114 research outputs found

    Non-linear Capital Taxation Without Commitment

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    We study efficient non-linear taxation of labour and capital in a dynamic Mirrleesian model incorporating political economy constraints. Policies are chosen sequentially over time, without commitment. Our main result is that the marginal tax on capital income is progressive, in the sense that richer agents face higher marginal tax rates

    Time-Dependent Internalization of Polymer-Coated Silica Nanoparticles in Brain Endothelial Cells and Morphological and Functional Effects on the Blood-Brain Barrier

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    Nanoparticle (NP)-assisted procedures including laser tissue soldering (LTS) offer advantages compared to conventional microsuturing, especially in the brain. In this study, effects of polymer-coated silica NPs used in LTS were investigated in human brain endothelial cells (ECs) and blood-brain barrier models. In the co-culture setting with ECs and pericytes, only the cell type directly exposed to NPs displayed a time-dependent internalization. No transfer of NPs between the two cell types was observed. Cell viability was decreased relatively to NP exposure duration and concentration. Protein expression of the nuclear factor k-light-chain-enhancer of activated B cells and various endothelial adhesion molecules indicated no initiation of inflammation or activation of ECs after NP exposure. Differentiation of CD34+ ECs into brain-like ECs co-cultured with pericytes, blood-brain barrier (BBB) characteristics were obtained. The established endothelial layer reduced the passage of integrity tracer molecules. NP exposure did not result in alterations of junctional proteins, BBB formation or its integrity. In a 3-dimensional setup with an endothelial tube formation and tight junctions, barrier formation was not disrupted by the NPs and NPs do not seem to cross the blood-brain barrier. Our findings suggest that these polymer-coated silica NPs do not damage the BBB

    Sorafenib increases 18-FDG colic uptake: demonstration in patients with differentiated thyroid cancer

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    BACKGROUND: To assess 18-fluorodeoxyglucose (FDG) bowel uptake in patients with differentiated thyroid cancer (DTC) treated with sorafenib. FINDINGS: Visual (5-point scale) and high maximum standard uptake value (SUVmax) semi-quantitative analyses were conducted in 63 positron emission tomography (PET) studies performed in patients on sorafenib (group 1, n = 20), in a control group (group 2, n = 28) and in patients on sunitinib or vandetanib (group 3, n = 15). Moderate or high and diffuse bowel uptake (grade 4 or 5) was observed in 90% of the PET scans of group 1 versus none in group 2. Only 20% of PET scans in group 3 were scored grade 4. SUVmax values were significantly higher for all colic segments in group 1 than in group 2 (P < 0.0001) or 3 (P < 0.0004). This uptake pattern appeared rapidly (one month) and disappeared after sorafenib withdrawal. CONCLUSIONS: FDG uptake is increased in the colon of DTC patients treated by sorafenib

    Evaluation of a virtual agent to train medical students conducting psychiatric interviews for diagnosing major depressive disorders

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    Background: A psychiatric diagnosis involves the physician's ability to create an empathic interaction with the patient in order to accurately extract semiology (i.e., clinical manifestations). Virtual patients (VPs) can be used to train these skills but need to be evaluated in terms of accuracy, and to be perceived positively by users. Methods: We recruited 35 medical students who interacted in a 35-min psychiatric interview with a VP simulating major depressive disorders. Semiology extraction, verbal and non-verbal empathy were measured objectively during the interaction. The students were then debriefed to collect their experience with the VP. Results: The VP was able to simulate the conduction of a psychiatric interview realistically, and was effective to discriminate students depending on their psychiatric knowledge. Results suggest that students managed to keep an emotional distance during the interview and show the added value of emotion recognition software to measure empathy in psychiatry training. Students provided positive feedback regarding pedagogic usefulness, realism and enjoyment in the interaction. Limitations: Our sample was relatively small. As a first prototype, the measures taken by the VP would need improvement (subtler empathic questions, levels of difficulty). The face-tracking technique might induce errors in detecting non-verbal empathy. Conclusion: This study is the first to simulate a realistic psychiatric interview and to measure both skills needed by future psychiatrists: semiology extraction and empathic communication. Results provide evidence that VPs are acceptable by medical students, and highlight their relevance to complement existing training and evaluation tools in the field of affective disorders.Bordeaux Region Aquitaine Initiative for NeurosciencePhénotypage humain et réalité virtuelleInitiative d'excellence de l'Université de Bordeau

    Standard first-line chemotherapy with or without nintedanib for advanced ovarian cancer (AGO-OVAR 12): a randomised, double-blind, placebo-controlled phase 3 trial.

