Déconvolution modale, bruit large bande, pompe à air, aéroacoustique

International audienceAircraft air conditioning system must be compliant with the Noise Regulations of every countries in which it will be operated. In the Clean Sky 2 project IDEAS, the system of interest is composed of an air pump, developped by Liebherr Aerospace, that generates low and mid-frequency noise that may be mitigated by the use of innovative acoustic liners. The aim of this study is to assess the level and modal content of the generated noise source in two industrial operating conditions. The modal detection solution proposed by ONERA leads to the post-treatments of measurements obtained by a flush-mounted microphone array located downstream of the diffuser. As microphones will be implemented in a hard-wall region of the duct, the modal basis characterizing the measured acoustic field does not depend on the lined walls, located in the diffuser area. The deconvolution method ARMADA leads to the minimization of the discrepancy, in the least-square sense, between measurements and an analytical model of the acoustic pressure field that propagates in cylindrical ducts. In the first part of this article, the analytical models in uniform and non-uniform flows are introduced, with underlying hypotheses. In the case of shear flow, the modal shapes are given by ONERA's MAMOUT code. Then, the deconvolution method is presented, considering that the modes are correlated, as wave reflections may occur at the end of Liebherr's bench. In the second part, the design of the IDEAS microphone array is defined, considering uniform flow only. Different sensor arrangements are compared. One design is retained and the associated estimation errors are assessed. In the third part, the impact of estimating modes under the uniform flow hypothesis despite the fact that shear flow occurs during measurements is evaluated. A potential misleading impact is highlighted at 3150 Hz on the m = 0 and n = 1 mode. Finally, the experimental setup is introduced and the analysis of the measurements performed in the facility without use of acoustic liners are detailed for two operating conditions.Le système de climatisation des aéronefs doit être conforme à la réglementation sur le bruit de chaque pays dans lequel il sera exploité. Dans le cadre du projet Clean Sky IDEAS, le système considéré, développé par Liebherr Aerospace, est composé d’une pompe à air qui génère du bruit à basses et moyennes fréquences, bruit pouvant être atténué par l’utilisation de revêtements acoustiques innovants. Le but de cette étude consiste à évaluer le niveau et le contenu modal de la source de bruit générée dans deux conditions d'exploitation industrielle. La méthode de détection modale proposée par l’ONERA est basée sur le traitement de mesures obtenues par un réseau de microphones en paroi, situé en aval du diffuseur. Les microphones étant installés sur une section rigide du banc de mesure, la base modale caractérisant le champ acoustique mesuré ne dépend pas du matériau absorbant, situé dans la zone du diffuseur.La méthode de déconvolution ARMADA minimise l'écart, au sens des moindres carrés, entre les mesures et un modèle analytique du champ de pression acoustique se propageant en conduit cylindrique. Dans la première partie de cet article, le modèle analytique sous les hypothèses d'écoulement uniforme et non uniforme est introduit, ainsi que les hypothèses sous-jacentes. Dans le cas d'un écoulement cisaillé, la base modale est fournie par le code ONERA MAMOUT. Ensuite, la méthode de déconvolution est présentée, en supposant que les modes sont corrélés, des réflexions pouvant se produire en extrémité du banc Liebherr. Dans la deuxième partie, l'antenne de microphones pour IDEAS est définie, sous l'hypothèse d'un flux uniforme. Différents désigns d'antennes sont comparés. Un arrangement est conservé et les erreurs d’estimation associées sont évaluées. Dans la troisième partie, on évalue l'impact d'une déconvolution supposant un écoulement uniforme alors que l'écoulement est cisaillé pendant les mesures. Un impact potentiellement important est mis en évidence à 3150 Hz sur le mode m = 0 et n = 1. Enfin, le banc de mesure est présenté et l'on détaille l'analyse des mesures effectuées dans l’installation sans revêtement acoustique, pour deux conditions de fonctionnement

Prise en Charge d’Une Dechirure Compliquee du Perinee Post Coital au Centre Hospitalier Universitaite de l’Amitie Sino-Centrafricaine

