Rôle de l'IRM cardiaque dans le dépistage des cardiomyopathies de l'adulte [Cardiomyopathy and cardiac magnetic resonance].

Cardiovascular magnetic resonance (CMR) is a rapidly emerging non-invasive imaging technique free of X-Ray and offers higher spatial resolution than alternative forms of cardiac imaging for the assessment of left ventricular (LV) anatomy, function, and viability due to the unique capability of myocardial tissue characterization after gadolinium-chelates contrast administration. This imaging technique has clinical utility over a broad spectrum of heart diseases: ranging from ischaemic to non ischaemic aetiologies. Cardiomyopathies (CMP) are a heterogeneous group of diseases of the myocardium associated with architectural abnormalities and mechanical dysfunction. CMR can help excluding coronary artery disease and can provide positive diagnostic features for several CMP resulted in better diagnosis and management, Leading to improvements in mortality.

Reconfigurations identitaires : un passage obligé dans l'appropriation du français ?

Une représentation sociale communément admise postule que le couple plurilingue et l'un de ses prolongements possibles, la vie en commun dans un pays, favorisent l'appropriation de la langue et la socialisation du partenaire alloglotte. Or, si c'est souvent le cas, il s'agit de dégager les conditions nécessaires à un tel processus positif d'apprentissage de la langue. De là découle l'intérêt d'une observation ethnographique des caractéristiques d'un mode d'apprentissage de la langue du milieu (ici, le français) qui s'actualise dans les couples plurilingues. Dans cet article je montrerai, par l'exemple d'un couple francophone/hispanophone établi en Suisse romande, comment la situation matrimoniale hétéroglotte propose un contexte spécifique à l'apprentissage de la langue. Je porterai particulièrement mon attention sur la construction par le partenaire alloglotte d'un sentiment de légitimité quant à son statut de locuteur plurilingue francophone

Prospective registry of symptomatic severe aortic stenosis in octogenarians: a need for intervention.

OBJECTIVE To study the factors associated with choice of therapy and prognosis in octogenarians with severe symptomatic aortic stenosis (AS). STUDY DESIGN Prospective, observational, multicenter registry. Centralized follow-up included survival status and, if possible, mode of death and Katz index. SETTING Transnational registry in Spain. SUBJECTS We included 928 patients aged ≥80 years with severe symptomatic AS. INTERVENTIONS Aortic-valve replacement (AVR), transcatheter aortic-valve implantation (TAVI) or conservative therapy. MAIN OUTCOME MEASURES All-cause death. RESULTS Mean age was 84.2 ± 3.5 years, and only 49.0% were independent (Katz index A). The most frequent planned management was conservative therapy in 423 (46%) patients, followed by TAVI in 261 (28%) and AVR in 244 (26%). The main reason against recommending AVR in 684 patients was high surgical risk [322 (47.1%)], other medical motives [193 (28.2%)], patient refusal [134 (19.6%)] and family refusal in the case of incompetent patients [35 (5.1%)]. The mean time from treatment decision to AVR was 4.8 ± 4.6 months and to TAVI 2.1 ± 3.2 months, P < 0.001. During follow-up (11.2-38.9 months), 357 patients (38.5%) died. Survival rates at 6, 12, 18 and 24 months were 81.8%, 72.6%, 64.1% and 57.3%, respectively. Planned intervention, adjusted for multiple propensity score, was associated with lower mortality when compared with planned conservative treatment: TAVI Hazard ratio (HR) 0.68 (95% confidence interval [CI] 0.49-0.93; P = 0.016) and AVR HR 0.56 (95% CI 0.39-0.8; P = 0.002). CONCLUSION Octogenarians with symptomatic severe AS are frequently managed conservatively. Planned conservative management is associated with a poor prognosis.

Predicting response and survival in chemotherapy-treated triple-negative breast cancer.

