Arachnoïdite post péridurale (à propos d'un cas)

Depuis maintenant plus d'un siècle les techniques médicales d'exploration ou d'intervention sont devenues usuelles. De nombreux scientifiques, médecins pour la plupart d'entre eux, ont permis grâce à leurs différents travaux de découvrir, d'améliorer et d'approfondir toutes ces techniques. L'anesthésie par voie péridurale fait partie de ces progrès. Dès la seconde moitié du 19ème siècle, des neurologues et chirurgiens américains, allemands puis français s'intéressèrent à ce sujet. Cette méthode d'anesthésie connut et connaît encore un vif succès tant au sein de la profession médicale que du grand public. Néanmoins rapidement, on constata l'apparition de complications, notamment neurologiques. C'est l'une de ces complications, rarement décrite dans la littérature, que nous avons choisie de décrire à partir d'un cas clinique qui a été exploré à l'hôpital de Compiègne mais surtout au CHU d' Amiens. Cette observation est intéressante à plusieurs titres : tout d'abord nous verrons en reprenant l'historique de ses complications leur rareté croissante et la place occupée par l'arachnoïdite, ainsi que les méthodes de prévention utilisées au fil du temps. Puis, nous mettrons l'accent sur les particularités sémiologiques de ce cas clinique notamment la gravité de l'atteinte médullaire et surtout son caractère extensif même à distance de l'épisode traumatisant. Nous décrirons ensuite l'importance de l'imagerie et de la biopsie méningée dans la discussion des autres étiologies potentielles. C'est à partir de ses éléments cliniques et para cliniques que nous confronterons les différentes hypothèses physiopathologiques de ces arachnoïdites et de leurs conséquences thérapeutiques en insistant sur l'importance de la prévention qui est au premier plan dans la politique générale de santéAMIENS-BU Santé (800212102) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

The Living Lab methodology for complex environments: Insights from the thermal refurbishment of a historical district in the city of Cahors, France

WOS:000414758300011International audienceThe city centre of Cahors (southwest of France) is recognized as a historical heritage site and, like other city centres in Europe, it faces the complex challenge of the thermal retrofitting of old dwellings. This complexity is partly explained by the relative incompatibility of the French energy performance certificate with the retrofitting of old buildings, and by the frequent conflicts between heritage conservation policies and energy efficiency improvements. Today, the level of deterioration and the high vacancy rate of the dwellings, combined with the fuel poverty of their occupants has created an urgent need for an energy retrofit. In order to respond to this set of problems, the city council of Cahors has initiated the "Living Lab" approach, an original idea. The methodology, participants, objectives and obstacles of which are presented in this paper. Living Labs have emerged as a new research concept in which users, traditionally considered as observed subjects and end clients, become co-creators of the innovation process. As opposed to classical approaches, which may fail due to the contradictions among political, ecological, socioeconomic and technological interests, the user centred approach allows the emergence of a sustainable answer in a complex eco-system in a real life context. The first result of this study was the success associated with involving many participants - craftsmen, students, end-users, local authorities, material producers which enabled an efficient and acceptable solution to be found for refurbishment. Another issue was the improvement of both energy efficiency and hydrothermal indoor comfort for the end-users. Longer term results will be the reduction of fuel poverty for occupants, and a city centre that is alive and enjoyable to live in again. (C) 2017 Elsevier Ltd. All rights reserved

Altered hub functioning and compensatory activations in the connectome:A meta- Analysis of functional neuroimaging studies in schizophrenia

BACKGROUND: Functional neuroimaging studies of schizophrenia have identified abnormal activations in many brain regions. In an effort to interpret these findings from a network perspective, we carried out a meta-analysis of this literature, mapping anatomical locations of under- and over-activation to the topology of a normative human functional connectome. METHODS: We included 314 task-based functional neuroimaging studies including more than 5000 patients with schizophrenia and over 5000 controls. Coordinates of significant under- or over-activations in patients relative to controls were mapped to nodes of a normative connectome defined by a prior meta-analysis of 1641 functional neuroimaging studies of task-related activation in healthy volunteers. RESULTS: Under-activations and over-activations were reported in a wide diversity of brain regions. Both under- and over-activations were significantly more likely to be located in hub nodes that constitute the “rich club” or core of the normative connectome. In a subset of 121 studies that reported both under- and over-activations in the same patients, we found that, in network terms, these abnormalities were located in close topological proximity to each other. Under-activation in a peripheral node was more frequently associated specifically with over-activation of core nodes than with over-activation of another peripheral node. CONCLUSIONS: Although schizophrenia is associated with altered brain functional activation in a wide variety of regions, abnormal responses are concentrated in hubs of the normative connectome. Task-specific under-activation in schizophrenia is accompanied by over-activation of topologically central, less functionally specialized network nodes, which may represent a compensatory response

