both traits. These findings suggest new genetic pathways underlying blood pressure variation, some of which may differentially influence SBP and DBP

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

Structure et nature des corps sedimentaires formes en regime post-glaciaire dans le domaine sous-marin du delta holocene de la Natashquan (Golfe du Saint-Laurent - Canada)

Available from INIST (FR), Document Supply Service, under shelf-number : TD 84134 / INIST-CNRS - Institut de l'Information Scientifique et TechniqueSIGLEFRFranc

[Hormonal control of the expression of alpha fetoprotein in newborn rats. Evidence for a selective action of glucocorticoids on gene transcription].

International audienceAdministration of glucocorticoid hormones to the newborn rat results in a rapid decrease in the synthesis of alpha-fetoprotein (AFP) by the liver. The molecular basis of this hormonal action was investigated by examining the steady-state levels of AFP mRNA and albumin mRNA sequences in polysomal and total RNA preparations isolated from dexamethasone-treated and control animals. Following dexamethasone treatment the number of polysomal and total mRNA sequences hybridizable to specific (32P) cDNA probes was drastically decreased for AFP while it was unchanged for albumin. These data indicate that glucocorticoids exert a selective action on AFP mRNA levels and suggest that dexamethasone operate at the transcriptional level

No evidence for post-transcriptional control of albumin and α-fetoprotein gene expression in developing rat liver and neoplasis

International audienceRot analysis of hybridization data using highly labeled alpha-fetoprotein (AFP) and albumin (32P)cDNA probes has been used to quantitate AFP and albumin mRNA sequences in RNA preparations from different subcellular fractions of developing rat liver and Morris hepatoma 7777. In addition, size analysis of these mRNA sequences has been carried out by electrophoretic fractionation on agarose gels containing methylmercury hydroxyde and hybridization to radioactive cloned albumin and AFP cDNA probes. In all the tissues examined (fetal, newborn and adult rat liver, and hepatoma 7777) most of the albumin and AFP mRNA sequences were found associated with the polysomes as mature mRNA molecules; less than 2% of these sequences were present in the nuclear or the non polysomal cytoplasmic compartments. The number of AFP mRNA molecules was found to decrease in parallel in all the cellular compartments during rat liver development. In Morris hepatoma 7777 the content of albumin mRNA was considerably decreased in all the cellular fractions as compared to normal liver. These results demonstrate that post-transcriptional control mechanisms leading to an accumulation of non-functional mRNA molecules are not implicated in the changes of expression of albumin and AFP genes during rat liver development and neoplasia

Polymorphisms of human albumin gene after DNA restriction by Hae III endonuclease

International audienceHybridization of albumin clones cDNA with human DNAs digested by several restriction endonucleases reveals two HaeIII polymorphisms. The first polymorphism, H1, is of low frequency (f1 = 0.05); the second, which is validated by family analysis, occurs frequently (f2 = 0.21) and is an intronic polymorphism, probably of substitution--base type