BACKGROUND In this study, we evaluated the ability of gene expression profiles to predict chemotherapy response and survival in triple-negative breast cancer (TNBC). METHODS Gene expression and clinical-pathological data were evaluated in five independent cohorts, including three randomised clinical trials for a total of 1055 patients with TNBC, basal-like disease (BLBC) or both. Previously defined intrinsic molecular subtype and a proliferation signature were determined and tested. Each signature was tested using multivariable logistic regression models (for pCR (pathological complete response)) and Cox models (for survival). Within TNBC, interactions between each signature and the basal-like subtype (vs other subtypes) for predicting either pCR or survival were investigated. RESULTS Within TNBC, all intrinsic subtypes were identified but BLBC predominated (55-81%). Significant associations between genomic signatures and response and survival after chemotherapy were only identified within BLBC and not within TNBC as a whole. In particular, high expression of a previously identified proliferation signature, or low expression of the luminal A signature, was found independently associated with pCR and improved survival following chemotherapy across different cohorts. Significant interaction tests were only obtained between each signature and the BLBC subtype for prediction of chemotherapy response or survival. CONCLUSIONS The proliferation signature predicts response and improved survival after chemotherapy, but only within BLBC. This highlights the clinical implications of TNBC heterogeneity, and suggests that future clinical trials focused on this phenotypic subtype should consider stratifying patients as having BLBC or not.

Comunicação Externa como Ferramenta Organizacional: o caso da Câmara Municipal da Praia

Este trabalho enquadra-se no âmbito da realização da monografia para a obtenção do grau de licenciatura em Ciências da Comunicação - vertente jornalismo, tem como tema “A Comunicação Organizacional Externa e como título “A Comunicação Externa Como Ferramenta Organizacional: O caso da Câmara Municipal da Praia (CMP).” A escolha do tema deve-se ao fato de se ter verificado a crescente preocupação em relação à comunicação externa organizacional, que significa a comunicação de uma organização com o seu meio externo. É uma ferramenta que permite às organizações dialogar, informar e interagir com o público utente/cliente e que é fundamental na construção da sua imagem.À comunicação externa organizacional foi atribuída a responsabilidade de disseminação de toda a informação necessária para o bom funcionamento da organização, a coordenação, a integração e planeamento de todo e qualquer serviço e atividade junto do stakeholders. Deste modo, reconheceu-se que uma comunicação elaborada, coerente e coesa reveste-se de extrema importância para qualquer organização que queira manter um relacionamento sólido e estreito com o seu público externo, e assim contribuir para o alcance dos objetivos organizacionais e de um diferencial competitivo.Sendo assim, neste trabalho iremos analisar a importância e o papel da comunicação externa nas organizações, as ferramentas existentes e todos os seus componentes.

Comunicação Externa como Ferramenta Organizacional: o caso da Câmara Municipal da Praia

Este trabalho enquadra-se no âmbito da realização da monografia para a obtenção do grau de licenciatura em Ciências da Comunicação - vertente jornalismo, tem como tema “A Comunicação Organizacional Externa e como título “A Comunicação Externa Como Ferramenta Organizacional: O caso da Câmara Municipal da Praia (CMP).” A escolha do tema deve-se ao fato de se ter verificado a crescente preocupação em relação à comunicação externa organizacional, que significa a comunicação de uma organização com o seu meio externo. É uma ferramenta que permite às organizações dialogar, informar e interagir com o público utente/cliente e que é fundamental na construção da sua imagem. À comunicação externa organizacional foi atribuída a responsabilidade de disseminação de toda a informação necessária para o bom funcionamento da organização, a coordenação, a integração e planeamento de todo e qualquer serviço e atividade junto do stakeholders. Deste modo, reconheceu-se que uma comunicação elaborada, coerente e coesa reveste-se de extrema importância para qualquer organização que queira manter um relacionamento sólido e estreito com o seu público externo, e assim contribuir para o alcance dos objetivos organizacionais e de um diferencial competitivo. Sendo assim, neste trabalho iremos analisar a importância e o papel da comunicação externa nas organizações, as ferramentas existentes e todos os seus componentes.

