Une écriture entre les lignes de l’Histoire : fiction narrative et vérité historique dans Marie Stuart de Stefan Zweig

Partant du constat qu’aucune figure historique n’a, autant que Marie Stuart, suscité de débats et de controverses chez les historiens comme chez les romanciers, Stefan Zweig se propose, dans son ouvrage consacré à la dernière reine d’Ecosse, d’aborder cette personnalité auréolée de mystère avec l’impartialité du psychologue et la ferveur de l’artiste. Ce faisant, il livre une œuvre singulière à propos de laquelle on peut se demander si sa neutralité, garantie par son recul par rapport aux causes idéologiques et politiques de l’époque, n’est cependant pas subvertie par sa sensibilité même d’artiste, c’est-à-dire si sa reine d’Ecosse n’est pas un personnage fortement fictionnel, et si son « essai » biographique ne se rattache pas en fait au statut générique du roman historique

"God is in the Details:" Architectural Evangelism in South Baltimore

How can a religious institution communicate its mission and values to an increasingly secular society? This thesis attempts to address how the Christian church can proclaim its faith to 21st century American society using architecture. It will focus on, but is not limited to, three specific questions of architectural communication: How are the liturgical requirements of contemporary worship reinforced and supported by the architecture? How do the aesthetics of the building, via structural expression, light, space, etc., communicate the worldview of the church? How can the ethical dimension of a building, in the form of responsible site usage, sustainability, energy efficiency, community benefits, etc., be made visible? As a means to explore this topic, the thesis is focused on the phenomenon of urban provisional and storefront-type churches in South Baltimore and the question of what happens when these grass-roots efforts desire a more permanent church building

Nouvelle manoeuvre de dérotation des torsions intra vaginales Orchidotaxie Funiculaire (OTF) Torsions du cordon spermatique

Intravaginal spermatic cord torsion (IVSCT) is a surgical emergency possibly treated with an instantly effective manoeuvre as described in 1893 by Nash.While all publications show that pre-operative manual detorsion (MD) decreases the risk of orchiectomy, it remains uncommon.Nowadays, despite the Doppler ultrasound, the diagnostic error between torsion and epididymitis remains a possible source of litigation.To describe the steps leading to the reduction of torsion during clinical examination (performed if possible under MEOPA) by an unambiguous maneuver: funicular orchidotaxy (FOT).The ascending and descending mobilization of the testicle reduces the testicular twist and contradicts the diagnostic interpretation of Prehn's sign.La torsion intravaginale (TIV) du cordon spermatique est une urgence chirurgicale accessible à une manœuvre instantanément efficace décrite dès 1893 par Nash.Alors que toutes les publications montrent que la détorsion manuelle (DM) pré opératoire diminue le risque d’orchidectomie, elle demeure peu répandue.De nos jours, malgré l’écho-doppler, l’erreur diagnostique entre torsion et épididymite reste une source possible de litiges.Décrire les étapes conduisant à la réduction de la torsion au cours de l’examen clinique (réalisé si possible sous MEOPA) par une manœuvre univoque : l ‘orchidotaxie funiculaire (OTF).La mobilisation ascendante et descendante du testicule, permet de réduire le twist testiculaire elle contredit l’interprétation diagnostique du signe de Prehn

Assessment of physical, environmental, and cardiac strain in 43 operators (wearing protective equipment) conducting clean-up of heavy oil products

Background. The aim of the study was to organise an assessment of the physical strains and environmental exposure to hydrocarbon derivatives in persons involved in shoreline clean-up of heavy oil products, in order to investigate the dangers of oil spill clean-up. Material and methods. Forty-three healthy volunteers wearing protective equipment cleaning up an artificial shoreline underwent cardiac strain measurements, as well as a study of thermal stress (approximate WBGT index, water loss, measurement of internal body temperature before and after physical activity). A subjective assessment of perceived exertion was correlated to articular strain indicators recorded for the weight of loads lifted, movement frequency, and the range of movement. Environmental exposure was determined by using portable hydrocarbon detectors. Results. For adult subjects in good physical condition, in neutral temperatures, oil spill clean-up is considered non-arduous. However, in sedentary, stressed subjects exposed to difficult climatic conditions, cleanup can be considered hard to extremely hard. In terms of environmental exposure, slight traces of toluene appeared once out of a total of 18 analysed samples. Conclusions. The sample studied was subject to physical articular strains and presented variable cardiac strain; environmental exposure was, on the other hand, slight when involving cleaning up heavy petroleum products. The subjects liable to carry out this activity are more tolerant to the efforts required when they are healthy, fit, young adults, in the non-arduous thermal conditions recorded in this study

