Les effets du miel sur la cicatrice de césarienne: Travail de Bachelor

Cadre de référence : l’incidence des complications associées à la césarienne est une préoccupation importante dans le métier de sage-femme. D’autant plus que le pourcentage de cet acte a nettement augmenté dans les dernières années. Bien qu’une prise de conscience générale soit advenue et que le taux de césariennes ait certainement atteint son maximum, ce geste demeure une pratique courante en obstétrique permettant de sauver des vies. C’est pour cela et afin de limiter l’impact de cette opération sur la période du post-­partum, qu’il est important de trouver le meilleur traitement cicatrisant possible à offrir aux femmes. Le miel, parce qu’il est un produit naturel, doux et a priori sans effet secondaire, représente un bon candidat. Objectif : le but de ce travail est d’explorer l’efficacité de l’application de miel sur des cicatrices de césariennes. Méthode : les cinq articles qui constituent cette revue de littérature ont été cherchés sur les moteurs de recherche suivants, d’après leur année de publication et le type de plaie étudié : Medline via Pubmed, CINAHL, Google Scholar et MIDIRS. Quatre d’entre eux sont des essais cliniques randomisés en double ou triple aveugle. Le dernier est une étude observationnelle avec comparaison temporelle. Tous ont été analysés, critiqués et discutés. Résultats : quatre études sur cinq arrivent à la conclusion que le miel est bénéfique pour la cicatrisation. En effet, il réduirait les complications telles que l’inflammation, l’infection et la douleur. De plus, il améliorerait aussi l’issue esthétique de la plaie. Il semblerait également que le miel n’ait pas d’effet secondaire, excepté un cas d’irritation passagère dans une des études. La dernière étude n’observe pas de différence significative avec l’utilisation du miel. Conclusion : l’utilisation du miel semble être une approche intéressante pour promouvoir la cicatrisation des plaies de césariennes. Bien que ces résultats soient encourageants, ils comportent toutefois quelques divergences. Pour cette raison, il serait nécessaire de procéder à de plus amples études afin d’évaluer l’efficacité des différents types de miels. Toutefois, de part le fait que le miel n’ait pas d’effet secondaire majeur, il est possible de le proposer comme soin

Development of FEM laboratory modules for an introductory undergraduate Geotechnical Engineering course

While geotechnical and structural engineers routinely rely heavily on finite element (FEM) modeling for analysis and design, exposure to numerical modeling and to software used in industry is generally limited in most civil engineering undergraduate curricula. This document summarizes the experience of introducing an industry FEM software - Midas GTS NX – into the Geotechnical Engineering I course at Purdue University in the Spring 2020 semester, through two laboratory modules built around key topics covered in the course: 2D groundwater flow and stress analysis. In addition to providing exposure to tools used in practice, the modules were designed to consolidate the comprehension of fundamental concepts, and enhance students’ learning experience by facilitating rapid iterative exploration of different technical scenarios in the context of practical applications of geotechnical engineering

Investigation of Design Alternatives for the Subbase of Concrete Pavements

In all pavement structures, one or more support layers separate the pavement from the subgrade. In addition to offering structural support, these layers have several important functions, which include: providing a stable and uniform construction platform, facilitating drainage, mitigating pumping of the subgrade fines, and protecting the pavement from the effects of frost heave. Their performance is critical in achieving the desired pavement smoothness, and in extending the service life of the structure. A range of designs, making use of unbound or stabilized aggregates and in some cases geosynthetics, are employed by different agencies to fulfill these functions. This project was motivated by constructability and long term performance concerns with the existing base/subbase design employed by INDOT for concrete pavements, as well as the desire to identify state of the art design solutions that could be applicable to both concrete and asphalt pavements. The primary objectives of the study were to: critically reexamine INDOT’s existing design; perform a preliminary evaluation (based on aggregate compaction, hydraulic conductivity, strength and compatibility properties) of select unbound design options identified in collaboration with the Study Advisory Committee (SAC); explore the potential use of geotextiles as separator; and develop recommendations for base/subbase aggregate laboratory testing and evaluation

