Mesure par spectroscopie des pertes d'énergie électroniques de la section efficace des dommages causés par l'impact des électrons de basse énergie sur des films condensés de tétrahydrofurane

L'interaction de la radiation ionisante avec la matière biologique implique la formation d'une très grande quantité d'électrons de basse énergie, pour la plupart en deçà de 20 eV, qui déposeront ultimement la plus grande partie de l'énergie transportée par cette radiation. Il est connu que ces électrons peuvent causer des dommages très importants à l'acide désoxyribonucléique (ADN) d'une cellule. Cependant, la connaissance des mécanismes par lesquels ces dommages sont créés demeure incomplète. Nous avons étudié l'effet des électrons de basse énergie (i.e., 1 - 18.5 eV) sur des films minces d'un analogue au désoxyribose de l'ADN, soit le tétrahydrofurane (THF), condensés sur un séparateur inerte de krypton. Nous avons observé à l'aide de spectres d'excitations vibrationnelle et électronique que l'exposition à ces électrons pouvait impliquer l'ouverture du cycle de la molécule de THF résultant en la formation d'un composé de type aldéhyde, identifié avec le plus de certitude comme étant du butyraldéhyde. [Résumé abrégé par UMI

Viraalimarkkinointi : vaihtoehto massamarkkinoinnille

Tämä opinnäytetyö käsittelee viraalimarkkinointia. Viraalimarkkinointi on perinteisestä word of mouth -markkinoinnista kehittynyt markkinointimuoto, jossa markkinointiviestit leviävät sähköisessä ympäristössä kuluttajalta toiselle kasvokkaisviestinnän sijaan. Tekniikan kehittyminen ja erilaisten sosiaalisten verkkoyhteisöjen alati kasvava suosio ovat tehneet viraalimarkkinoinnista yrityksien keskuudessa suositun ja kustannustehokkaan vaihtoehdon massamarkkinoinnille. Opinnäytetyön tavoitteena on koota manuaali, jolla voi selventää viraalimarkkinointia markkinointimuotona asiasta tietämättömille henkilöille. Opinnäytetyö on jaettu kolmeen lukuun, joista ensimmäinen käsittelee teoreettisesti word of mouth -markkinointia. Toinen luku käsittelee teoreettisesti varsinaista aihetta, eli viraalimarkkinointia. Kolmas luku esittelee eri asiantuntijoiden ja tutkijoiden neuvoja viraalikampanjan toteuttamiseen sekä konkreettisen ohjeen luoda yksinkertainen viraalikampanja.This thesis focuses on viral marketing. Viral marketing is a developed form of traditional word-of-mouth marketing. In viral marketing the marketing message spreads through electronical environment from one consumer to another, instead of face-to-face communication as in traditional word-of-mouth marketing. The tremendous development of technology and continuously crescent popularity of social web communities have made viral marketing a popular and cost efficient alternative for massmarketing among enterprises. The research problem of the thesis is to assemble a manual that would clarify viral marketing as a marketing form to persons who are not familiar with it. The thesis is divided into three different parts. The first, the theoretically part, focuses on word-of- mouth marketing. The second theoretical section focuses on viral marketing, the primary subject of the thesis. And finally, the third part introduces advice for executing actual viral campaigning by experts and researchers. The third part also introduces a concrete guideline to create a simple viral campaign

Airfoil data sensitivity analysis for actuator disc simulations used in wind turbine applications

To analyse the sensitivity of blade geometry and airfoil characteristics on the prediction of performance characteristics of wind farms, large-eddy simulations using an actuator disc (ACD) method are performed for three different blade/airfoil configurations. The aim of the study is to determine how the mean characteristics of wake flow, mean power production and thrust depend on the choice of airfoil data and blade geometry. In order to simulate realistic conditions, pre-generated turbulence and wind shear are imposed in the computational domain. Using three different turbulence intensities and varying the spacing between the turbines, the flow around 4-8 aligned turbines is simulated. The analysis is based on normalized mean streamwise velocity, turbulence intensity, relative mean power production and thrust. From the computations it can be concluded that the actual airfoil characteristics and blade geometry only are of importance at very low inflow turbulence. At realistic turbulence conditions for an atmospheric boundary layer the specific blade characteristics play an minor role on power performance and the resulting wake characteristics. The results therefore give a hint that the choice of airfoil data in ACD simulations is not crucial if the intention of the simulations is to compute mean wake characteristics using a turbulent inflow

