48 research outputs found

    Post-operative computed tomography imaging evaluation of ascending aorta surgery

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    Ascending thoracic aorta disease is often a life-threatening condition. Aortic aneurysm and aortic dissection are the most frequent ascending aorta diseases requiring surgical intervention. Surgical repair techniques of the ascending aorta are various; they include reconstruction of the ascending aorta by using a graft with or without a prosthetic valve, reconstruction with a composite artificial graft or using a biological graft, and reconstruction of the ascending aorta with a composite graft preserving the native valve and arch repair. The radiologist plays a key role in the identification of post-operative complications; differentiation from normal postoperative findings is fundamental. Our aim is to discuss the main diseases affecting the ascending aorta requiring surgery and the different techniques used to treat them. We also discuss the normal computed tomography (CT) imaging findings and after-surgery complications

    Paraphrastic Reformulations in Spoken Corpora

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    International audienceOur work addresses the automatic detection of paraphrastic reformulation in French spoken corpora. The proposed approach is syn-tagmatic. It is based on specific markers and the specificities of the spoken language. Manual multi-dimensional annotation performed by two annotators provides fine-grained reference data. An automatic method is proposed in order to decide whether sentences contain or not paraphras-tic relations. The obtained results show up to 66.4% precision. Analysis of the manual annotations indicates that few paraphrastic segments show morphological modifications (inflection, derivation or compounding) and that the syntactic equivalence between the segments is seldom respected, as these usually belong to different syntactic categories

    A critical assessment of the WHO responsiveness tool: lessons from voluntary HIV testing and counselling services in Kenya

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    <p>Abstract</p> <p>Background</p> <p>Health, fair financing and responsiveness to the user's needs and expectations are seen as the essential objectives of health systems. Efforts have been made to conceptualise and measure responsiveness as a basis for evaluating the non-health aspects of health systems performance. This study assesses the applicability of the responsiveness tool developed by WHO when applied in the context of voluntary HIV counselling and testing services (VCT) at a district level in Kenya.</p> <p>Methods</p> <p>A mixed method study was conducted employing a combination of quantitative and qualitative research methods concurrently. The questionnaire proposed by WHO was administered to 328 VCT users and 36 VCT counsellors (health providers). In addition to the questionnaire, qualitative interviews were carried out among a total of 300 participants. Observational field notes were also written.</p> <p>Results</p> <p>A majority of the health providers and users indicated that the responsiveness elements were very important, e.g. confidentiality and autonomy were regarded by most users and health providers as very important and were also reported as being highly observed in the VCT room. However, the qualitative findings revealed other important aspects related to confidentiality, autonomy and other responsiveness elements that were not captured by the WHO tool. Striking examples were inappropriate location of the VCT centre, limited information provided, language problems, and concern about the quality of counselling.</p> <p>Conclusion</p> <p>The results indicate that the WHO developed responsiveness elements are relevant and important in measuring the performance of voluntary HIV counselling and testing. However, the tool needs substantial revision in order to capture other important dimensions or perspectives. The findings also confirm the importance of careful assessment and recognition of locally specific aspects when conducting comparative studies on responsiveness of HIV testing services.</p

    Theoretical and numerical study of strain localization under high strain rate solicitation

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    Our study deals with the dynamic behavior of metallic materials and in particular of titanium alloy TA6V. For high strain rates, we can notice the occurrence of a phenomenon called adiabatic shearing. This phenomenon is about a plastic instability, which results in the appearance of a strain localization in narrow bands. In this paper we developed a thermo mechanical model to reproduce the formation and the propagation of adiabatic shear bands. A Johnson Cook thermo visco plastic behavior law was chosen for the titanium alloy TA6V. The law parameters were identified from static and dynamic torsion tests at various temperatures between ambient and 350∘350^{\circ}C. A 2D numerical simulation of torsion test was performed with the explicit finite elements code Abaqus. The thermo mechanical coupling and the heat conduction are taken into account. A roughness defect was inserted in the centre of a torsion specimen. The results showed that the strain of localization and the shear band speed increase when the amplitude and the size of the defect decrease

    Preliminary Short-term Results of a Population of Patients Treated with MitraClip therapy: one Center Experience

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    Objectives: This retrospective analysis sought to evaluate 1-month outcomes and therapy effectiveness of a population of patients treated with MitraClip therapy. We describe in this article the preliminary results of primary effictiveness endpoint. Background Percutaneous Mitral Repair is being developed to treat severe mitral regurgitation (MR), with increasing real-world cases of functional MR (FMR). In the EVEREST (Endovascular Valve Edge-to-Edge Repair Study) II trial, percutaneous device showed superior safety but less reduction in MR at 1year. 4-year outcomes from EVEREST II trial showed no difference in the prevalence of moderate-severe and severe MR or mortality at 4years between surgical mitral repair and percutaneous approach. Methods We analysed retrospectively collected data from one center experience in Italy enrolled from January 2011 to December 2016. The study included 62 patients [mean age74±11 years, 43 men (69%)] with MR of at least grade 3+. All patients had functional MR, were in New York Heart Association (NYHA) functional class III or IV, with a large portion (78%) of mild-to-moderate Tricuspid Regurgitation (TR). One or more clips were implanted in 67 procedures (62 patients). Results & Conclusions Results and Conclusions: Severity of MR was reduced in all successfully treated patients,54(90%) were discharged with MR.2+ (primary effictiveness endpoint). Clinical 1-month follow-up data showed an improvement in NYHA functional class (42 patients (70%) in NYHA class I-II). 60 of 62 (97 %) successfully treated patients were free from death and mitral valve surgery at 1-month follow-up. MitraClip therapy reduces functional MR with acute MR reduction to <2+ in the great majority of patients,with a large freedom from death, surgery or recurrent MR in a great portion of patients

    Comparison of village dog and wolf genomes highlights the role of the neural crest in dog domestication

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    Abstract Background Domesticated from gray wolves between 10 and 40 kya in Eurasia, dogs display a vast array of phenotypes that differ from their ancestors, yet mirror other domesticated animal species, a phenomenon known as the domestication syndrome. Here, we use signatures persisting in dog genomes to identify genes and pathways possibly altered by the selective pressures of domestication. Results Whole-genome SNP analyses of 43 globally distributed village dogs and 10 wolves differentiated signatures resulting from domestication rather than breed formation. We identified 246 candidate domestication regions containing 10.8 Mb of genome sequence and 429 genes. The regions share haplotypes with ancient dogs, suggesting that the detected signals are not the result of recent selection. Gene enrichments highlight numerous genes linked to neural crest and central nervous system development as well as neurological function. Read depth analysis suggests that copy number variation played a minor role in dog domestication. Conclusions Our results identify genes that act early in embryogenesis and can confer phenotypes distinguishing domesticated dogs from wolves, such as tameness, smaller jaws, floppy ears, and diminished craniofacial development as the targets of selection during domestication. These differences reflect the phenotypes of the domestication syndrome, which can be explained by alterations in the migration or activity of neural crest cells during development. We propose that initial selection during early dog domestication was for behavior, a trait influenced by genes which act in the neural crest, which secondarily gave rise to the phenotypes of modern dogs
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