Lorsqu'un dossier est à l'AI, il est souvent déjà trop tard! Réponse et complément à la discussion lancée par R. Conne sur la capacité de travail et l'assurance invalidité

L'article «Capacité de travail et assurance invalidité » [1] décrit le malaise actuel concernant la réhabilitation à la place de travail. Cette problématique n'est toutefois pas uniquement valable pour des incapacités de travail liées à des raisons psychiques, mais aussi pour des incapacités de travail dues à des troubles musculo-squelettiques. De plus, les difficultés de réhabilitation à la place de travail ne doivent pas être imputées uniquement à l'assurance invalidité. En effet, elles sont dues d'une part à des données structurelles de la Suisse (comme une faible implantation de la médecine du travail dans les entreprises et un accès peu développé à la médecine de réhabilitation) et d'autre part, à un manque de définition claire de répartition des coûts ou des responsabilités. Dans son article R. Conne décrit de façon pertinente le malaise existant en Suisse en ce qui concerne la question de la réhabilitation à la place de travail ou de la récupération de sa capacité de travail. Toutefois, cet article se base principalement sur des incapacités de travail dues à des causes psychiques. En temps que médecin du travail et médecin en réhabilitation, nous souhaitons nous emparer de la discussion et l'élargir. Cet élargissement comprend d'une part la prise en compte d'incapacités de travail pour des causes non psychiques et d'autre part, la situation générale des assurances en Suisse. En effet, plutôt que de se focaliser uniquement sur le problème de l'assurance invalidité, il nous semble utile d'étendre le débat à la situation générale des assurances. [Auteurs]

Wind Tunnel Analysis of the Effects of Planting at Highway Grade Separation Structures, HR-202, 1979

Blowing and drifting snow has been a problem for the highway maintenance engineer virtually since the inception of the automobile. In the early days, highway engineers were limited in their capability to design and construct drift free roadway cross sections, and the driving public tolerated the delays associated with snow storms. Modern technology, however, has long since provided the design expertise, financial resources, and construction capability for creating relatively snowdrift free highways, and the driver today has come to expect a highway facility that is free of snowdrifts, and if drifts develop they expect highway maintenance crews to open the highway within a short time. Highway administrators have responded to this charge for better control of snowdrifting. Modern highway designs in general provide an aerodynamic cross section that inhibits the deposition of snow on the roadway insofar as it is economically feasible to do so.

KRAS mutation testing for predicting response to anti-EGFR therapy for colorectal carcinoma: proposal for an European quality assurance program.

Novel therapeutic agents targeting the epidermal growth factor receptor (EGFR) have improved outcomes for patients with colorectal carcinoma. However, these therapies are effective only in a subset of patients. Activating mutations in the KRAS gene are found in 30-40% of colorectal tumors and are associated with poor response to anti-EGFR therapies. Thus, KRAS mutation status can predict which patient may or may not benefit from anti-EGFR therapy. Although many diagnostic tools have been developed for KRAS mutation analysis, validated methods and standardized testing procedures are lacking. This poses a challenge for the optimal use of anti-EGFR therapies in the management of colorectal carcinoma. Here we review the molecular basis of EGFR-targeted therapies and the resistance to treatment conferred by KRAS mutations. We also present guideline recommendations and a proposal for a European quality assurance program to help ensure accuracy and proficiency in KRAS mutation testing across the European Union.

Mice with an adipocyte-specific lipin 1 separation-of-function allele reveal unexpected roles for phosphatidic acid in metabolic regulation.

Lipin 1 is a coregulator of DNA-bound transcription factors and a phosphatidic acid (PA) phosphatase (PAP) enzyme that catalyzes a critical step in the synthesis of glycerophospholipids. Lipin 1 is highly expressed in adipocytes, and constitutive loss of lipin 1 blocks adipocyte differentiation; however, the effects of Lpin1 deficiency in differentiated adipocytes are unknown. Here we report that adipocyte-specific Lpin1 gene recombination unexpectedly resulted in expression of a truncated lipin 1 protein lacking PAP activity but retaining transcriptional regulatory function. Loss of lipin 1-mediated PAP activity in adipocytes led to reduced glyceride synthesis and increased PA content. Characterization of the deficient mice also revealed that lipin 1 normally modulates cAMP-dependent signaling through protein kinase A to control lipolysis by metabolizing PA, which is an allosteric activator of phosphodiesterase 4 and the molecular target of rapamycin. Consistent with these findings, lipin 1 expression was significantly related to adipose tissue lipolytic rates and protein kinase A signaling in adipose tissue of obese human subjects. Taken together, our findings identify lipin 1 as a reciprocal regulator of triglyceride synthesis and hydrolysis in adipocytes, and suggest that regulation of lipolysis by lipin 1 is mediated by PA-dependent modulation of phosphodiesterase 4.

