Towards a shared method to classify contaminated territories in the case of an accidental nuclear event: the PRIME project

The analysis of the management of the accidentally radioactive contaminated areas such as those around Chernobyl nuclear power plant highlights the fact that the current spatial classification methods hardly help in recovering proper use of the contaminated territory. The cause is mainly to be searched for in the traditional construction of risks assessment methods; these methods rest on criteria defined by institutional experts, which are not applicable in practise because they are not shared by all the stakeholders involved in the management of the contaminated territories. Opposite such top-down tentative management, local efforts supported by Non-Governmental Organizations to restore life in the contaminated area seem to be more fruitful but very time and resources consuming and limited to the specific areas where they are experimented. The aim of the PRIME project, in progress at the French Institute for Radioprotection and Nuclear Safety, is to mix the advantages of both approaches in building a multicriteria decision tool based on the territorial specificities. The criteria of the method are chosen and weighted with representatives of the territory’s stakeholders (decision makers, local actors and experts) to warrant that all the points of view are taken into account and to enable the risk managers to choose the appropriate strategy in case of an accident involving radioactive substances. The area chosen for the pilot study is a 50 km radius territory around the nuclear sites of Tricastin-Pierrelatte in the lower valley of Rhône (France). One of the exploration questions of the PRIME project is whether a multicriteria method may be an appropriate tool to treat the data and make them visible and accessible for all the stakeholders

Clinical review: bedside assessment of alveolar recruitment

Recruitment is a dynamic physiological process that refers to the reopening of previously gasless lung units. Cumulating evidence has led to a better understanding of the rules that govern both recruitment and derecruitment during mechanical ventilation of patients with acute respiratory distress syndrome. Therefore not only the positive end-expiratory pressure, but also the tidal volume, the inspired oxygen fraction, repeated tracheal suctioning as well as sedation and paralysis may affect recruitment of acute respiratory distress syndrome lungs that are particularly prone to alveolar instability. In the present article, we review the recently reported data concerning the physiological significance of the pressure-volume curve and its use to assess alveolar recruitment. We also describe alternate techniques that have been proposed to assess recruitment at the bedside. Whether recruitment should be optimized remains an ongoing controversy that warrants further clinical investigation

Successfully treated necrotizing fasciitis using extracorporeal life support combined with hemoadsorption device and continuous renal replacement therapy

INTRODUCTION: Necrotizing fasciitis represents a life-threatening infectious condition that causes spreading necrotisis of superficial fascia and subcutaneous cellular tissues. We describe the case of a patient diagnosed with septic and toxic shocks leading to multiple organ failure successfully treated with a combination of extracorporeal life support, continuous renal replacement therapy, and a hemoadsorption device. METHODS: A 41-year-old patient presented with necrotizing fasciitis and multi-organ failure. Initial extracorporeal life support therapy was implanted, compensating for systolic failure. Due to acute renal failure that persisted in time, continuous renal replacement therapy was added. Despite these treatments and as a last attempt to control the septic condition, a CytoSorb hemoadsorption device was installed in parallel to the extracorporeal life support circuit and two sessions were run. RESULTS: During the days following CytoSorb treatment, hemodynamic stabilization was observed, as well as normalization of lactic acidosis and blood parameters. CONCLUSION: This case describes the successful use of CytoSorb with continuous renal replacement therapy and extracorporeal life support in a combined way to overcome a critical phase of septic shock in a young adult patient. This combination of treatments turned out to be efficient for this patient in the context of necrotizing fasciitis

Smooth 2D Coordinate Systems on Discrete Surfaces

International audienceWe introduce a new method to compute conformal param- eterizations using a recent definition of discrete conformity, and estab- lish a discrete version of the Riemann mapping theorem. Our algorithm can parameterize triangular, quadrangular and digital meshes. It can be adapted to preserve metric properties. To demonstrate the efficiency of our method, many examples are shown in the experiment section

Quadri-tilings of the plane

We introduce {\em quadri-tilings} and show that they are in bijection with dimer models on a {\em family} of graphs $\{R^*\}$ arising from rhombus tilings. Using two height functions, we interpret a sub-family of all quadri-tilings, called {\em triangular quadri-tilings}, as an interface model in dimension 2+2. Assigning "critical" weights to edges of $R^*$, we prove an explicit expression, only depending on the local geometry of the graph $R^*$, for the minimal free energy per fundamental domain Gibbs measure; this solves a conjecture of \cite{Kenyon1}. We also show that when edges of $R^*$ are asymptotically far apart, the probability of their occurrence only depends on this set of edges. Finally, we give an expression for a Gibbs measure on the set of {\em all} triangular quadri-tilings whose marginals are the above Gibbs measures, and conjecture it to be that of minimal free energy per fundamental domain.Comment: Revised version, minor changes. 30 pages, 13 figure

Factors affecting compliance with glove removal after contact with a patient or environment in four intensive care units

International audienc

A note on dimer models and McKay quivers

We give one formulation of an algorithm of Hanany and Vegh which takes a lattice polygon as an input and produces a set of isoradial dimer models. We study the case of lattice triangles in detail and discuss the relation with coamoebas following Feng, He, Kennaway and Vafa.Comment: 25 pages, 35 figures. v3:completely rewritte