95 research outputs found
Numelyo ou la dix-septième bibliothèque
Lancée en décembre 2012, la bibliothèque Numelyo est une nouvelle étape dans le développement du numérique à la BmL qui hérite d\u27une histoire, s\u27inscrit dans les objectifs définis par le projet d\u27établissement et se projette dans un environnement en évolution rapide
Surgical Stabilization for Multiple Rib Fractures: Whom the Benefit? -A Prospective Observational Study
Background: Surgical repair has demonstrated a beneficial effect on outcome for patients presenting with flail chest or with multiple rib fractures. We hypothesized that benefit on outcome parameters concerns predominantly patients being extubated within 24 hours post-operatively.
Methods: We prospectively recorded all patients presenting with chest traumatism eligible for surgical repair with anticipated early extubation according to our institutional consensus (flail chest, major deformity, poor pain control, associated lesions requiring thoracotomy). We compared outcomes of patients extubated within 24 hours post-operatively to those who required prolonged ventilator support. We tested predictive factors for prolonged intubation with univariate and multivariate analysis.
Results: From 2010 to 2014, 132 patients required surgical repair. Two thirds were extubated within 24 hours following surgical repair. Pneumonia was the main complication and occurred in 30.3% of all patients. Patients extubated within 24 hours following surgical repair had significantly shorter ICU stay and shorter in-hospital stay (P<0.0001 both). Pneumonia occurred significantly more often in patients with longer mechanical ventilation (over 24 hours) (P<0.0001) and the overall post-operative complications rate was higher (P=0.0001). Main independent risk factors for delayed extubation were bilateral chest rib fractures
and initially associated pneumothorax.
Conclusions: We conclude that patients extubated within 24 hours after repair have an improved outcome with reduced complication rate and shorter hospital stay. The initial extent of the trauma is an important risk factor for delayed extubation and high complication rate despite surgical stabilization
Vers une nouvelle érudition : numérisation et recherche en histoire du livre
En décembre 1999, à l\u27Enssib, s’est déroulé le colloque "Vers une nouvelle érudition : numérisation et recherche en histoire du livre", organisé dans le cadre des 12e Entretiens du Centre Jacques Cartier sous la responsabilité de Dominique Varry (enssib), Annie Charon (école nationale des chartes) et Guylaine Baudry (Université de Montréal)
Modelling Strategies for Predicting the Residual Strength of Impacted Composite Aircraft Fuselages
Aeronautic Certification rules established for the metallic materials are not convenient for the composite structures concerning the resistance against impact. The computerbased design is a new methodology that is thought about to replace the experimental tests. It becomes necessary for numerical methods to be robust and predictive for impact. Three
questions are addressed in this study: (i) can a numerical model be “mechanically intrinsic” to predict damage after impact, (ii) can this model be the same for a lab sample and a large structure, and (iii) can the numerical model be predictive enough to predict the Compression After Impact (CAI)? Three different computational strategies are used and compared: a Cohesive Model (CM), a Continuous Damage Model (CDM) coupling failure modes and
damage, and a Mixed Methodology (MM) using the CDM for delamination initiation and the
CM for cracks propagation. The first attempts to use the Smooth Particle Hydrodynamics
method are presented. Finally, impact on a fuselage is modelled and a numerical two-stage
strategy is developed to predict the CAI
CC9 Livestock-Associated Staphylococcus aureus Emerges in Bloodstream Infections in French Patients Unconnected With Animal Farming
We report 4 bloodstream infections associated with CC9 agr type II Staphylococcus aureus in individuals without animal exposure. We demonstrate, by microarray analysis, the presence of egc cluster, fnbA, cap operon, lukS, set2, set12, splE, splD, sak, epiD, and can, genomic features associated with a high virulence potential in human
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