Introduction : La violence sexuelle d’enfants est une violation grave des droits fondamentaux de l’homme. Elle constitue un sujet de préoccupations de santé publique mondiale. But de l’étude : Dénoncer la violence sexuelle chez une mineure et informer les autorités sur l’ampleur du problème dans le pays. Observation : Nous rapportons un cas clinique de violence sexuelle compliqué d’une déchirure complète du périnée ainsi que de la cloison vésico-utérine chez une fille âgée de 10 ans. Ce cas est reçu en urgence au service de gynécologie-obstétrique du Centre Hospitalier Universitaire de l’Amitié Sino –Centrafricaine de Bangui. Une laparotomie est réalisée et les lésions réparées. Les suites opératoires étant simples à court terme, la victime est sortie après 15 jours d’hospitalisation. Cependant, un syndrome de stress post-traumatique est décrit chez cette patiente avec une prise en charge psychologique. Discussion : Notre observation est discutée par rapport aux données de la littérature. Conclusion : La violence sexuelle chez les survivantes pédiatriques est de plus en plus fréquente dans le pays dans un contexte de post-conflit.   Introduction : Child sexual abuse is a serious violation of fundamental human rights. It is a subject of global public health concern. Purpose : Denounce sexual violence in a minor and inform the authorities of the extent of the problem in the country. Observation: We report a clinical case of sexual violence complicated by a complete tearing of the perineum as well as the vesico-uterine septum in a 10-year-old girl. This case was received urgently at the gynecology-obstetrics department of the Centre Hospitalier Universitaire de l’Amitié Sino –Centrafricaine in Bangui. A laparotomy is performed and the lesions repaired. The postoperative course being simple in the short term, the victim was discharged after 15 days of hospitalization. However, a post-traumatic stress syndrome is described in this patient with psychological care. Conclusion: Sexual violence among pediatric survivors is increasingly common in the country in a post-conflict context

Prise en Charge de Dechirure Compliquee du Perinee Post Coital au Centre Hospitalier Unuversitaire de l’Amitie SinoCentrafricaine

Introduction : La violence sexuelle d’enfants est une violation grave des droits fondamentaux de l’homme. Elle constitue un sujet de préoccupations de santé publique mondiale. But de l’étude : Dénoncer la violence sexuelle chez une mineure et informer les autorités sur l’ampleur du problème dans le pays. Observation : Nous rapportons un cas clinique de violence sexuelle chez une fille de 10 ans compliqué de déchirures complète et compliquée du périnée et d’une cloison vésico-utérine. Ce cas était reçu en urgence au service de gynécologie-obstétrique du Centre Hospitalier Universitaire de l’Amitié Sino –Centrafricaine de Bangui. Une laparotomie était réalisée et les lésions réparées. Les suites opératoires étant simples à court terme, la survivante était sortie après 15 jours d’hospitalisation. Cependant, un syndrome de stress post-traumatique était décrit chez elle et prise en charge psychologiquement. Discussion : Notre observation était discutée par rapport aux données de la littérature. Conclusion : La violence sexuelle chez les survivantes pédiatriques est de plus en plus fréquent dans le pays dans un contexte de post-conflit.   Introduction : Child sexual abuse is a serious violation of fundamental human rights. It is a subject of global public health concern. Purpose : Denounce sexual violence in a minor and inform the authorities of the extent of the problem in the country. Observation : We report a clinical case of sexual violence in a 10-year-old girl complicated by complete and complicated tears of the perineum and a vesico-uterine septum. This case was received urgently at the gynecology-obstetrics department of the Sino-Central African Friendship University Hospital Center in Bangui. A laparotomy was performed and the lesions repaired. The postoperative course being simple in the short term, the survivor was discharged after 15 days of hospitalization. However, a post-traumatic stress syndrome was described in her and psychologically taken care of. Discussion : Our observation was discussed in relation to data from the literature. Conclusion : Sexual violence among child survivors is increasingly common in the country in a post-conflict context

