Ostéopathie et pédiatrie : deux mondes reliés par l'enfant et ses parents

Objectif : le but de cette étude est d'évaluer la connaissance des pédiatres du canton de Vaud quant à la prise en charge ostéopathique de leurs patients, analyser et quantifier la communication entre pédiatres et ostéopathes de ce même canton et les perspectives futures de cette collaboration, de comparer les propositions de prise en charge face aux principaux motifs de consultations des nourrissons chez l'ostéopathes, et finalement d'évaluer les raisons poussant les parents à consulter un ostéopathe pour leur enfant durant son premier mois de vie, ceci toujours à travers l'avis des pédiatres et ostéopathes du canton de Vaud. Méthode : une étude prospective réalisée dans un premier temps par des entretiens semi-structurés auprès de pédiatres hospitaliers, d'ostéopathes et de pédiatres installés, complétée dans un deuxième temps par un questionnaire en ligne transmis aux pédiatres et ostéopathes du canton de Vaud. Résultats : 77.8% des pédiatres ayant répondu au questionnaire déclarent qu'ils ont connaissance de la prise en charge ostéopathique de moins de trente pourcents de leurs patients et 53.6% des ostéopathes savent que moins de trente pourcents des pédiatres de leurs clients en âge pédiatriques savent qu'ils sont suivi par un ostéopathe. L'intermédiaire presque exclusif entre les deux professions est le parent (plus de quatre-vingts pourcents pour 57.8% des pédiatres, idem pour les ostéopathes). La communication entre pédiatres et ostéopathes est faible (selon 67.6% des ostéopathes) à inexistante (selon 60% des pédiatres). 89.7% de l'ensemble du panel souhaite une amélioration de cette situation. La considération que se portent les deux professions est opposée avec des valeurs de coefficients de corrélations négatifs (κ2=(-0.642), ICC=(-0.494), r=(-0.691)). 31.1% des pédiatres ne conseil en aucun cas une prise en charge ostéopathique à leurs patients alors que 62.2% le font en cas de plagiocéphalie. Les prises en charges proposées par les deux corps de métiers pour les coliques du nourrisson et suite à un accouchement difficile sont très peu corrélées (respectivement κ2=0.091 et 0.021, ICC=0.169 et (-0.076), r=0.232 et 0.120). Les sages-femmes conseillant la visite chez l'ostéopathe ont été désignées comme principale cause de la visite ostéopathique durant le premier mois de vie des enfants par les ostéopathes (90.1%) et seconde cause par les pédiatres (82.2%), y voyant premièrement l'effet d'une mode ou tendance de notre époque (88.9%). Conclusion : Les pédiatres n'ont connaissance de la prise en charge ostéopathique que d'une partie de leur patientèle ayant cette prise en charge parallèle et l'information de cette prise en charge repose presque exclusivement sur les épaules des parents. La communication entre pédiatres et ostéopathes est très faible mais une amélioration de cette situation est souhaitée et des pistes pour réaliser cette communication sont proposées. L'estime que se portent pédiatres et ostéopathes quant à leurs prises en charges s'oppose ce qui fait que plus de trente pourcents des pédiatres ne conseillent pour aucune indication la prise en charge ostéopathique. Cela s'explique également par le fait que leurs propositions de prise en charge ne se corrèlent pas. La première cause poussant la consultation ostéopathique des nourrissons dans le premier mois de vie a été désignée comme étant les sages femmes

Private Function Evaluation with Cards

Card-based protocols allow to evaluate an arbitrary fixed Boolean function on a hidden input to obtain a hidden output, without the executer learning anything about either of the two (e.g., [12]). We explore the case where implements a universal function, i.e., is given the encoding ⟨⟩ of a program and an input and computes (⟨⟩,)=(). More concretely, we consider universal circuits, Turing machines, RAM machines, and branching programs, giving secure and conceptually simple card-based protocols in each case. We argue that card-based cryptography can be performed in a setting that is only very weakly interactive, which we call the “surveillance” model. Here, when Alice executes a protocol on the cards, the only task of Bob is to watch that Alice does not illegitimately turn over cards and that she shuffles in a way that nobody knows anything about the total permutation applied to the cards. We believe that because of this very limited interaction, our results can be called program obfuscation. As a tool, we develop a useful sub-protocol $_{II}$↑ that couples the two equal-length sequences , and jointly and obliviously permutes them with the permutation ∈ that lexicographically minimizes (). We argue that this generalizes ideas present in many existing card-based protocols. In fact, AND, XOR, bit copy [37], coupled rotation shuffles [30] and the “permutation division” protocol of [22] can all be expressed as “coupled sort protocols”