Uniform estimates in the Poincare-Aronszajn theorem on the separation of singularities of analytic functions

We study the possibility of splitting any bounded analytic function $f$ with singularities in a closed set $E\cup F$ as a sum of two bounded analytic functions with singularities in $E$ and $F$ respectively. We obtain some results under geometric restrictions on the sets $E$ and $F$ and we provide some examples showing the sharpness of the positive results.

Assessment of Nondestructive Testing Technologies for Quality Control/Quality Assurance of Asphalt Mixtures, TR-653, 2015

Asphalt pavements suffer various failures due to insufficient quality within their design lives. The American Association of State Highway and Transportation Officials (AASHTO) Mechanistic-Empirical Pavement Design Guide (MEPDG) has been proposed to improve pavement quality through quantitative performance prediction. Evaluation of the actual performance (quality) of pavements requires in situ nondestructive testing (NDT) techniques that can accurately measure the most critical, objective, and sensitive properties of pavement systems. The purpose of this study is to assess existing as well as promising new NDT technologies for quality control/quality assurance (QC/QA) of asphalt mixtures. Specifically, this study examined field measurements of density via the PaveTracker electromagnetic gage, shear-wave velocity via surface-wave testing methods, and dynamic stiffness via the Humboldt GeoGauge for five representative paving projects covering a range of mixes and traffic loads. The in situ tests were compared against laboratory measurements of core density and dynamic modulus. The in situ PaveTracker density had a low correlation with laboratory density and was not sensitive to variations in temperature or asphalt mix type. The in situ shear-wave velocity measured by surface-wave methods was most sensitive to variations in temperature and asphalt mix type. The in situ density and in situ shear-wave velocity were combined to calculate an in situ dynamic modulus, which is a performance-based quality measurement. The in situ GeoGauge stiffness measured on hot asphalt mixtures several hours after paving had a high correlation with the in situ dynamic modulus and the laboratory density, whereas the stiffness measurement of asphalt mixtures cooled with dry ice or at ambient temperature one or more days after paving had a very low correlation with the other measurements. To transform the in situ moduli from surface-wave testing into quantitative quality measurements, a QC/QA procedure was developed to first correct the in situ moduli measured at different field temperatures to the moduli at a common reference temperature based on master curves from laboratory dynamic modulus tests. The corrected in situ moduli can then be compared against the design moduli for an assessment of the actual pavement performance. A preliminary study of microelectromechanical systems- (MEMS)-based sensors for QC/QA and health monitoring of asphalt pavements was also performed.

Blind channel deconvolution of real world signals using source separation techniques

In this paper we present a method for blind deconvolution of linear channels based on source separation techniques, for real word signals. This technique applied to blind deconvolution problems is based in exploiting not the spatial independence between signals but the temporal independence between samples of the signal. Our objective is to minimize the mutual information between samples of the output in order to retrieve the original signal. In order to make use of use this idea the input signal must be a non-Gaussian i.i.d. signal. Because most real world signals do not have this i.i.d. nature, we will need to preprocess the original signal before the transmission into the channel. Likewise we should assure that the transmitted signal has non-Gaussian statistics in order to achieve the correct function of the algorithm. The strategy used for this preprocessing will be presented in this paper. If the receiver has the inverse of the preprocess, the original signal can be reconstructed without the convolutive distortion.

Why do they separate it or not? Attitudes and behaviors towards organic waste separation

This article shows the results of an exploratory study related to the separation of organic waste in order to offer suggestions for the improvement of waste disposal communication campaigns. The overall objective is to analyze attitude and behavior of those who do and those who do not separate organic waste, related to a specific promotional campaign carried out in two neighborhoods, in the municipality of Badalona (Spain), within the framework of the study of proenvironmental attitudes and behaviors and based on the Psychosocial Four Spheres Model. 1,010 interviews were conducted and data was analyzed using Chi-Squared Automatic Interaction Detector (CHAID). Waste separation behavior was used as a dependent variable. The reasons given to explain why people do or do not separate organic waste and sociodemographic variables, have been introduced as independent variables. In accordance with the Four Spheres Model, results show significant differences in waste separation. Based on the profiles obtained, we find some predictive variables that facilitate the development of communication campaigns according to the requirements of each community.