Mild bleeding disorders

Contrairement aux troubles hémorragiques sévères, les maladies hémorragiques modérées (Mild Bleeding Disorders = MBD) sont difficiles à diagnostiquer chez les enfants, car la limite entre le physiologique et le pathologique est mal définie et l'approche diagnostique est peu systématisée. Qu'entend-on par MBD ? On peut les définir comme des diathèses hémorragiques sans répercussion sévère sur la vie quotidienne et, en principe, sans risque vital : épistaxis, gingivorragies, rectorragies, purpuras, hémorragies modérées per- ou postopératoires, hématomes faciles, ménorragies. Typiquement, dans la pratique quotidienne, les patients et leurs médecins sont fréquemment confrontés à de telles situations où il est difficile de faire cliniquement la part des choses entre l'encore normal et le franchement pathologique, sachant de plus que les tests de screening de l'hémostase en laboratoire ont une performance médiocre. Mais l'identification des patients souffrant de MBD est primordiale pour la prévention de certaines pathologies telles que l'anémie ferriprive secondaire, l'exposition aux transfusions de produits sanguins ou une complication hémorragique pour une fois plus sévère en per- ou postopératoire. Actuellement, les pédiatres, généralistes et même les spécialistes en hématologie des hôpitaux universitaires (CHUV et HUG pour notre région) ne disposent pas d'une stratégie unifiée et systématique dans l'approche de ces patients. Il en découle une prise en charge très hétérogène, en particulier en ce qui concerne les examens de laboratoire pour explorer l'hémostase primaire et secondaire. Ce Travail de Master s'inscrit dans la phase initiale, rétrospective, d'une étude clinique elle-même prospective, visant à établir une approche standardisée pour le diagnostic des MBD de l'enfant, l'adolescent et l'adulte dans une consultation universitaire spécialisée (CHUV et HUG) et de mesurer l'impact d'une telle approche sur la prise en charge. Un élément central de cette étude multicentrique sera l'utilisation systématique d'un score clinique (Tosetto et al. 2006 et 2008) publié récemment et validé dans l'une des MBD les plus fréquentes, la maladie de Von Willebrand, chez l'adulte6,7 comme chez l'enfant2,4,8. Si l'anamnèse personnelle et familiale du patient ainsi que le score de Tosetto (≥ 4 points chez l'adulte et la jeune-fille pubère, ≥ 2 chez l'enfant) sont suggestifs d'une MBD, des examens d'hémostase plus précis que le seul screening (TP, aPTT et fibrinogène) seront effectués

Modular Invariance on the Torus and Abelian Chern-Simons Theory

The implementation of modular invariance on the torus as a phase space at the quantum level is discussed in a group-theoretical framework. Unlike the classical case, at the quantum level some restrictions on the parameters of the theory should be imposed to ensure modular invariance. Two cases must be considered, depending on the cohomology class of the symplectic form on the torus. If it is of integer cohomology class $n$, then full modular invariance is achieved at the quantum level only for those wave functions on the torus which are periodic if $n$ is even, or antiperiodic if $n$ is odd. If the symplectic form is of rational cohomology class $\frac{n}{r}$, a similar result holds --the wave functions must be either periodic or antiperiodic on a torus $r$ times larger in both direccions, depending on the parity of $nr$. Application of these results to the Abelian Chern-Simons is discussed.Comment: 24 pages, latex, no figures; title changed; last version published in JM

Revision of the age of magnetization of the Montmartin red beds, Normandy, France

A new roadcut has enabled us to sample the south-dipping limb of the Montmartin syncline for a palaeomagnetic reevaluation of an earlier result published by Jones, Van der Voo & Bonhommet. In combination with the results previously published in 1979 for the north-dipping beds of the syncline, a conclusively negative fold test is obtained. The resulting magnetization (declination/inclination =206°/-3°, Α 95 = 12°, palaeopole at 38°S, 325°E) is interpreted to be of Late Carboniferous age, not Late Devonian as thought earlier. Simultaneously, we have re-evaluated the age of the rocks, previously thought to be Late Devonian on the basis of Acritarchs, Chitinozoans and spores. It has not been possible to reconfirm these fossils, not even in the same samples as studied originally; in contrast, the regional presence of Early Palaeozoic fossils suggests to us an age similar to that of other red beds in the Arrnorican Massif, which have been dated as Early Ordovician. The geodynamic implications of our finding that the Montmartin rocks are completely remagnetized, however, are of no great consequence for the geodynamics of the Hercynian belt. Pre-folding magnetization obtained from Silurian and Devonian rocks in Spain and Germany argue for the same conclusion as reached erroneously in our earlier study, namely that the Armorican Massif and adjacent parts of Hercynian Europe were adjointed to North America, Great Britain, the Baltic Shield and the Russian Platform since at least Late Devonian time. If a Medio-European ocean existed during the Palaeozoic, it was virtually closed before the mid-Devonian and of insignificant width during Culm deposition in Early Carboniferoirs time.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/74719/1/j.1365-246X.1985.tb05108.x.pd

Clinical Characteristics of Suicidal Youths and Adults: A One-Year Retrospective Study