IEA-Task 31 WAKEBENCH: Towards a protocol for wind farm flow model evaluation. Part 1: Flow-over-terrain models

The IEA Task 31 Wakebench is setting up a framework for the evaluation of wind farm flow models operating at microscale level. The framework consists on a model evaluation protocol integrated on a web-based portal for model benchmarking (www.windbench.net). This paper provides an overview of the building-block validation approach applied to flow-over-terrain models, including best practices for the benchmarking and data processing procedures for the analysis and qualification of validation datasets from wind resource assessment campaigns. A hierarchy of test cases has been proposed for flow-over-terrain model evaluation, from Monin-Obukhov similarity theory for verification of surface-layer properties, to the Leipzig profile for the near-neutral atmospheric boundary layer, to flow over isolated hills (Askervein and Bolund) to flow over mountaneous complex terrain (Alaiz). A summary of results from the first benchmarks are used to illustrate the model evaluation protocol applied to flow-over-terrain modeling in neutral conditions

A value-based comparison of the management of ambulatory respiratory diseases in walk-in clinics, primary care practices, and emergency departments : protocol for a multicenter prospective cohort study

Background: In Canada, 30%-60% of patients presenting to emergency departments are ambulatory. This category has been labeled as a source of emergency department overuse. Acting on the presumption that primary care practices and walk-in clinics offer equivalent care at a lower cost, governments have invested massively in improving access to these alternative settings in the hope that patients would present there instead when possible, thereby reducing the load on emergency departments. Data in support of this approach remain scarce and equivocal. Objective: The aim of this study is to compare the value of care received in emergency departments, walk-in clinics, and primary care practices by ambulatory patients with upper respiratory tract infection, sinusitis, otitis media, tonsillitis, pharyngitis, bronchitis, influenza-like illness, pneumonia, acute asthma, or acute exacerbation of chronic obstructive pulmonary disease. Methods: A multicenter prospective cohort study will be performed in Ontario and Québec. In phase 1, a time-driven activity-based costing method will be applied at each of the 15 study sites. This method uses time as a cost driver to allocate direct costs (eg, medication), consumable expenditures (eg, needles), overhead costs (eg, building maintenance), and physician charges to patient care. Thus, the cost of a care episode will be proportional to the time spent receiving the care. At the end of this phase, a list of care process costs will be generated and used to calculate the cost of each consultation during phase 2, in which a prospective cohort of patients will be monitored to compare the care received in each setting. Patients aged 18 years and older, ambulatory throughout the care episode, and discharged to home with one of the aforementioned targeted diagnoses will be considered. The estimated sample size is 1485 patients. The 3 types of care settings will be compared on the basis of primary outcomes in terms of the proportion of return visits to any site 3 and 7 days after the initial visit and the mean cost of care. The secondary outcomes measured will include scores on patient-reported outcome and experience measures and mean costs borne wholly by patients. We will use multilevel generalized linear models to compare the care settings and an overlap weights approach to adjust for confounding factors related to age, sex, gender, ethnicity, comorbidities, registration with a family physician, socioeconomic status, and severity of illness. Results: Phase 1 will begin in 2021 and phase 2, in 2023. The results will be available in 2025. Conclusions: The end point of our program will be for deciders, patients, and care providers to be able to determine the most appropriate care setting for the management of ambulatory emergency respiratory conditions, based on the quality and cost of care associated with each alternative

The Changing Landscape for Stroke\ua0Prevention in AF: Findings From the GLORIA-AF Registry Phase 2

Background GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non\u2013vitamin K antagonist oral anticoagulant (NOAC), became available. Objectives This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase 1. Methods During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients\u2019 baseline characteristics. Atrial fibrillation disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics. Results Of the total patients, 45.5% were female; median age was 71 (interquartile range: 64, 78) years. Patients were from Europe (47.1%), North America (22.5%), Asia (20.3%), Latin America (6.0%), and the Middle East/Africa (4.0%). Most had high stroke risk (CHA2DS2-VASc [Congestive heart failure, Hypertension, Age  6575 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score  652; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc = 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N = 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients received NOAC, VKA, and antiplatelet drugs, respectively; 7.5% received no antithrombotic treatment. NOAC use was less common in Asia (27.7%), where 27.5% of patients received VKA, 25.0% antiplatelet drugs, and 19.8% no antithrombotic treatment. Conclusions The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in Asia and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [GLORIA-AF]; NCT01468701