Context Sensitive Health Informatics: Concepts, Methods and Tools

__Abstract__ Context is a key consideration when designing and evaluating health information technology (HIT) and cannot be overstated. Unintended consequences are common post HIT implementation and even well designed technology may not achieve desired outcomes because of contextual issues. While context should be considered in the design and evaluation of health information systems (HISs) there is a shortcoming of empirical research on contextual aspects of HIT. This conference integrates the sociotechnical and Human-Centered-Design (HCD) approaches and showcases current research on context sensitive health informatics. The papers and presentations outlines theories and models for studying contextual issues and insights on how we can better design HIT to accommodate different healthcare contexts

Cartographie De La Vulnérabilité À La Pollution Des Aquifères Du Socle Précambrien : Cas De La Région D’oumé (Centre-Ouest De La Côte D’ivoire)

Development of agricultural and mining activities and the rapid growth of the population (3.8%) in Oumé’s area, constitute a potential risk of groundwater’s pollutions. This study interested Oumé’s area and aims to elaborate a map of vulnerability to pollution for a better management of groundwaters. The database is constituted by various data in particular, geological, hydrogeological, geomorphological, pluviometric data and satellite image. Methods DRASTIC and GOD were used in this study. Results of DRASTIC method indicated that 31.86% of study area have a very low vulnerability, 68.12% a low vulnerability and 0.02% a moderate vulnerability. With GOD method, 12.8% of study area have a very low vulnerability, 86.46% a low vulnerability and 0.74% a moderate vulnerability. The chemical analysis of groundwater showed that weaker rates of nitrates (0-14mg/l) registered inside the surely well protected zones. These observations have led to validate some various maps obtained. Result of the test of Kappa revealed that coefficient K is reliable and gave moderate agreement (K=0.43) between both methods. This agreement is confirmed by the surface analysis (79.01%). In this study, the DRASTIC method supplied better results and is thus better adapted for the evaluation of vulnerability in the pollution of groundwater of this area

Assessment of potential cardiotoxic side effects of mitoxantrone in patients with multiple sclerosis

Previous studies showed that mitoxantrone can reduce disability progression in patients with multiple sclerosis (MS). There is, however, concern that it may cause irreversible cardiomyopathy with reduced left ventricular (LV) ejection fraction (EF) and congestive heart failure. The aim of this prospective study was to investigate cardiac side effects of mitoxantrone by repetitive cardiac monitoring in MS patients. The treatment protocol called for ten courses of a combined mitoxantrone (10 mg/m(2) body surface) and methylprednisolone therapy. Before each course, a transthoracic echocardiogram was performed to determine the LV end-diastolic diameter, the end-systolic diameter and the fractional shortening; the LV-EF was calculated. Seventy-three patients participated (32 males; age 48 +/- 12 years, range 20-75 years; 25 with primary progressive, 47 with secondary progressive and 1 with relapsing-remitting MS) who received at least four courses of mitoxantrone. Three of the 73 patients were excluded during the study (2 patients discontinued therapy; 1 patient with a previous history of ischemic heart disease developed atrial fibrillation after the second course of mitoxantrone). The mean cumulative dose of mitoxantrone was 114.0 +/- 33.8 mg. The mean follow-up time was 23.4 months (range 10-57 months). So far, there has been no significant change in any of the determined parameters (end-diastolic diameter, end-systolic diameter, fractional shortening, EF) over time during all follow-up investigations. Mitoxantrone did not cause signs of congestive heart failure in any of the patients. Further cardiac monitoring is, however, needed to determine the safety of mitoxantrone after longer follow-up times and at higher cumulative doses. Copyright (C) 2005 S. Karger AG, Basel

Frequency and syndrome specificity of antibodies to aquaporin-4 in neurological patients with rheumatic disorders