Osobennosti perevoda proizvedenij russkix pravoslavnyx myslitelej na francuzskij jazyk (S.N.Bulgakov, A.F. Losev) [Les spécificités de la traduction des textes des penseurs orthodoxes russes en français (S. Bulgakov, A. Losev)]

This article is attempt to crarify some conceptuel and linguistic problems in the translation (from Russian and French) of philosophical texts written in the first of the 20th century - in particular, those by S. Bulgakov and A. Losev. We consider any transation as a form of cross-cultural communication taking place between the author and the translator(s) of the texte. Any translation involves a complex interaction of different historical and cultural factors that are attempt to combine and to remove cultural and conceptual misunderstandings.

Estado del arte en soluciones de virtualización : Sistemas gestores de Cloud: OpenNebula

En el presente proyecto se ha abordado la tarea de acercar las tecnologías existentes de plataformas de gestión de infraestructuras ofrecidas en la nube (Cloud Management Platform, aka CMP) al mundo empresarial. En concreto, se ha desplegado una solución de explotación de infraestructuras privadas en la nube (IaaS) enfocada a la gestión de un datacenter virtualizado, utilizando para ello soluciones completamente basadas en software libre, en concreto, OpenNebula.

Design Methodology for Corrugated Metal Pipe Tiedowns, HR-332, Phase 1, 1993

Questionnaires were sent to transportation agencies in all 50 states in the U.S., to Puerto Rico, and all provinces in Canada asking about their experiences with uplift problems of - corrugated metal pipe (CMP). Responses were received from 52 agencies who reported 9 failures within the last 5 years. Some agencies also provided design standards for tiedowns to resist uplift. There was a wide variety in restraining forces used; for example for a pipe 6 feet in diameter, the resisting force ranged from 10 kips to 66 kips. These responses verified the earlier conclusion based on responses from Iowa county engineers that a potential uplift danger exists.when end restraint is not provided for CMP and that existing designs have an unclear theoretical or experimental basis. In an effort to develop more rational design standards, the longitudinal stiffness of three CMP ranging from 4 to 8 feet in diameter were measured in the laboratory. Because only three tests were conducted, a theoretical model to evaluate the stiffness of pipes of a variety of gages and corrugation geometries was also developed. The experimental results indicated a "stiffness" EI in the range of 9.11 x 10^5 k-in^2 to 34.43 x 10^5 k-in^2 for the three pipes with the larger diameter pipes having greater stiffness. The theoretical model developed conservatively estimates these stiffnesses.

Design Methodology for Corrugated Metal Pipe Tiedowns, HR-362, Phase II, 1995

This investigation is the final phase of a three part study whose overall objectives were to determine if a restraining force is required to prevent inlet uplift failures in corrugated metal pipe (CMP) installations, and to develop a procedure for calculating the required force when restraint is required. In the initial phase of the study (HR-306), the extent of the uplift problem in Iowa was determined and the forces acting on a CMP were quantified. In the second phase of the study (HR- 332), laboratory and field tests were conducted. Laboratory tests measured the longitudinal stiffness ofCMP and a full scale field test on a 3.05 m (10 ft) diameter CMP with 0.612 m (2 ft) of cover determined the soil-structure interaction in response to uplift forces. Reported herein are the tasks that were completed in the final phase of the study. In this phase, a buried 2.44 m (8 ft) CMP was tested with and without end-restraint and with various configurations of soil at the inlet end of the pipe. A total of four different soil configurations were tested; in all tests the soil cover was constant at 0.61 m (2 ft). Data from these tests were used to verify the finite element analysis model (FEA) that was developed in this phase of the research. Both experiments and analyses indicate that the primary soil contribution to uplift resistance occurs in the foreslope and that depth of soil cover does not affect the required tiedown force. Using the FEA, design charts were developed with which engineers can determine for a given situation if restraint force is required to prevent an uplift failure. If an engineer determines restraint is needed, the design charts provide the magnitude of the required force. The design charts are applicable to six gages of CMP for four flow conditions and two types of soil.