Semaglutide and cardiovascular outcomes in patients with obesity and prevalent heart failure: a prespecified analysis of the SELECT trial

Background: Semaglutide, a GLP-1 receptor agonist, reduces the risk of major adverse cardiovascular events (MACE) in people with overweight or obesity, but the effects of this drug on outcomes in patients with atherosclerotic cardiovascular disease and heart failure are unknown. We report a prespecified analysis of the effect of once-weekly subcutaneous semaglutide 2·4 mg on ischaemic and heart failure cardiovascular outcomes. We aimed to investigate if semaglutide was beneficial in patients with atherosclerotic cardiovascular disease with a history of heart failure compared with placebo; if there was a difference in outcome in patients designated as having heart failure with preserved ejection fraction compared with heart failure with reduced ejection fraction; and if the efficacy and safety of semaglutide in patients with heart failure was related to baseline characteristics or subtype of heart failure. Methods: The SELECT trial was a randomised, double-blind, multicentre, placebo-controlled, event-driven phase 3 trial in 41 countries. Adults aged 45 years and older, with a BMI of 27 kg/m2 or greater and established cardiovascular disease were eligible for the study. Patients were randomly assigned (1:1) with a block size of four using an interactive web response system in a double-blind manner to escalating doses of once-weekly subcutaneous semaglutide over 16 weeks to a target dose of 2·4 mg, or placebo. In a prespecified analysis, we examined the effect of semaglutide compared with placebo in patients with and without a history of heart failure at enrolment, subclassified as heart failure with preserved ejection fraction, heart failure with reduced ejection fraction, or unclassified heart failure. Endpoints comprised MACE (a composite of non-fatal myocardial infarction, non-fatal stroke, and cardiovascular death); a composite heart failure outcome (cardiovascular death or hospitalisation or urgent hospital visit for heart failure); cardiovascular death; and all-cause death. The study is registered with ClinicalTrials.gov, NCT03574597. Findings: Between Oct 31, 2018, and March 31, 2021, 17 604 patients with a mean age of 61·6 years (SD 8·9) and a mean BMI of 33·4 kg/m2 (5·0) were randomly assigned to receive semaglutide (8803 [50·0%] patients) or placebo (8801 [50·0%] patients). 4286 (24·3%) of 17 604 patients had a history of investigator-defined heart failure at enrolment: 2273 (53·0%) of 4286 patients had heart failure with preserved ejection fraction, 1347 (31·4%) had heart failure with reduced ejection fraction, and 666 (15·5%) had unclassified heart failure. Baseline characteristics were similar between patients with and without heart failure. Patients with heart failure had a higher incidence of clinical events. Semaglutide improved all outcome measures in patients with heart failure at random assignment compared with those without heart failure (hazard ratio [HR] 0·72, 95% CI 0·60-0·87 for MACE; 0·79, 0·64-0·98 for the heart failure composite endpoint; 0·76, 0·59-0·97 for cardiovascular death; and 0·81, 0·66-1·00 for all-cause death; all pinteraction>0·19). Treatment with semaglutide resulted in improved outcomes in both the heart failure with reduced ejection fraction (HR 0·65, 95% CI 0·49-0·87 for MACE; 0·79, 0·58-1·08 for the composite heart failure endpoint) and heart failure with preserved ejection fraction groups (0·69, 0·51-0·91 for MACE; 0·75, 0·52-1·07 for the composite heart failure endpoint), although patients with heart failure with reduced ejection fraction had higher absolute event rates than those with heart failure with preserved ejection fraction. For MACE and the heart failure composite, there were no significant differences in benefits across baseline age, sex, BMI, New York Heart Association status, and diuretic use. Serious adverse events were less frequent with semaglutide versus placebo, regardless of heart failure subtype. Interpretation: In patients with atherosclerotic cardiovascular diease and overweight or obesity, treatment with semaglutide 2·4 mg reduced MACE and composite heart failure endpoints compared with placebo in those with and without clinical heart failure, regardless of heart failure subtype. Our findings could facilitate prescribing and result in improved clinical outcomes for this patient group. Funding: Novo Nordisk