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    peer reviewed[en] BACKGROUND: Angiogenesis is a target in the treatment of ovarian cancer. Nintedanib, an oral triple angiokinase inhibitor of VEGF receptor, platelet-derived growth factor receptor, and fibroblast growth factor receptor, has shown activity in phase 2 trials in this setting. We investigated the combination of nintedanib with standard carboplatin and paclitaxel chemotherapy in patients with newly diagnosed advanced ovarian cancer. METHODS: In this double-blind phase 3 trial, chemotherapy-naive patients (aged 18 years or older) with International Federation of Gynecology and Obstetrics (FIGO) IIB-IV ovarian cancer and upfront debulking surgery were stratified by postoperative resection status, FIGO stage, and planned carboplatin dose. Patients were randomly assigned (2:1) via an interactive voice or web-based response system to receive six cycles of carboplatin (AUC 5 mg/mL per min or 6 mg/mL per min) and paclitaxel (175 mg/m(2)) in addition to either 200 mg of nintedanib (nintedanib group) or placebo (placebo group) twice daily on days 2-21 of every 3-week cycle for up to 120 weeks. Patients, investigators, and independent radiological reviewers were masked to treatment allocation. The primary endpoint was investigator-assessed progression-free survival analysed in the intention-to-treat population. This trial is registered with ClinicalTrials.gov, number NCT01015118. FINDINGS: Between Dec 9, 2009, and July 27, 2011, 1503 patients were screened and 1366 randomly assigned by nine study groups in 22 countries: 911 to the nintedanib group and 455 to the placebo group. 486 (53%) of 911 patients in the nintedanib group experienced disease progression or death compared with 266 (58%) of 455 in the placebo group. Median progression-free survival was significantly longer in the nintedanib group than in the placebo group (17·2 months [95% CI 16·6-19·9] vs 16·6 months [13·9-19·1]; hazard ratio 0·84 [95% CI 0·72-0·98]; p=0·024). The most common adverse events were gastrointestinal (diarrhoea: nintedanib group 191 [21%] of 902 grade 3 and three [<1%] grade 4 vs placebo group nine [2%] of 450 grade 3 only) and haematological (neutropenia: nintedanib group 180 [20%] grade 3 and 200 (22%) grade 4 vs placebo group 90 [20%] grade 3 and 72 [16%] grade 4; thrombocytopenia: 105 [12%] and 55 [6%] vs 21 [5%] and eight [2%]; anaemia: 108 [12%] and 13 [1%] vs 26 [6%] and five [1%]). Serious adverse events were reported in 376 (42%) of 902 patients in the nintedanib group and 155 (34%) of 450 in the placebo group. 29 (3%) of 902 patients in the nintedanib group experienced serious adverse events associated with death compared with 16 (4%) of 450 in the placebo group, including 12 (1%) in the nintedanib group and six (1%) in the placebo group with a malignant neoplasm progression classified as an adverse event by the investigator. Drug-related adverse events leading to death occurred in three patients in the nintedanib group (one without diagnosis of cause; one due to non-drug-related sepsis associated with drug-related diarrhoea and renal failure; and one due to peritonitis) and in one patient in the placebo group (cause unknown). INTERPRETATION: Nintedanib in combination with carboplatin and paclitaxel is an active first-line treatment that significantly increases progression-free survival for women with advanced ovarian cancer, but is associated with more gastrointestinal adverse events. Future studies should focus on improving patient selection and optimisation of tolerability. FUNDING: Boehringer Ingelheim

    Abstracts from the 20th International Symposium on Signal Transduction at the Blood-Brain Barriers

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    https://deepblue.lib.umich.edu/bitstream/2027.42/138963/1/12987_2017_Article_71.pd

