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Impact de la tenue vestimentaire du médecin généraliste sur la confiance du patient
No full textObjectif : L’apparence et la tenue du médecin généraliste semblent avoir un rôle dans la relation médecin-patient. La confiance est un élément clef de cette relation, et est associée à des effets de santé. L’objectif de ce travail est de déterminer l’impact de la tenue vestimentaire du médecin généraliste sur la confiance que lui porte le patient ainsi que de rechercher si une tenue semble optimiser cette confiance. <br>Matériel et méthode : Une étude prospective multicentrique sur la région du Var a été conduite de novembre 2016 à février 2017 au sein de différentes pharmacies, utilisant un questionnaire d’évaluation de confiance couplé à des photographies de médecins de styles vestimentaires différents. <br>Résultats : 731 sujets ont été inclus durant ces quatre mois. Il existait, pour la plupart des questions, une différence significative ou une tendance statistique entre les types de tenue. <br>Discussion : L’impact de la tenue vestimentaire sur la confiance du patient en France est confirmé. Les tenues « blouse » et « smart casual » semblent optimiser la confiance dans le cas du médecin homme. Pour le médecin femme, la tenue blouse semble associée au meilleur niveau de confiance. L’âge ou le sexe du répondant ne semblent pas avoir d’impact majeur sur le niveau de confiance (analyses secondaires)
Perte de la dimension verticale d'occlusion (DVO) par abrasion, attrition, érosion : panel thérapeutique de la dentisterie adhésive actuelle pour sa réhabilitation
No full textA leurs stades les plus précoces, les lésions d’usure n’induisent que de minimes pertes tissulaires : ainsi, comment justifier leur traitement en ayant recourt à des prothèses traditionnelles d’autant plus mutilantes ? C’est par l’émergence de la dentisterie adhésive, que toute cette problématique semble trouver une réponse. L’avènement de nouveaux procédés et matériaux céramiques, ainsi que de colles encore plus performantes, permet de travailler sur des épaisseurs toujours plus fines et respectueuses de l’organe dentaire.<br>La perte de Dimension Verticale d’Occlusion (DVO) induite par ces lésions d’usure, peut désormais être interceptée aux stades initiaux, et minimiser le coût biologique. La clé de ces réhabilitations souvent très étendues et anxiogènes pour le praticien, demeure dans la reproductibilité d’un protocole précis, et d’un dialogue efficace avec le prothésiste.<br>Ce travail résume la prise en charge rigoureuse, pas à pas, des différentes thérapeutiques contemporaines
Staphylococcus lugdunensis: a neglected pathogen of infections involving fracture-fixation devices
No full textInternational audiencePurpose Cases of fracture-fixation device infection involving Staphylococcus lugdunensis are not frequent. The clinical characteristics and the choice of treatment strategies of these infections are not obviously known to date. Methods We performed a review of fracture-fixation device infection involving S. lugdunensis managed by our centres. Results Among the 38 cases of fracture-fixation device infection involving S. lugdunensis, 53% were located in the tibia. Most of our cases (87%) were chronic infections. Purulent discharge, which occurred in 79% of cases, was the most frequent clinical symptom, followed by pain in 63%, local inflammation in 55%, and fever in 37%. Bacteremia and severe sepsis occurred in 10% and 18% of cases, respectively. Four cases (10%) were treated exclusively with antimicrobial treatment alone. Thirty-four cases (89%) were treated with a combination of surgery with antimicrobial therapy including surgical debridement, antibiotics and osteosynthesis device retention in six cases (16%), and osteosynthesis device removal in 27 cases (71%). The mean length of antibiotic treatment was 119 days. The relapse rate was high that was not related to selection of resistant strains. Polymicrobial infection had no impact on clinical outcome. A combination of surgery with antimicrobial therapy was identified as a significant prognostic factor associated with remission (p = 0.042). Conclusions S. lugdunensis is probably involved in more infections than has been reported. Using appropriate microbiological methods laboratories should routinely identify the species of all coagulase-negative Staphylococci isolates involved in fracture-fixation device infection to better achieve the treatment strategies of fracture-fixation device infection involving S. lugdunensis
Upper Limits on the Stochastic Gravitational-Wave Background from Advanced LIGO's First Observing Run