PCN21 FIRST-LINE BEVACIZUMAB-BASED THERAPY VERSUS PEMETREXED + CISPLATIN FOR THE TREATMENT OF ADVANCED ADENOCARCINOMA NONSQUAMOUS NON-SMALL CELL LUNG CANCER: INDIRECT COMPARISON APPLYING REAL-LIFE OUTCOMES

Digitalitzat per Artypla

Societal savings in patients with advanced non-squamous non-small-cell lung cancer receiving bevacizumab-based versus non-bevacizumab-based treatments in France, Germany, Italy, and Spain

BACKGROUND: The purpose of this study was to investigate the savings accrued using bevacizumab-based treatment for non-small-cell lung cancer from the societal perspective, taking only public costs into account, in France, Germany, Italy, and Spain. METHODS: Societal costs were estimated by collecting and analyzing labor costs, carer costs, sickness benefits, disability benefits, and home care benefits. Cost inputs were derived from publicly available databases or from the published literature. Expert opinion was only used if no other source was available. Efficacy data from two randomized clinical trials were used. The time horizon in the health economic model was lifetime. Efficacy and costs were discounted by 3.5%. All main model parameters were tested in deterministic and probabilistic sensitivity analyses. RESULTS: Mean incremental savings to society per patient ranged from €2277 in Italy to €4461 in Germany. The results were most sensitive to the change in proportion of patients working fulltime and the proportion of patients who were able to return to work. CONCLUSION: This analysis shows that bevacizumab-based treatment in non-small-cell lung cancer is associated with more savings to society compared to standard chemotherapy in terms of increased productivity and decreased social benefits paid to patients who are able to work in France, Germany, Italy, and Spain

Lightweight Acquisition and Ranging of Flows in the Data Plane

As networks get more complex, the ability to track almost all the flows is becoming of paramount importance. This is because we can then detect transient events impacting only a subset of the traffic. Solutions for flow monitoring exist, but it is getting very difficult to produce accurate estimations for every tuple given the memory constraints of commodity programmable switches. Indeed, as networks grow in size, more flows have to be tracked, increasing the number of tuples to be recorded. At the same time, end-host virtualization requires more specific flowIDs, enlarging the memory cost for every single entry. Finally, the available memory resources have to be shared with other important functions as well (e.g., load balancing, forwarding, ACL). To address those issues, we present FlowLiDAR (Flow Lightweight Detection and Ranging), a new solution that is capable of tracking almost all the flows in the network while requiring only a modest amount of data plane memory which is not dependent on the size of flowIDs. We implemented the scheme in P4, tested it using real traffic from ISPs and compared it against four state-of-the-art solutions: FlowRadar, NZE, PR-sketch, and Elastic Sketch. While those can only reconstruct up to 60% of the tuples, FlowLiDAR can track 98.7% of them with the same amount of memory

Energy Modelling on the Alpine Bow

The Alpine bow has a great potential for renewable energy (RE) development. At the same time, wildlife in Alpine areas is at risk and has to be protected. More of 40% of the Alpine area is covered by protected areas. They vary in definition and level of protection regarding their category, region, and country. Therefore, some of those protected areas may be suited for the development of bioenergy whereas others may be more suited for the development of hydropower. Using a precise classification of those protected areas, and assuming the correct protection level the techno-economic model, spatial explicit, BeWhere, will identify the potential from hydropower, bioenergy, wind and solar power while balancing the ecosystems services in the Alps. The model is based on the minimization of the whole supply chain, starting from the collection of the feedstock to the delivery of the final product to the consumers in the Alps and in the major cities outside the Alps. Access to the site is a determinant issue to build a new power plant in the Alps, therefore the model uses a detailed road network for the transport of the feedstock and accessibility, as well as a map of the high voltage power line. The future RE production plants will be installed if the production cost is competitive enough against fossil fuel based power and heat. The model will then provide the optimal locations, numbers, technologies, and capacities for hydropower stations, bioenergy production plants, solar PV fields and wind parks, together with their corresponding costs and emissions. A series of scenarios will be carried out varying the fossil fuel price, the carbon cost and the level of protection of the environment. For each of the scenarios, the RE potential, production cost, and emission reductions will be assessed. The results will provide key indications to the stakeholders and the policymakers on the consequences of protecting the environment and the development of RE production