Background: A new autoantibody (termed NMO-IgG, or AQP4-Ab) has recently been described in patients with neuromyelitis optica (NMO) and its formes frustes, longitudinally extensive transverse myelitis (LETM) and recurrent optic neuritis (rON). However, AQP4-Ab has been found also in patients with co-existing rheumatic diseases such as systemic lupus erythematosus (SLE) or Sjögren’s syndrome (SS), conditions which are characterized by broad, polyspecific B cell activation. Objectives: In this study, we aimed at evaluating the syndrome specificity and frequency of AQP4-Ab in patients with rheumatic diseases and neurological symptoms. Methods: For this purpose, serum samples from 109 neurological patients with established connective tissue disorders (CTD) (n = 54), possible CTD (n = 42), or vasculitis (n = 13) were analysed for the presence of AQP4-Ab by a cell-based assay employing recombinant human AQP4. Results: AQP4-Ab was detectable in 31/40 (78%) patients with CTD and NMO spectrum disorders (median titre, 1:1000) but in none of the samples obtained from patients with CTD or vasculitis and neurological disorders other than NMO, LETM, or rON (n = 69). Conclusion: The high syndrome specificity of the antibody for neuromyelitis optica spectrum disorders (NMOSDs) in patients with CTD supports the concept of AQP4-Ab being involved in the pathogenesis of these neurological conditions, and argues against AQP4-Ab simply being part of the polyclonal B cell activation generally associated with rheumatic diseases. Moreover, the finding that AQP4-Ab is present in patients with CTD and co-existing NMOSD with approximately the same frequency as in patients without CTD strengthens the case of CTD and AQP4-Ab positive NMOSD representing two co-existing yet distinct entities in the majority of patients

Establishment of a community managed marine reserve in the Bay of Ranobe, southwest Madagascar

The Bay of Ranobe, in southwest Madagascar, once noted for its high biodiversity and fish abundance, is under increasing pressure from overfishing, pollution, sedimentation and tourism. The declining health of the coral reef is reflected in fishery productivity and survey data on biological diversity. Sustainable conservation requires the engagement of all interested parties and the integration of their needs into resource management. The British NGO ReefDoctor has adopted this approach in establishing the first community-protected site in the Bay of Ranobe, the Massif des Roses. This is a large coral patch with a high percentage of live coral cover (38%) and important fish diversity compared to other sites surveyed in the lagoon. Since 25 May 2007 it has been legally recognised as a community managed marine reserve under temporary protection where fishing is banned. Tourists must now pay an entry fee to visit the site, with the proceeds contributing to the funding of community projects. In conjunction with the protection of this site, ReefDoctor has worked with local people, regional and local government, tour operators and hotels, and conservation organisations to set up ‘FIMIHARA’, an association representative of local people responsible for the management of this site and the development of sustainable conservation initiatives in the Bay of Ranobe. This paper explains the approach taken by ReefDoctor, by setting up and working with FIMIHARA, to protect the Massif des Roses site and develop other conservation initiatives and community projects in the Bay of Ranobe. RÉSUMÉ La baie de Ranobe, au sud-ouest de Madagascar, autrefois remarquable pour sa biodiversité et l’abondance de la pêche, est de plus en plus menacée par la surpêche, la sédimentation, la pollution et le tourisme. Le déclin de l’état de santé du récif corallien se reflète dans la diminution de la productivité des pêcheries et dans les suivis de la biodiversité marine. La situation est à présent critique car les ressources marines associées au récif assurent la subsistance des populations côtières vivant le long de la baie. Nous considérons ici qu’une protection pérenne nécessite un engagement concret de toutes les parties prenantes - en particulier des communautés locales - et que leurs besoins soient intégrés dans la gestion des ressources. L’ONG ReefDoctor a mis en oeuvre cette approche lors de la création de la première réserve marine dans la baie de Ranobe gérée par la communauté locale, le Massif des Roses. Cette réserve est constituée d’un grand massif de corail largement couvert de coraux et abritant une importante diversité de poissons par rapport au reste du lagon. Depuis le 25 mai 2007, ce site est légalement reconnu comme réserve marine communautaire avec un statut de protection temporaire ; la pêche et les pratiques destructrices associées au tourisme y sont interdites. De plus, les touristes doivent désormais payer un droit d’entrée pour visiter le site, qui contribue au financement de projets communautaires. En parallèle avec la protection du site, ReefDoctor a travaillé avec les communautés locales, les responsables nationaux et régionaux du gouvernement, les opérateurs touristiques et diverses organisations de protection de la nature pour créer l’association FIMIHARA, représentative de la population locale. Cette association, qui a un statut légal depuis le 11 avril 2007, a pour but d’améliorer la qualité de vie de ceux qui vivent le long de la baie de Ranobe et de mettre en oeuvre des projets de conservation des ressources marines et terrestres dans la région de la baie de Ranobe. La création de la réserve marine communautaire du Massif des Roses a rapidement connu le succès qui s’est traduit par la vente de plus d’un millier de tickets, mais l’association FIMIHARA doit encore faire face à de nombreux défis. L’objectif principal de l’association à long terme est de développer son indépendance par rapport à l’ONG ReefDoctor et sa capacité à gérer indépendamment les ressources marines de la baie de Ranobe dont les communautés locales dépendent pour leur survie