Engineering Properties of Marls

The term “marl” is used to designate soft, carbonate-rich, fine-grained soils, which pose concerns related to both settlement and stability. Despite the prevalence of marls in Indiana and the concerns associated with their behavior, very limited work has been done to study the engineering properties of these soils. This was the motivation for this research project, which involved two primary activities: a) the creation of a map and database of existing information on marl deposits in Indiana; and b) an in-depth characterization of the properties of a marl deposit in Daviess County, which was considered representative of similar deposits encountered in Indiana. The marl database was generated using ArcGIS 10.0.from information available at the INDOT, and involved mining data from over five thousand boreholes. The second part of the project involved field tests (seismic cone penetration tests, standard penetration tests, field vane shear tests), and laboratory experiments (index tests, incremental and constant rate of strain consolidation tests, and K0-consolidated undrained triaxial tests) conducted on high quality Shelby tubes samples. Additionally, the mineralogy and the microstructure of the soil were studied in detail. The laboratory tests reveal that the deposit was not homogeneous as was initially anticipated, but was, instead, formed by two types of soils that repeat in horizontal thin layers. These two soils, referred to as ‘soil M’ and ‘soil C’, are both characterized by very high calcium carbonate contents but show distinct index and engineering properties, that may be ascribed to differences in mineralogy and composition. This stratification is not detected by the field tests. The consolidation tests show that the deposit has an OCR less than 2 and compressibility parameters markedly dependent on stress level, as typical of sensitive soils. K0-consolidated undrained compression triaxial tests show that both soils exhibit normalized behavior, and that the relationship between strength and stress history is well described by the SHANSEP equation (although the SHANSEP parameters differ for the two soils). Comparison of the field data and laboratory results provides the means to validate published correlations for interpretation of the geotechnical properties of marls from field results. For the site examined, correlations to estimate shear wave velocity, stress history, and undrained strength from CPT results are identified. Implementation recommendations are provided for soil identification, sampling and specimen preparation, interpretation of filed data, and preliminary design

Verification of the Enhanced Integrated Climatic Module Soil Subgrade Input Parameters in the MEPDG

At the beginning of 2009, INDOT adopted the Mechanistic-Empirical Pavement Design Guide (MEPDG) method to study the tong-term pavement performance. The implementation of this new design approach led to difficulties for the pavement to pass the INDOT performance criteria; in particular pavement roughness (IRI) when A-6 or A-7-6 soils were considered as subgrade. This study focuses on investigating the influence of the soil input parameters in the Enhanced Integrated Climatic Model (EICM) on the prediction of the soil resilient modulus (MR) in the MEPDG. A total of four sites located around the state of Indiana are used to propose/validate the observations and conclusions made in the research. The study shows that (1) for the climatic conditions existing in Indiana, the location of the water table does not affect the value that the MEPDG uses for the subgrade MR; (2) the gravimetric water content is the most influential parameter on the EICM since it is directly related to the optimum degree of saturation of the subgrade; and (3) For A-7-6 soils, the overall deformation of the pavement structure is controlled by the subgrade (~80% of total deformation). In order to properly model the pavement structure, the MR input into the MEPDG for the subgrade should represent the optimum condition. This value will then be reduced within the EICM to reflect actual site conditions; and the MR input into the MEPDG for the treated layer should be a constant (i.e. not affected by EICM) and with PI and P200 values that are representative of the soil after treatment, given that the fines content and plasticity of a chemically-treated soil tend to decrease with treatment

Rapid, Label-Free Detection of Brain Tumors with Stimulated Raman Scattering Microscopy

Surgery is an essential component in the treatment of brain tumors. However, delineating tumor from normal brain remains a major challenge. We describe the use of stimulated Raman scattering (SRS) microscopy for differentiating healthy human and mouse brain tissue from tumor-infiltrated brain based on histoarchitectural and biochemical differences. Unlike traditional histopathology, SRS is a label-free technique that can be rapidly performed in situ. SRS microscopy was able to differentiate tumor from nonneoplastic tissue in an infiltrative human glioblastoma xenograft mouse model based on their different Raman spectra. We further demonstrated a correlation between SRS and hematoxylin and eosin microscopy for detection of glioma infiltration (κ = 0.98). Finally, we applied SRS microscopy in vivo in mice during surgery to reveal tumor margins that were undetectable under standard operative conditions. By providing rapid intraoperative assessment of brain tissue, SRS microscopy may ultimately improve the safety and accuracy of surgeries where tumor boundaries are visually indistinct.Chemistry and Chemical Biolog