Suicide is a major mental health problem, particularly during youth, when it is the second leading cause of death. Since young people at risk of suicide are often cared for by the adult health system, we sought to identify the specificities and similarities between suicidal youths and adults in order to further inform the potential need for adaptations in taking care of suicidal youths. For this study, we used the following data: mental disorders, treatments, previous hospitalization, and reasons for current hospitalization, that were collected from November 2016 to October 2017 among people hospitalized for a suicidal crisis in a specialized psychiatric unit. First, we compared the data from the youth group with those from the adult group, and then we tried to determine if there were any associations between variables. Analyses showed that youths were more similar to adults than expected. In particular, we found comparable rates of personality disorders (especially borderline) and relapse, and similar profiles of reasons for hospitalization in suicidal crisis. Remarkably, among youth, neuroleptics appeared to be associated with fewer hospitalizations for behavioral than ideational reasons, but with more relapses. Results of this study suggest that young people could benefit from brief psychotherapeutic interventions implemented for adult

Lowest weight representations of super Schrodinger algebras in low dimensional spacetime

We investigate the lowest weight representations of the super Schrodinger algebras introduced by Duval and Horvathy. This is done by the same procedure as the semisimple Lie algebras. Namely, all singular vectors within the Verma modules are constructed explicitly then irreducibility of the associated quotient modules is studied again by the use of singular vectors. We present the classification of irreducible Verma modules for the super Schrodinger algebras in (1+1) and (2+1) dimensional spacetime with N = 1, 2 extensions.Comment: 10pages, talk given at GROUP28 conference New Castle 26-30th July 2010, reference adde

A class of solvable Lie algebras and their Casimir Invariants

A nilpotent Lie algebra n_{n,1} with an (n-1) dimensional Abelian ideal is studied. All indecomposable solvable Lie algebras with n_{n,1} as their nilradical are obtained. Their dimension is at most n+2. The generalized Casimir invariants of n_{n,1} and of its solvable extensions are calculated. For n=4 these algebras figure in the Petrov classification of Einstein spaces. For larger values of n they can be used in a more general classification of Riemannian manifolds.Comment: 16 page

Observables and Correlators in Nonrelativistic ABJM Theory

Non-relativistic ABJM theory is defined by Galilean limit of mass-deformed N=6 Chern-Simons theory. Holographic string theory dual to the theory is not known yet. To understand features candidate gravity dual might exhibit, we examine local and nonlocal physical observables and their correlations in the non-relativistic ABJM theory. We show that gauge invariant local observables correspond to zero-norm states and that correlation functions among them are trivial. We also show that a particular class of nonlocal observables, Wilson loops, are topological in the sense that their correlation functions coincide with those of pure Chern-Simons theory. We argue that the theory is nevertheless physical and illustrate several physical observables whose correlation functions are nontrivial. We also study quantum aspects. We show that Chern-Simons level is finitely renormalized and that dilatation operator acting on spin chain is trivial at planar limit. These results all point to string scale geometry of gravity dual and to intriguing topological and tensionless nature of dual string defined on it.Comment: 1+30 pages, no figure, v2. typos fixed and references adde

The universal enveloping algebra of the Schrödinger algebra and its prime spectrum

The prime, completely prime, maximal, and primitive spectra are classified for the universal enveloping algebra of the Schrödinger algebra. The explicit generators are given for all of these ideals. A counterexample is constructed to the conjecture of Cheng and Zhang about nonexistence of simple singular Whittaker modules for the Schrödinger algebra (and all such modules are classified). It is proved that the conjecture holds ‘generically’

Magnetic and Electronic Properties of Metal-Atom Adsorbed Graphene

We systematically investigate the magnetic and electronic properties of graphene adsorbed with diluted 3d-transition and noble metal atoms using first principles calculation methods. We find that most transition metal atoms (i.e. Sc, Ti, V, Mn, Fe) favor the hollow adsorption site, and the interaction between magnetic adatoms and \pi-orbital of graphene induces sizable exchange field and Rashba spin-orbit coupling, which together open a nontrivial bulk gap near the Dirac points leading to the quantum-anomalous Hall effect. We also find that the noble metal atoms (i.e. Cu, Ag, Au) prefer the top adsorption site, and the dominant inequality of the AB sublattice potential opens another kind of nontrivial bulk gap exhibiting the quantum-valley Hall effect.Comment: Submitted to PRL on Aug. 10, 2011. 11 pages(4.5 pages for the main text and 6.5 pages for the supporting materials

Feasibility of a mass vaccination campaign using a two-dose oral cholera vaccine in an urban cholera-endemic setting in Mozambique.

We conducted a study to assess the feasibility and the potential vaccine coverage of a mass vaccination campaign using a two-dose oral cholera vaccine in an urban endemic neighbourhood of Beira, Mozambique. The campaign was conducted from December 2003 to January 2004. Overall 98,152 doses were administered, and vaccine coverage of the target population was 58.6% and 53.6% for the first and second rounds, respectively. The direct cost of the campaign, which excludes the price of the vaccine, amounted to slightly over 90,000 dollars, resulting in the cost per fully vaccinated person of 2.09 dollars, which is relatively high. However, in endemic settings where outbreaks are likely to occur, integrating cholera vaccination into the routine activities of the public health system could reduce such costs