Embroidered Antenna-Microchip Interconnections and Contour Antennas in Passive UHF RFID Textile Tags

International audienceWe studied the possibilities of embroidered antenna-IC interconnections and contour antennas in passive ultrahigh-frequency radio-frequency identification textile tags. The tag antennas were patterned from metal-coated fabrics and embroidered with conductive yarn. The wireless performance of the tags with embroidered antenna-IC interconnections was evaluated through measurements, and the results were compared to identical tags, where the ICs were attached using regular conductive epoxy. Our results show that the textile tags with embroidered antenna-IC interconnections attained similar performance. In addition, the tags where only the borderlines of the antennas were embroidered showed excellent wireless performance

Cost- and time-effective sewing patterns for embroidered passive UHF RFID tags

Embroidery is an efficient method for the fabrication of textile antennas. We studied the effects of reducing the amount of conductive thread to achieve savings in material costs and the effects of the sewing pattern on the wireless performance of embroidered passive UHF RFID tags on two different fabric substrates. The antennas were sewed on cotton and polyamide fabrics, the ICs were attached to the embroidered antennas with a conductive adhesive, and the wireless performance of the ready-made textile RFID tags was evaluated through measurements. The fabric parameters were found to have a major effect on the tag performance. Based on our results, significant amounts of time and conductive yarn can be saved in the embroidery of RFID tag antennas by only partially sewing the tag antenna.acceptedVersionPeer reviewe

Cognitive relevance of the community structure of the human brain functional coactivation network.

There is growing interest in the complex topology of human brain functional networks, often measured using resting-state functional MRI (fMRI). Here, we used a meta-analysis of the large primary literature that used fMRI or PET to measure task-related activation (>1,600 studies; 1985–2010). We estimated the similarity (Jaccard index) of the activation patterns across experimental tasks between each pair of 638 brain regions. This continuous coactivation matrix was used to build a weighted graph to characterize network topology. The coactivation network was modular, with occipital, central, and default-mode modules predominantly coactivated by specific cognitive domains (perception, action, and emotion, respectively). It also included a rich club of hub nodes, located in parietal and prefrontal cortex and often connected over long distances, which were coactivated by a diverse range of experimental tasks. Investigating the topological role of edges between a deactivated and an activated node, we found that such competitive interactions were most frequent between nodes in different modules or between an activated rich-club node and a deactivated peripheral node. Many aspects of the coactivation network were convergent with a connectivity network derived from resting state fMRI data (n = 27, healthy volunteers); although the connectivity network was more parsimoniously connected and differed in the anatomical locations of some hubs. We conclude that the community structure of human brain networks is relevant to cognitive function. Deactivations may play a role in flexible reconfiguration of the network according to cognitive demand, varying the integration between modules, and between the periphery and a central rich club

La spécialisation des juges

La réforme de la carte judiciaire amorcée en 2008 devait inciter à une réflexion globale, non seulement sur l’organisation judiciaire, mais aussi sur la façon dont un contentieux est attribué à un juge ou à une juridiction. Perçue comme l’un des moyens de mettre en oeuvre une justice efficace et de qualité, la spécialisation des juges fait pourtant débat. Elle agite la doctrine, impose aux juges un très haut niveau de compétence et n’est pas sans influence sur les auxiliaires de justice. Les raisons qui justifient une spécialisation accrue ne manquent pourtant pas : la technicité, la complexité d’un contentieux notamment ou encore la rareté de certains d’entre eux, sont les plus classiques. Aussi, pour répondre à l’objectif d’une meilleure justice, plusieurs moyens sont utilisés. Il peut s’agir a minima de répartir les fonctions au sein d’une juridiction de droit commun, en créant des chambres spécialisées et des juges uniques aux fonctions particulières, de sorte que la spécialisation n’est pas l’apanage des juridictions d’exception, dites plus volontiers aujourd’hui, juridictions spécialisées. Par ailleurs, l’attribution d’une compétence matérielle précise peut aussi s’accompagner d’une extension de compétence territoriale, permettant le regroupement des contentieux au travers de pôles spécialisés. Au-delà d’une compétence juridique spécifique acquise par une formation appropriée, la spécialisation des juges implique celle des assistants spécialisés et des auxiliaires de justice, d’autant plus nécessaire que la spécialisation va souvent de pair avec le caractère dérogatoire des procédures. Ces travaux ont pour ambition de mieux comprendre les enjeux de la spécialisation des juges, de mesurer ses avantages et ses inconvénients, et de contribuer au débat à défaut de le clore