Association of serum copeptin and urinary uromodulin with kidney function, blood pressure and albuminuria at 6 weeks post-partum in pre-eclampsia

BackgroundPreeclampsia (PE) is associated with subsequent higher risk of cardiovascular and kidney disease. Serum copeptin, as a proxy for vasopressin, and urinary uromodulin, were associated with PE physiopathology and kidney functional mass respectively. We describe concentrations of these proteins in the post-partum period and characterize their association with persistent hypertension (HTN) or albuminuria.MethodsPatients with PE and healthy controls with uncomplicated pregnancy were prospectively included at two teaching hospitals in Switzerland. Clinical parameters along with serum copeptin and urinary uromodulin were measured at 6 weeks post-partum. PE patients were further characterized based on presence of HTN (defined as either systolic BP (SBP) ≥140 mmHg or diastolic (BP) ≥90 mmHg) or albuminuria [defined as urinary albumin to creatinine ratio (ACR) ≥3 mg/mmol].ResultsWe included 226 patients with 35 controls, 120 (62.8%) PE with persistent HTN/albuminuria and 71 (37.1%) PE without persistent HTN/albuminuria. Median serum copeptin concentration was 4.27 (2.9–6.2) pmol/L without differences between study groups (p > 0.05). Higher copeptin levels were associated with higher SBP in controls (p = 0.039), but not in PE (p > 0.05). Median urinary uromodulin concentration was 17.5 (7.8–28.7) mg/g with lower levels in PE patients as compared to healthy controls (p < 0.001), but comparable levels between PE patients with or without HTN/albuminuria (p > 0.05). Higher uromodulin levels were associated with lower albuminuria in PE as well as control patients (p = 0.040).ConclusionSerum copeptin levels at 6 weeks post-partum are similar between PE patients and healthy controls and cannot distinguish between PE with or without residual kidney damage. This would argue against a significant pathophysiological role of the vasopressin pathway in mediating organ damage in the post-partum period. On the opposite, post-partum urinary uromodulin levels are markedly lower in PE patients as compared to healthy controls, potentially reflecting an increased susceptibility to vascular and kidney damage that could associate with adverse long-term cardiovascular and kidney outcomes

Data Interpretation of Automated Plate Load Test (APLT) for Real-Time In Situ Determination of Unbound Layer Resilient Modulus

This project examined the results of an extensive program of (1) cyclic plate loading tests carried out at Purdue University’s S-BRITE site on two testing strips comprised of a coarse aggregate (Indiana #53) subbase layer compacted over either untreated or cement-stabilized subgrade, and (2) static loading tests conducted on #53 aggregate compacted in a 3.6-foot-deep testing pit. The testing program on the two strips included multistage resilient modulus (MR) tests and extended cyclic performance tests with random distributed loading (RDL) tests on both the subbase and the underlying subgrade. Two of the RDL tests were performed at locations where a nonwoven geotextile had been placed between subgrade and subbase. The work was aimed at improving the understanding of the behavior of subbase and subgrade materials under cyclic loading, mitigating ambiguities regarding the performance of subbase and subgrade materials, and exploring the use of automated plate load tests for determining such properties, ultimately advancing the state of pavement design practice at INDOT

Application of honey to reduce perineal laceration pain during the postpartum period ::a randomized controlled trial

Perineal lacerations affect between 35 and 85% of women during childbirth and may be responsible for postpartum pain. Honey has been demonstrated to have interesting properties that can promote wound healing. The aim was to evaluate the effectiveness of the application of honey to the perineum to reduce perineal pain during the early postpartum period. A randomized controlled trial including 68 women was conducted. In the intervention group, honey was applied to perineal lacerations for four days, in addition to standard care. The control group received only standard care. The primary outcome was pain intensity using the Visual Analog Scale and pain perception using the McGill Pain Questionnaire (QDSA). The secondary outcomes were a burning sensation, the use of a pain killer, and the women’s satisfaction with the honey application. The intensity of pain was not significantly different between the groups on Day 1 (VAS 3.38 in the control group versus 3.34 in the intervention group, p = 0.65) or on Day 4 (VAS 2.28 versus 1.41, respectively, p = 0.09). There was no significant difference regarding the perception of pain with the QDSA. Despite this, most of the women in the intervention group (93%) were satisfied or very satisfied with the use of honey on their perineum