Hypatie ou la fin de l’Histoire

Hypatie ou la fin des dieux (1989) est le premier volet du Triptyque des temps perdus de Jean Marcel, oeuvre qui, d’après son surtitre et les titres des trois romans qui la composent, se présente comme un tableau d’une époque révolue — celle de la fin de l’Antiquité et de l’essor du christianisme, peinte à partir des biographies de personnages historiques. À l’aide d’une analyse de la structure du roman, des formes et de l’agencement de ses éléments constituants, et d’une comparaison entre les faits relatés et les données historiques, cet article situe Hypatie dans une tendance contemporaine caractérisée par l’usage de la « métafiction ».Hypatie ou la fin des dieux (1989) is the first part of Jean Marcel’s Triptyque des temps perdus. The overall title of this trilogy, and the titles of its three novels, indicates that it is intended as a portrait of a bygone era—the end of Antiquity and the rise of Christianity—depicted on the basis of biographies of historical figures. Having analyzed the novel’s structure and the forms and organization of its components, and having compared events related in the novel with historical data, this article identifies Hypatie as part of a contemporary trend characterized by the use of «metafiction»

How University of Chicago Medicine designed virtual rounding to maintain human connections during COVID-19

This story is about how the Patient Experience and Engagement Program (PEEP) team at University of Chicago Medicine adapted our patient rounding program from in-person to virtual during the COVID-19 crisis. With creativity and ingenuity, our team shifted on a dime to ensure that patients received the kind of care and connection that allowed them to start the recovery process from what could otherwise be a traumatizing experience before they even leave the hospital. I will explain the steps we took to quickly transition our rounding program from in-person to virtual. But more than that, I want to convey the power of connection to support healing – especially when circumstances are challenging. During and after the COVID-19 pandemic, people need ways to maintain human connections. Experience Framework This article is associated with the Innovation & Technology lens of The Beryl Institute Experience Framework. (http://bit.ly/ExperienceFramework) Access other PXJ articles related to this lens. Access other resources related to this len

A successful pregnancy following SEM fine tuning of hormonal priming

BACKGROUND: Manipulation of the uterine epithelium utilising standard dose exogenous oestrogen (E(2)) and progesterone (P(4)) has been shown to achieve a mature secretory morphological response. However, in an in vitro fertilisation (IVF) setting, frozen embryo transfer (ET) has had a low success rate. We propose that in patients with previously failed ET attempts, the uterine epithelium can be directly visualised by biopsy and Scanning Electron Microscopy (SEM) and that with an individualised fine tuning of the hormone supplementation regime, based on the SEM examination of sequential uterine biopsies, it is possible to provide a uterine environment conducive to successful ET. METHODS: A 47 year old women was chosen for endometrial biopsy, histopathological dating and endometrial observation utilising SEM to determine the integrity of her secretory uterine epithelium because of her age and several previously failed attempts at frozen ET. Exogenous E(2) and P(4) supplementation was administered in modified doses according to the SEM result, in consecutive cycles until the epithelial response appeared satisfactory for potential implantation. RESULTS: This case study demonstrates the dramatic change in epithelial characteristics that can be achieved as a response to these altered doses of E(2) and P(4). The uterine morphology changed from a hypotrophic to a mature, receptive epithelium such that ET resulted in the birth of healthy twin boys. CONCLUSION: The comparison between the consecutive biopsies in direct response to the SEM analysis and tailored modification of E(2) and P(4) dose clearly demonstrates, in this case, the effectiveness of individual morphological monitoring to maximise the successful outcome of ET

Computer-based clinical decision support for general practitioners.

A GP makes many decisions within every consultation. A computer-based clinical decision support system (CDSS) is software designed to support this decision making. It matches individual patient characteristics to a computerized clinical knowledge base and then provides patient-specific assessments or recommendations to the clinician to support a decision that can relate to diagnosis, investigation, prognosis or treatment. CDSSs offers the potential to translate the most up to date and robust evidence into practice. An example would include a GP being prompted to use a clinical prediction rule for pharyngitis (such as the Centor score) through a CDSS integrated into the electronic health record, after typing the word ‘sore throat’, with suggested management options then being delivered to the GP.</p

A multiple imputation strategy for sequential multiple assignment randomized trials

Sequential multiple assignment randomized trials (SMARTs) are increasingly being used to inform clinical and intervention science. In a SMART, each patient is repeatedly randomized over time. Each randomization occurs at a critical decision point in the treatment course. These critical decision points often correspond to milestones in the disease process or other changes in a patient's health status. Thus, the timing and number of randomizations may vary across patients and depend on evolving patient‐specific information. This presents unique challenges when analyzing data from a SMART in the presence of missing data. This paper presents the first comprehensive discussion of missing data issues typical of SMART studies: we describe five specific challenges and propose a flexible imputation strategy to facilitate valid statistical estimation and inference using incomplete data from a SMART. To illustrate these contributions, we consider data from the Clinical Antipsychotic Trial of Intervention and Effectiveness, one of the most well‐known SMARTs to date. Copyright © 2014 John Wiley & Sons, Ltd.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/108622/1/sim6223-sup-0001-SupInfo.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/108622/2/sim6223.pd

Mentoring and Self-Management Career Strategies For Entrepreneurs

The purpose of this article is to examine the literature on self management and mentoring to develop practical methods of enhancing the career success of entrepreneurs. The authors believe that both behavioural and cognitive self-management strategies can be useful to entrepreneurs. These techniques include goal-setting, self-observation, self-rewards, cueing, self-talk, visualization and the active reframing of obstacles into opportunities. In addition, the varying roles and functions of mentors, including emotional, vocational and role modelling support, will have many positive benefits for both entrepreneurial proteges and mentors. Recommendations for furture research and an entrepreneurial model of career development are provided

Mentoring and Self-Management Career Strategies For Entrepreneurs

The purpose of this article is to examine the literature on self management and mentoring to develop practical methods of enhancing the career success of entrepreneurs. The authors believe that both behavioural and cognitive self-management strategies can be useful to entrepreneurs. These techniques include goal-setting, self-observation, self-rewards, cueing, self-talk, visualization and the active reframing of obstacles into opportunities. In addition, the varying roles and functions of mentors, including emotional, vocational and role modelling support, will have many positive benefits for both entrepreneurial proteges and mentors. Recommendations for furture research and an entrepreneurial model of career development are provided

Endometrial response to IVF hormonal manipulation: Comparative analysis of menopausal, down regulated and natural cycles

BACKGROUND: Uterine luminal epithelial cell response to different hormonal strategies was examined to determine commonality when an endometrium attains a receptive, stimulated, morphological profile that may lead to successful implantation. METHODS: Endometrial biopsies from 3 cohorts of patients were compared. The tissue samples taken from these patients were categorized into 8 different groups according to their baseline and the hormone regime used. RESULTS: Pre-treatment natural cycle tissue was variable in appearance. Downregulation with a GnRH analogue tissue appeared menopausal in character. HRT after downregulation resulted in tissue uniformity. HRT in menopause resulted in a 'lush' epithelial surface. HST in the natural cycle improved the morphology with significant difference in secretion between the two regimes examined. CONCLUSIONS: Down regulation plus HRT standardized surface appearance but tissue response is significantly different from the natural cycle, natural cycle plus HRT or menopause plus HRT. HRT in menopause reinstates tissue to a state similar to a natural cycle but significantly different from a natural cycle plus HST. HST with a natural cycle is similar to tissue from the natural cycle but significant differences reflect the influence of the particular hormones present (at any point) within the cycle