No full textSee paper for full list of authors - 14 pages, 6 figuresInternational audienceA wide variety of astrophysical and cosmological sources are expected to contribute to a stochastic gravitational-wave background. Following the observations of GW150914 and GW151226, the rate and mass of coalescing binary black holes appear to be greater than many previous expectations. As a result, the stochastic background from unresolved compact binary coalescences is expected to be particularly loud. We perform a search for the isotropic stochastic gravitational-wave background using data from Advanced LIGO's first observing run. The data display no evidence of a stochastic gravitational-wave signal. We constrain the dimensionless energy density of gravitational waves to be with 95% confidence, assuming a flat energy density spectrum in the most sensitive part of the LIGO band (20-86 Hz). This is a factor of ~33 times more sensitive than previous measurements. We also constrain arbitrary power-law spectra. Finally, we investigate the implications of this search for the background of binary black holes using an astrophysical model for the background
Les verba sonandi associés aux animaux dans les langues slaves : emplois métaphoriques et constructions (sur l’exemple du russe et du serbe)
No full textInternational audienceThis study focuses on the realization of the main semantic valencies of animal sound verbs in Russian and in Serbian, such as the valencies of content, addressee, cause, and internal localization. The analysis highlights metaphorical constructions with these verbs when they are used with respect to humans.L’étude est centrée sur les principales valences sémantiques des verbes de bruit associés aux animaux en russe et en serbe, à savoir les valences correspondant au contenu, au destinataire, à la cause et à la localisation interne. L’analyse met au jour les constructions mobilisées par les emplois métaphoriques de ces verbes lorsque ces derniers s’appliquent à l’homme
Serre-type equations in deep water
Get PDF27 pages, 4 figures, 56 references. Other author's papers can be downloaded at http://www.denys-dutykh.com/National audienceThis manuscript is devoted to the modelling of water waves in the deep water regime with some emphasis on the underlying variational structures. The present article should be considered as a review of some existing models and modelling approaches even if new results are presented as well. Namely, we derive the deep water analogue of the celebrated Serre-Green-Naghdi equations which have become the standard model in shallow water environments. The relation to existing models is discussed. Moreover, the multi-symplectic structure of these equations is reported as well. The results of this work can be used to develop various types of robust structure-preserving variational integrators in deep water. The methodology of constructing approximate models presented in this study can be naturally extrapolated to other physical flow regimes as well
Wikipedia, une encyclopédie en communs
Get PDFInternational audienceRetour sur la place occupée par Wikipédia à l'échelle du Web, et DBpedia à l'échelle du Web de données
The Role of R&D Collaboration Networks on Regional Knowledge Creation: Evidence from Information and Communication Technologies
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Discrete-time system optimal dynamic traffic assignment (SO-DTA) with partial control for horizontal queuing networks
Get PDFInternational audienceWe consider the System Optimal Dynamic Traffic Assignment problem with Partial Control (SO-DTA-PC) for general networks with horizontal queuing. The goal of which is to optimally control any subset of the networks agents to minimize the total congestion of all agents in the network. We adopt a flow dynamics model that is a Godunov discretization of the Lighthill-Williams-Richards (LWR) partial differential equation with a triangular flux function and a corresponding multi-commodity junction solver. Full Lagrangian paths are assumed to be known for the controllable agents, while we only assume knowledge of the aggregate turn ratios for the non-controllable (selfish) agents. We solve the resulting finite horizon non-linear optimal control problem using the discrete adjoint method
Energy localization effects within a reverberation chamber and their reduction in chaotic geometries
Get PDFInternational audienceA method of studying energy localization effects in a reverberation chamber is proposed and applied to simulation results. Its application to field spatial distributions of a classical reverberation chamber equipped with a mode stirrer shows a strong energy localization phenomenon of damaging effect on the field homogeneity. From the energy distributions it appears that this phenomenon is principally related to energy localization around the mode stirrer. To avoid the presence of a mode stirrer causing this phenomenon, an alternative shape of reverberation chamber, inspired from geometries of chaotic cavities, is pro- posed. The results obtained with this new cavity configuration show that the strong energy localizations are avoided and the resonant modes better contribute to the field uniformity and isotropy within the working volume