Prise en Charge de Dechirure Compliquee du Perinee Post Coital au Centre Hospitalier Unuversitaire de l’Amitie SinoCentrafricaine

Introduction : La violence sexuelle d’enfants est une violation grave des droits fondamentaux de l’homme. Elle constitue un sujet de préoccupations de santé publique mondiale. But de l’étude : Dénoncer la violence sexuelle chez une mineure et informer les autorités sur l’ampleur du problème dans le pays. Observation : Nous rapportons un cas clinique de violence sexuelle chez une fille de 10 ans compliqué de déchirures complète et compliquée du périnée et d’une cloison vésico-utérine. Ce cas était reçu en urgence au service de gynécologie-obstétrique du Centre Hospitalier Universitaire de l’Amitié Sino –Centrafricaine de Bangui. Une laparotomie était réalisée et les lésions réparées. Les suites opératoires étant simples à court terme, la survivante était sortie après 15 jours d’hospitalisation. Cependant, un syndrome de stress post-traumatique était décrit chez elle et prise en charge psychologiquement. Discussion : Notre observation était discutée par rapport aux données de la littérature. Conclusion : La violence sexuelle chez les survivantes pédiatriques est de plus en plus fréquent dans le pays dans un contexte de post-conflit.   Introduction : Child sexual abuse is a serious violation of fundamental human rights. It is a subject of global public health concern. Purpose : Denounce sexual violence in a minor and inform the authorities of the extent of the problem in the country. Observation : We report a clinical case of sexual violence in a 10-year-old girl complicated by complete and complicated tears of the perineum and a vesico-uterine septum. This case was received urgently at the gynecology-obstetrics department of the Sino-Central African Friendship University Hospital Center in Bangui. A laparotomy was performed and the lesions repaired. The postoperative course being simple in the short term, the survivor was discharged after 15 days of hospitalization. However, a post-traumatic stress syndrome was described in her and psychologically taken care of. Discussion : Our observation was discussed in relation to data from the literature. Conclusion : Sexual violence among child survivors is increasingly common in the country in a post-conflict context

A New High-Throughput Tool to Screen Mosquito-Borne Viruses in Zika Virus Endemic/Epidemic Areas

International audienceMosquitoes are vectors of arboviruses affecting animal and human health. Arboviruses circulate primarily within an enzootic cycle and recurrent spillovers contribute to the emergence of human-adapted viruses able to initiate an urban cycle involving anthropophilic mosquitoes. The increasing volume of travel and trade offers multiple opportunities for arbovirus introduction in new regions. This scenario has been exemplified recently with the Zika pandemic. To incriminate a mosquito as vector of a pathogen, several criteria are required such as the detection of natural infections in mosquitoes. In this study, we used a high-throughput chip based on the BioMark™ Dynamic arrays system capable of detecting 64 arboviruses in a single experiment. A total of 17,958 mosquitoes collected in Zika-endemic/epidemic countries (Brazil, French Guiana, Guadeloupe, Suriname, Senegal, and Cambodia) were analyzed. Here we show that this new tool can detect endemic and epidemic viruses in different mosquito species in an epidemic context. Thus, this fast and low-cost method can be suggested as a novel epidemiological surveillance tool to identify circulating arboviruses

Inflammatory profile of vertically HIV-1 infected adolescents receiving ART in Cameroon: a contribution toward optimal pediatric HIV control strategies

