184 research outputs found
Vasopressor Therapy and the Brain: Dark Side of the Moon
No full textInternational audienceSepsis, a leading cause of morbidity and mortality, is caused by a deregulated host response to pathogens, and subsequent life-threatening organ dysfunctions. All major systems, including the cardiovascular, respiratory, renal, hepatic, hematological, and the neurological system may be affected by sepsis. Sepsis associated neurological dysfunction is triggered by multiple factors including neuro-inflammation, excitotoxicity, and ischemia. Ischemia results from reduced cerebral blood flow, caused by extreme variations of blood pressure, occlusion of cerebral vessels, or more subtle defects of the microcirculation. International guidelines comprehensively describe the initial hemodynamic management of sepsis, revolving around the normalization of systemic hemodynamics and of arterial lactate. By contrast, the management of sepsis patients suffering from brain dysfunction is poorly detailed, the only salient point being mentioned is that sedation and analgesia should be optimized. However, sepsis and the hemodynamic consequences thereof as well as vasopressors may have severe untoward neurological consequences. The current review describes the general neurological complications, as well as the consequences of vasopressor therapy on the brain and its circulation and addresses methods for cerebral monitoring during sepsis. © Copyright © 2020 Heming, Mazeraud, Azabou, Moine and Annane
Kwaliteit van arbeid, geautomatiseerd... Een studie naar kwaliteit van arbeid en de relatie tussen automatisering, arbeid en organisatie
No full textTechnology, Policy and Managemen
Temporomandibular Joint Pain is Negatively Correlated to TNF Alpha and Osteoprotegrin Content in Synovial Fluid in Patients with Juvenile Idiopathic Arthritis.
No full textObjective: Temporomandibular joint (TMJ) involvement occurs in up to 80% of children with juvenile idiopathic arthritis (JIA). Little is known with regard to the complexity of the protein profile in synovial fluid (SF) from JIA arthritis during growth as compared to both JIA and rheumatoid arthritis (RA) of adults.
Design: Synovial fluid was collected from 54 joints/30 patients with TMJ arthritis (JIA 35 joints/20 patients, JIA adults 9 joints/5 patients, RA 10 joints/5 patients). Three cytokines and seven bone markers were quantified using Luminex multiplex assays and compared to demographic and clinical data of function and pain.
Results: Pain (spontaneous and upon palpation) and duration of pain were all negatively correlated with the TMJ SF content of tumor necrosis factor (TNF)-α. The level of Adrenocorticotropic hormone (ACTH) was negatively correlated to TMJ pain upon palpation and post-treatment pain and function. The concentration of ACTH was significantly lower in SF in JIA (1.4 ± 2.8 pg/ml) compared to adults with JIA (4.7 ± 12.2 pg/ml) and significantly higher compared to adults with RA (0.8 ± 1.5 pg/ml). Osteoprotegerin (OPG) was negatively correlated to spontaneous pain.
Conclusions: Our results indicate that the local concentrations of TNF-α, ACTH and OPG in TMJ fluid may not contribute to TMJ pain and tissue destruction in JIA/RA patients.
© 2014 Olsen-Bergem H, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
Damage detection in semiconductor devices by non-linear elastic wave spectroscopy
No full textSemiconductor devices can be found everywhere in our daily lives, for example in self-driving cars, bank cards and personal devices such as smart phones or notebooks. Once part of these personal devices, one does not want them to show failure. Although reliability of such devices is taken into account in the design, the fabrication process might lead to the emergence of small damages in the product. Since these damages or their propagation might cause failure of the device, a series of visual inspections and functional tests is part of the fabrication process. The obtained resolution by optical microscopy, currently the state of the art inspection method, is not sufficient for the detection of small damages such as microcracks or damages located inside a sample. To keep improving the reliability of semiconductor devices, these damages need to be detected in another high speed, low cost way.As semiconductor devices shrink in size, their natural vibration frequencies increase and approach theMHz-range. Vibration based damage detection methods might therefore offer an alternative high speed in-situ inspection method. The main goal of this thesis is to identify and experimentally verify vibration characteristics that indicate the presence of damage, with a focus on microcracks, in semiconductor devices. While linear vibration based damage methods have proven to be insensitive to small damages such as microcracks, non-linear vibration based damage detection methods show much higher sensitivities to this type of damage. The non-linear elastic wave spectroscopy (NEWS) of several damaged materials have shown two characteristic phenomena: amplitude dependent natural frequency shifts and the generation of higher harmonics. Both are explained by a phenomenological non-linear hysteric elastic model. While the applicability of NEWS is proven for several materials, its performance for silicon, in particular at microscale, is still unknown.Mechanical Engineering | Micro and Nano Engineerin
Acute Management of Sepsis beyond 24 Hours
No full textInternational audienceSepsis manifests as a dysregulated immune response to an infection, leading to tissue damage, organ failure, and potentially death or long-term health issues. Sepsis remains a major health challenge globally, causing approximately 50 million cases and 11 million deaths annually. Early management of sepsis focuses on source control, antimicrobial treatment, and supporting vital organ function. Subsequent care includes metabolic, nutritional, and immune therapies to address the complex needs of septic patients. Metabolic management is based on obtaining moderate glucose targets. Nutritional support aims to mitigate hypercatabolism and muscle wasting, but aggressive early nutrition does not improve outcomes and could even be harmful. Immune modulation is crucial due to the dual nature of sepsis-induced immune responses. Corticosteroids have shown benefits in shock and organ dysfunction reversal and in mortality reduction with current guidelines recommending them in vasopressor therapy-dependent patients. In conclusion, sepsis management beyond the initial hours requires a multifaceted approach, focusing on metabolic, nutritional, and immune system support tailored to individual patient needs to enhance survival and recovery
The drama of the forests, romance and adventure, by Arthur Heming; illustrated by the author with reproductions from a series of his paintings owned by the Royal Ontario museum.
No full textxiii, 324 p
A geometric flow on noncompact affine Riemannian manifolds
No full textIn this paper, we obtain the existence criteria for a geometic flow on
noncompact affine Riemannian manifolds. Our results can be regarded as a real
version of Lee-Tam [19]. As an application, we prove that a complete noncompact
Hessian manifold with nonnegative Hessian sectional curvature and bounded
geometry is diffeomorphic to if its tangent bundle has maximal
volume growth.Comment: arXiv admin note: text overlap with arXiv:math/0504422,
arXiv:1708.00141 by other author
Creativity and Its Necessity in Teaching and in the Administration of Schools
No full textAs a research exercise, the study of creativity has long been the province of psychologists. In recent y ears, administrators have researched the creativity literature and have encouraged administrative practitioners to accelerate discovery and increase effectiveness of their organizations through more efficient use of their personnel. The author discusses why and how school administrators must manage schools creatively if creativity is to be fostered in the classroom
Hyperspectral Imagery Classification Using Sparse Representations of Convolutional Neural Network Features
No full textIn recent years, deep learning has been widely studied for remote sensing image analysis. In this paper, we propose a method for remotely-sensed image classification by using sparse representation of deep learning features. Specifically, we use convolutional neural networks (CNN) to extract deep features from high levels of the image data. Deep features provide high level spatial information created by hierarchical structures. Although the deep features may have high dimensionality, they lie in class-dependent sub-spaces or sub-manifolds. We investigate the characteristics of deep features by using a sparse representation classification framework. The experimental results reveal that the proposed method exploits the inherent low-dimensional structure of the deep features to provide better classification results as compared to the results obtained by widely-used feature exploration algorithms, such as the extended morphological attribute profiles (EMAPs) and sparse coding (SC)
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