Quasistatic rheology, force transmission and fabric properties of a packing of irregular polyhedral particles

By means of contact dynamics simulations, we investigate a dense packing composed of polyhedral particles under quasistatic shearing. The effect of particle shape is analyzed by comparing the polyhedra packing with a packing of similar characteristics except for the spherical shape of the particles. The polyhedra packing shows higher shear stress and dilatancy but similar stress-dilatancy relation compared to the sphere packing. A harmonic approximation of granular fabric is presented in terms of branch vectors (connecting particle centers) and contact force components along and perpendicular to the branch vectors. It is found that the origin of enhanced shear strength of the polyhedra packing lies in its higher force anisotropy with respect to the sphere packing which has a higher fabric anisotropy. Various contact types (face-vertex, face-face, etc) contribute differently to force transmission and fabric anisotropy. In particular, most face-face contacts belong to strong force chains along the major principal stress direction whereas vertex-face contacts are correlated with weak forces and oriented on average along the minor principal stress direction in steady shearing

Creep behaviour of confined layers of polyhedral grains

By means of contact dynamics simulations, we investigate the creep deformation of a thin granular layer composed of irregular polyhedral particles under the action of a constant vertical overload applied on a horizontal wall on top of the layer. We show that the total deformation induced by the overload increases with the ratio between the vertical and confining horizontal stresses and the aspect ratio of the sample. The effect of the aspect ratio is a consequence of the mobilized wall-grain friction forces at the top and bottom boundaries, that lead to enhanced strength by stabilizing strong force chains at the center of the sample. We also evidence the influence of loading history due to strain-induced fabric change or inertial effects resulting from the instant application of the overload. The topology of the contact network evolves in close correlation with creep. In particular, the face/face contacts between polyhedral particles concentrate largest force chains and their number is an increasing function of creep. A crucial feature of a confined granular system is the statistical variability of the mechanical response that we analyzed for creep deformations by performing a large number of simulations for independent initial configurations. Our data indicate that the distribution of fluctuations with respect to the mean creep falls off exponentially

Short-time dynamics of a packing of polyhedral grains under horizontal vibrations

We analyze the dynamics of a 3D granular packing composed of particles of irregular polyhedral shape confined inside a rectangular box with a retaining wall sub jected to horizontal harmonic forcing. The simulations are performed by means of the contact dynamics method for a broad set of loading parameters. We explore the vibrational dynamics of the packing, the evolution of solid fraction and the scaling of dy- namics with the loading parameters. We show that the motion of the retaining wall is strongly anharmonic as a result of jamming and grain rearrangements. It is found that the mean particle displacement scales with inverse square of frequency, the inverse of the force amplitude and the square of gravity. The short- time compaction rate grows in proportion to frequency up to a characteristic frequency, corresponding to collective particle rearrangements between equilibrium states, and then it declines in inverse proportion to frequency

Recommandations pour l’utilisation de la toxine botulinique de type A (Botox®) dans l’hyperactivité vésicale réfractaire idiopathique