Antiretroviral therapy (ART) has improved the lifespan of people living with HIV. However, their immune system remains in a state of sustained activation/inflammation, which favors viral replication and depletion of helper T-cells with varying profiles according to ART-response. We herein sought to ascertain the inflammatory profile of adolescents living with perinatal HIV-1 infection (ALPHI) receiving ART in an African context. In this cross-sectional and comparative study among ART-experienced ALPHI in Yaoundé-Cameroon, HIV-1 RNA was measured by Abbott Real-time PCR; CD4 cells were enumerated using flow cytometry; serum cytokines were measured by ELISA; HIV-1 proviral DNA was genotyped by Sanger-sequencing; and archived drug resistance mutations (ADRMs) were interpreted using Stanford HIVdb.v9.0.1. Overall, 73 adolescents were enrolled (60 ALPHI and 13 HIV-1 negative peers) aged 15 (13-18) years; 60.00% were female. ART median duration was 92 (46-123) months; median viral load was 3.99 (3.17-4.66) RNA Log10 (copies)/mL and median CD4 count was 326 (201-654) cells/mm3. As compared to HIV-negative adolescents, TNFα was highly expressed among ALPHI (p<0.01). Following a virological response, inflammatory cytokines (IFNγ and IL-12), anti-inflammatory cytokines (IL-4 and IL-10) and inflammation-related cytokines (IL-6 and IL-1β) were highly expressed with viral suppression (VS) vs. virological failure (VF), while the chemokine CCL3 was highly expressed with VF (p<0.01). Regarding the immune response, the inflammatory cytokine TNFα was highly expressed in those that are immunocompetent (CD4≥500 cell/mm3) vs. immunocompromised (CD4<500 cell/mm3), p ≤ 0.01; while chemokine CCL2 was highly expressed in the immunocompromised (p<0.05). In the presence of ADRMs, IL-4 and CCL3 were highly expressed (p=0.027 and p=0.043 respectively). Among ART-experienced ALPHI in Cameroon, the TNFα cytokine was found to be an inflammatory marker of HIV infection; IFNγ, IL-1β, IL-6, and IL-12 are potential immunological markers of VS and targeting these cytokines in addition to antiretroviral drugs may improve management. Moreover, CCL3 and CCL2 are possible predictors of VF and/or being immunocompromised and could serve as surrogates of poor ART response

Genotypic resistance testing improves antiretroviral treatment outcomes in a cohort of adolescents in Cameroon: Implications in the dolutegravir‑era

Background: Acquired drug resistance (ADR) is common among adolescents living with perinatal HIV (APHI) in sub-Saharan Africa (SSA). Personalized management has the potential to improve pediatric antiretroviral therapy (ART), even in the presence of long-term treatment and HIV-1 subtype diversity. Objective: We sought to evaluate the effect of HIV-1 mutational profiling on immuno-virological response and ADR among APHI. Methods: A cohort-study was conducted from 2018-2020 among 311 APHI receiving ART in Cameroon. Clinical, immunological and virological responses were measured at enrolment (T1), 6-months (T2) and 12-months (T3). Immunological failure (IF: CD4<250 cells/mm3), VF (viremia≥1000 copies/ml), and ADR were analyzed, with p<0.05 considered significant. Results: Mean age was 15(±3) years; male-female ratio was 1:1; median [IQR] ART-duration was 36[21-81] months. At T1, T2, and T3 respectively, adherence-level was 66.4%, 58.3% and 66.5%; 14 viral clades were found, driven by CRF02_AG (58.6%); ADR-mutations favored increased switch to second-line ART (16.1%, 31.2%, and 41.9%, p<0.0001). From T1-T3 respectively, there were declining rates of IF (25.5%, 18.9%, and 9.83, p<0.0001), VF (39.7%, 39.9%, and 28.2%, p=0.007), and HIVDR (96.4%, 91.7%, and 85.0%, p=0.099). Predictors of ADR were being on first-line ART (p=0.045), high viremia at enrolment (AOR=12.56, p=0.059), and IF (AOR=5.86, p=0.010). Of note, optimized ART guided by mutational profile (AOR=0.05, p=0.002) was protective. Moreover, full Tenofovir+Lamivudine+Dolutegravir efficacy was predicted in 77% and 62% of APHI respectively after first- and second-line failure. Conclusions: Among APHI in this SSA setting, viral mutational profiling prompts the use of optimized Dolutegravir-based ART regimens, leading to improved immuno-virological response and declining ADR burdens. Thus, implementing personalized HIV medicine in this vulnerable population would substantially improve ART response and the achievement of the 95-95-95 goals in these underserved populations

Inflammatory profile of vertically HIV-1 infected adolescents receiving ART in Cameroon: a contribution toward optimal pediatric HIV control strategies