    Atlas des occurences et des types de fibres d'amiante sur mine

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    Le problĂšme de santĂ© publique posĂ© par la prĂ©sence d’amiante dans certainsenvironnements naturels de Nouvelle-CalĂ©donie constitue Ă  la fois une prioritĂ© dugouvernement du territoire et une prĂ©occupation pour l’ensemble de la professionminiĂšre. Depuis 2005, le groupe de travail qui s’est constituĂ© sur ce sujet et quicomprend le Bureau de Recherches GĂ©ologiques et MiniĂšres (BRGM), l'Institut Pasteurde Nouvelle-CalĂ©donie (IPNC), l'Institut pour la Recherche et le DĂ©veloppement (IRD)et l'UniversitĂ© de Nouvelle-CalĂ©donie (UNC), s’est efforcĂ© d’amĂ©liorer lesconnaissances sur cet alĂ©a gĂ©ologique si prĂ©occupant en termes de santĂ© publique.En Nouvelle-CalĂ©donie, la prĂ©sence d’amiante dans l’environnement naturel concerneplusieurs grands domaines gĂ©ologiques, dont la nappe des pĂ©ridotites. Compte tenudes enjeux industriels et Ă©conomiques que reprĂ©sentent les massifs de pĂ©ridotite pourla Nouvelle-CalĂ©donie, ces occurrences amiantifĂšres se devaient d’ĂȘtre analysĂ©es pourĂȘtre mieux comprises et au final mieux apprĂ©hendĂ©es et gĂ©rĂ©es par l’ensemble de lafiliĂšre miniĂšre.Les objectifs de l’étude Ă  laquelle le prĂ©sent rapport est attachĂ© ont donc Ă©tĂ© decomplĂ©ter les connaissances fondamentales sur ces occurrences d’amiante dans lesmassifs de pĂ©ridotite, tant au plan gĂ©ologique que minĂ©ralogique, avec pour finalitĂ© larecherche de critĂšres permettant Ă  la profession miniĂšre de mieux contrĂŽler cesoccurrences. Les rĂ©sultats de cette Ă©tude ont d’ores et dĂ©jĂ  fait l’objet de la publicationd’un rapport distinct (Rapport BRGM/RP-60192-FR). Le prĂ©sent rapport, Ă©laborĂ© Ă  lademande du GIP CNRT « Nickel et son environnement », synthĂ©tise l’ensemble desrĂ©sultats obtenus sous la forme d’un atlas destinĂ© Ă  aider la profession miniĂšre Ă identifier les occurrences prĂ©sentes sur mine

    Atlas des latérites nickélifÚres de Nouvelle-Calédonie

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    ConsidĂ©rĂ©e comme l’une des premiĂšres rĂ©serves mondiales de Ni-Co (Elias 2001, Dalvi et al. 2004), la Nouvelle-CalĂ©donie exploite et traite enpyromĂ©tallurgie des minerais silicatĂ©s Ă  une teneur de coupure supĂ©rieure Ă  2,5 % Ni-Co. Ces minerais silicatĂ©s, communĂ©ment qualifiĂ©s de "mineraisgarniĂ©ritiques" par les mineurs, sont exploitĂ©s dans les Ă©pais niveaux d’altĂ©ration (saprolite) des pĂ©ridotites. L’exploitation de ces minerais, initiĂ©e en 1880par la "SociĂ©tĂ© Le Nickel" (SLN), a Ă©tĂ© accrue en 2013 par la mise en service de la nouvelle usine de la Province Nord par "Koniambo Nickel Society"(KNS).Le dĂ©veloppement de nouveaux procĂ©dĂ©s hydromĂ©tallurgiques a permis d’augmenter les ressources en nickel de la Nouvelle-CalĂ©donie et d’envisagerl’exploitation des minerais oxydĂ©s situĂ©s dans les niveaux supĂ©rieurs des profils d’altĂ©ration (latĂ©rites sensu stricto). Ces niveaux constituĂ©spresqu’exclusivement d’oxyhydroxydes de fer, et plus localement d’oxydes de manganĂšse, prĂ©sentent des teneurs en Ni-Co plus faibles (< 2,2 %) et nesont exploitĂ©s de nos jours qu’à une teneur de coupure gĂ©nĂ©ralement supĂ©rieure Ă  0,9 %. L’usine hydromĂ©tallurgique de la Province Sud de la compagnieminiĂšre VALE a ouvert de nouvelles perspectives pour l’exploitation des immenses gisements en minerais oxydĂ©s des plaines du Massif du Sud et Ă  pluslongs termes de ceux de l’ensemble du pays.Selon les estimations actuelles (Mudd & Jowitt 2014), la Nouvelle-CalĂ©donie disposerait de plus de 25 % des ressources en nickel de la planĂšte et environ40 % des ressources mondiales en minerais oxydĂ©s. L’augmentation de la ressource et de la capacitĂ© du pays Ă  traiter ces deux types de minerais(silicatĂ©s et oxydĂ©s) ont amenĂ© le "CNRT Nickel et son environnement" Ă  lancer en 2009 un appel Ă  projet de recherche sur les "Facteurs de minĂ©ralisationNi/Co des latĂ©rites de Nouvelle-CalĂ©donie". Cet appel visait Ă  obtenir une meilleure connaissance des processus et facteurs environnementaux Ă  l’originede l’enrichissement en Ni et Co des minerais oxydĂ©s destinĂ©s au traitement hydromĂ©tallurgique.Pour atteindre ces objectifs, deux projets ont Ă©tĂ© retenus et financĂ©s dans le cadre de cet appel d’offre, "Analyse fine de minerais latĂ©ritiques" et "Nickal".Ces deux projets ont entre autres cherchĂ© Ă  obtenir une meilleure caractĂ©risation des phases minĂ©rales porteuses de mĂ©taux d’intĂ©rĂȘt Ă©conomique (plusparticuliĂšrement de Ni et Co) et des structures dans lesquelles ces phases sont susceptibles d’ĂȘtre observĂ©es sur le terrain (Bailly et al. 2014 ; Fritsch et al.2015). Ces types de donnĂ©es rĂ©coltĂ©es dans le cadre des deux projets prĂ©citĂ©s ont permis d’élaborer cet atlas

    Atlas des latérites nickélifÚres de Nouvelle-Calédonie. Les gisements de nickel latéritique de Nouvelle-Calédonie, volume V

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    ConsidĂ©rĂ©e comme l’une des premiĂšres rĂ©serves mondiales de Ni-Co (Elias 2001, Dalvi et al. 2004), la Nouvelle-CalĂ©donie exploite et traite enpyromĂ©tallurgie des minerais silicatĂ©s Ă  une teneur de coupure supĂ©rieure Ă  2,5 % Ni-Co. Ces minerais silicatĂ©s, communĂ©ment qualifiĂ©s de "minerais garniĂ©ritiques" par les mineurs, sont exploitĂ©s dans les Ă©pais niveaux d’altĂ©ration (saprolite) des pĂ©ridotites. L’exploitation de ces minerais, initiĂ©e en 1880 par la "SociĂ©tĂ© Le Nickel" (SLN), a Ă©tĂ© accrue en 2013 par la mise en service de la nouvelle usine de la Province Nord par "Koniambo Nickel Society" (KNS).Le dĂ©veloppement de nouveaux procĂ©dĂ©s hydromĂ©tallurgiques a permis d’augmenter les ressources en nickel de la Nouvelle-CalĂ©donie et d’envisager l’exploitation des minerais oxydĂ©s situĂ©s dans les niveaux supĂ©rieurs des profils d’altĂ©ration (latĂ©rites sensu stricto). Ces niveaux constituĂ©s presqu’exclusivement d’oxyhydroxydes de fer, et plus localement d’oxydes de manganĂšse, prĂ©sentent des teneurs en Ni-Co plus faibles (< 2,2 %) et ne sont exploitĂ©s de nos jours qu’à une teneur de coupure gĂ©nĂ©ralement supĂ©rieure Ă  0,9 %. L’usine hydromĂ©tallurgique de la Province Sud de la compagnie miniĂšre VALE a ouvert de nouvelles perspectives pour l’exploitation des immenses gisements en minerais oxydĂ©s des plaines du Massif du Sud et Ă  plus longs termes de ceux de l’ensemble du pays.Selon les estimations actuelles (Mudd & Jowitt 2014), la Nouvelle-CalĂ©donie disposerait de plus de 25 % des ressources en nickel de la planĂšte et environ 40 % des ressources mondiales en minerais oxydĂ©s. L’augmentation de la ressource et de la capacitĂ© du pays Ă  traiter ces deux types de minerais (silicatĂ©s et oxydĂ©s) ont amenĂ© le "CNRT Nickel et son environnement" Ă  lancer en 2009 un appel Ă  projet de recherche sur les "Facteurs de minĂ©ralisation Ni/Co des latĂ©rites de Nouvelle-CalĂ©donie". Cet appel visait Ă  obtenir une meilleure connaissance des processus et facteurs environnementaux Ă  l’origine de l’enrichissement en Ni et Co des minerais oxydĂ©s destinĂ©s au traitement hydromĂ©tallurgique.Pour atteindre ces objectifs, deux projets ont Ă©tĂ© retenus et financĂ©s dans le cadre de cet appel d’offre, "Analyse fine de minerais latĂ©ritiques" et "Nickal". Ces deux projets ont entre autres cherchĂ© Ă  obtenir une meilleure caractĂ©risation des phases minĂ©rales porteuses de mĂ©taux d’intĂ©rĂȘt Ă©conomique (plus particuliĂšrement de Ni et Co) et des structures dans lesquelles ces phases sont susceptibles d’ĂȘtre observĂ©es sur le terrain (Bailly et al. 2014 ; Fritsch et al. 2015). Ces types de donnĂ©es rĂ©coltĂ©es dans le cadre des deux projets prĂ©citĂ©s ont permis d’élaborer cet atlas
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