RésuméObjectifsDéfinir des recommandations pour l’utilisation pratique de la toxine botulinique de type A (BoNTA) dans l’hyperactivité vésicale réfractaire idiopathique (HAVRI).MéthodeÉlaboration de recommandations de bonne pratique par consensus formalisé, validées par un groupe de 13 experts puis par un groupe de lecture indépendant.RésultatsEn cas d’infection urinaire celle-ci doit être traitée et l’injection reportée. Avant l’injection, il est recommandé de s’assurer de la faisabilité et de l’acceptabilité de l’auto-sondage. L’injection peut être réalisée après une anesthésie locale urétro-vésicale (lidocaïne), éventuellement complétée par l’inhalation de protoxyde d’azote et parfois sous anesthésie générale. L’injection sera réalisée au bloc opératoire ou en salle d’endoscopie. La vessie ne doit pas être trop remplie (risque de perforation). Le traitement doit être appliqué en 10 à 20 injections de 0,5 à 1mL réparties de manière homogène dans la vessie en restant à distance des méats urétéraux. Il n’est pas recommandé de laisser en place une sonde vésicale sauf en cas d’hématurie importante. Le patient doit être surveillé jusqu’à la reprise mictionnelle. Une note d’information sur les effets indésirables éventuels doit lui être remise à sa sortie. Une consultation doit être prévue 3 mois après la première injection (calendrier mictionnel, débitmétrie, résidu post-mictionnel et examen cytobactériologique des urines). Un résidu >200mL et/ou symptomatique doit faire discuter des auto-sondages. Une nouvelle injection pourra être envisagée lorsque le bénéfice clinique de la précédente s’estompe (entre 6 et 9 mois).ConclusionsLe respect de ces recommandations devrait permettre une utilisation optimale de la BoNTA.Niveau de preuve3.SummaryObjectivesProvide guidelines for practical usage of botulinum toxin type A (BoNTA) for refractory idiopathic Overactive Bladder management.Patients and methodsGuidelines using formalized consensus guidelines method. These guidelines have been validated by a group of 13 experts quoting proposals, subsequently reviewed by an independent group of experts.ResultsIn the case of patients with urinary tract infection, it must be treated and injection postponed. Before proposing an injection, it is recommended to ensure the feasibility and acceptability of self-catheterisation by patient. The injection can be performed after local anesthesia of the bladder and urethra (lidocaine), supplemented where necessary by nitrous oxide inhalation and sometimes under general anesthesia. Injection is performed in the operating room or endoscopy suite. The bladder should not be too filled (increased risk of perforation). Treatment should be applied in 10 to 20 injections of 0.5 to 1mL homogeneously distributed in the bladder at a distance from the urethral orifices. It is not recommended to leave a urinary catheter in place except in cases of severe hematuria. The patient should be monitored until resumption of micturition. After the first injection, an appointment must be scheduled within 3 months (micturition diary, uroflowmetry, measurement of residual urine and urine culture). Performance of self-catheterisation should be questioned in the case of a symptomatic post-void residual and/or a residue>200mL. A new injection may be considered when the clinical benefit of the previous injection diminishes (between 6 and 9 months). A period of three months must elapse between each injection.ConclusionsImplementation of these guidelines may promote best practice usage of BoNTA with optimal risk/benefit ratio

Marxism Lost and Found: Alasdair MacIntyre and the Contemporary Debate

This paper examines the changing nature of debates that focus on the philosophy of Alasdair MacIntyre. Whilst outlining the history of MacIntyre’s engagement with Marxism and some of his key ideas, it argues that it is only recently that such debates have begun to rightfully recognise the continued relevance of Marxism to such discussions. I note that crucial aspects of MacIntyre’s politics and philosophy, particularly his opposition to capitalism, are now integral to the contemporary debate which helps in generating a shared vision of radical politics. Nevertheless, I point out that key disagreements still remain as to the role of Marxism within such debates, the validity of MacIntyre’s critique of Marxism, as well as the potentially problematic post-Marxist practice that MacIntyre advocates in After Virtue and beyond

Radical prostatectomy after vascular-targeted photodynamic therapy (VTP) with TOOKAD® : feasibility, early and intermediate results

Purpose: Vascular targeted photodynamic therapy with TOOKAD® is a new therapeutic option for localized prostate cancer management. The objectives of this study were to assess the feasibility of radical prostatectomy after vascular targeted photodynamic therapy and describe functional and oncologic outcomes. Materials and Methods: We retrospectively included in study 45 patients who underwent salvage radical prostatectomy after vascular targeted photodynamic therapy for recurrent prostate cancer at a total of 14 surgical centers in Europe between October 2008 and March 2017. Of the 42 radical prostatectomies performed 16 were robot-assisted, 6 were laparoscopic and 20 were open surgery. Primary end points were morbidity and technical difficulties. Secondary end points were early and intermediate postoperative functional and oncologic outcomes. Results: Median operative time was 180 minutes (IQR 150-223). Median blood loss was 200 ml (IQR 155-363). According to the surgeons the surgery was easy in 29 patients (69%) and difficult in 13 (31%). Nerve sparing was feasible in 14 patients (33%). Five postoperative complications (12%) were found, including 2 Clavien I, 2 Clavien II and 1 Clavien IIIB complications. Of the cases 13 (31%) were pT3 and 21 (50%) were pT2c. Surgical margins were positive in 13 patients (31%). Prostate specific antigen was undetectable at 6 to 12 months in 37 patients (88%). Nine patients underwent complementary radiotherapy. Four patients had final prostate specific antigen greater than 0.2 ng/ml at a median followup of 23 months (IQR 12-36). At 1 year 27 patients (64%) were completely continent (no pads) and 10 (24%) had low incontinence (1 pad). Four patients (11%) recovered potency without treatment and 23 (64%) recovered potency with appropriate treatment. Conclusions: Salvage radical prostatectomy after vascular targeted photodynamic therapy treatment was feasible and safe without difficulty for most of the surgeons