Antiretroviral therapy (ART) has improved the lifespan of people living with HIV. However, their immune system remains in a state of sustained activation/inflammation, which favors viral replication and depletion of helper T-cells with varying profiles according to ART-response. We herein sought to ascertain the inflammatory profile of adolescents living with perinatal HIV-1 infection (ALPHI) receiving ART in an African context. In this cross-sectional and comparative study among ART-experienced ALPHI in Yaoundé-Cameroon, HIV-1 RNA was measured by Abbott Real-time PCR; CD4 cells were enumerated using flow cytometry; serum cytokines were measured by ELISA; HIV-1 proviral DNA was genotyped by Sanger-sequencing; and archived drug resistance mutations (ADRMs) were interpreted using Stanford HIVdb.v9.0.1. Overall, 73 adolescents were enrolled (60 ALPHI and 13 HIV-1 negative peers) aged 15 (13-18) years; 60.00% were female. ART median duration was 92 (46-123) months; median viral load was 3.99 (3.17-4.66) RNA Log10 (copies)/mL and median CD4 count was 326 (201-654) cells/mm3. As compared to HIV-negative adolescents, TNFα was highly expressed among ALPHI (p&lt;0.01). Following a virological response, inflammatory cytokines (IFNγ and IL-12), anti-inflammatory cytokines (IL-4 and IL-10) and inflammation-related cytokines (IL-6 and IL-1β) were highly expressed with viral suppression (VS) vs. virological failure (VF), while the chemokine CCL3 was highly expressed with VF (p&lt;0.01). Regarding the immune response, the inflammatory cytokine TNFα was highly expressed in those that are immunocompetent (CD4≥500 cell/mm3) vs. immunocompromised (CD4&lt;500 cell/mm3), p ≤ 0.01; while chemokine CCL2 was highly expressed in the immunocompromised (p&lt;0.05). In the presence of ADRMs, IL-4 and CCL3 were highly expressed (p=0.027 and p=0.043 respectively). Among ART-experienced ALPHI in Cameroon, the TNFα cytokine was found to be an inflammatory marker of HIV infection; IFNγ, IL-1β, IL-6, and IL-12 are potential immunological markers of VS and targeting these cytokines in addition to antiretroviral drugs may improve management. Moreover, CCL3 and CCL2 are possible predictors of VF and/or being immunocompromised and could serve as surrogates of poor ART response

les tumeurs carcinoïdes bronchiques (à propos d'un cas clinique)

Cette thèse évoque le cas d'une tumeur carcinoïde bronchique d'évolution atypique. Les tumeurs carcinoïdes font parties du groupe des tumeurs neuro-endocrines. L'origine de ces tumeurs est la cellule de Kulchitsky-Masson (ou cellule entérochromaffine ou cellule du système APUD) qui appartient au groupe des cellules neuro-endocrines, qui se répartit sur tout le tube digestif et le poumon. Dans la dernière classification OMS, les tumeurs neuro-endocrines du poumon sont divisées en 2 sous-groupes : les carcinoïdes avec le carcinoïde typique et atypique ; et les TNE avec les tumeurs à grandes cellules et les tumeurs à petites cellules. Le cas clinique de cette thèse évoque la découverte fortuite d'une tumeur carcinoïde typique chez une jeune patiente, évoluant 7 ans plus tard avec l'apparition de métastases ganglionnaires en carcinoïde atypique. La reprise chirurgicale exceptionnelle, réalisée sur les ganglions métastatiques permet d'éviter la pneumonectomie. Actuellement il n'existe pas de facteur pronostic permettant d'évaluer les chances de guérison d'un patient opéré d'une tumeur carcinoïde. La génétique moléculaire étudie ces tumeurs et de nouveaux marqueurs (mutation de le protéine p53, anomalie chromosomique 5q21) pourraient apporter une aide à leur pronostic. Leur traitement est en cours d'évolution avec de nouvelles techniques (Octréoscan) encore peu utilisées.TOULOUSE3-BU Santé-Centrale (315552105) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF