The rising prevalence of prescription opioid injection and its association with hepatitis C incidence among street-drug users

Ce manuscrit est une pré-publication d'un article paru dans Addiction 2012; 107(7): 1318-1327 url: http://www.addictionjournal.org/

Cannabis use correlates of syringe sharing among injection drug users

Ce manuscrit est une pré-publication d'un article paru dans The American Journal on Addictions 2010; 19(3): 231-237 url: http://onlinelibrary.wiley.com/doi/10.1111/ajad.2010.19.issue-3/issuetoc

L’association entre les divers types de services de santé et l’initiation du traitement de l’hépatite C chez les utilisateurs de drogues par injection.

Introduction: Malgré des taux d’efficacité comparable du traitement antiviral de l’hépatite C (VHC) entre utilisateurs de drogues par injection (UDIs) et non-UDIs, il y a encore d’importantes barrières à l’accessibilité au traitement pour cette population vulnérable. La méfiance des UDIs à l’égard des autorités médicales, ainsi que leur mode de vie souvent désorganisé ont un impact sur l’initiation du traitement. L’objectif de cette étude est d’examiner les liens entre l’initiation du traitement du VHC et l’utilisation des services de santé chez les UDIs actifs. Methode: 758 UDIs actifs et séropositifs aux anticorps anti-VHC ont été interrogés durant la période de novembre 2004 à mars 2011, dans la région de Montréal. Des questionnaires administrés par des intervieweurs ont fourni des informations sur les caractéristiques socio-économiques, ainsi que sur les variables relatives à l’usage de drogues et à l’utilisation des services de santé. Des échantillons sanguins ont été prélevés et testés pour les anticorps anti-VHC. Une régression logistique multivariée a permis de générer des associations entre les facteurs relatifs aux services de santé et l’initiation du traitement contre le VHC. Resultats: Parmi les 758 sujets, 55 (7,3%) avaient initié un traitement du VHC avant leur inclusion dans l’étude. Selon les analyses multivariées, les variables significativement associées à l’initiation du traitement sont les suivantes: avoir vu un médecin de famille dans les derniers 6 mois (Ratio de Cote ajusté (RCa): 1,96; Intervalle de Confiance à 95% (IC): 1,04-3,69); plus de 2 ans sous traitement de la dépendance à vie, sans usage actuel de méthadone (RCa: 2,25; IC: 1,12-4,51); plus de 2 ans sous traitement de la dépendance à vie, avec usage actuel de méthadone (RCa: 3,78; IC: 1,85-7,71); et avoir déjà séjourné en prison (RCa: 0,44; IC: 0,22-0,87). Conclusion: L’exposition à des services d’aide à la dépendance et aux services médicaux est associée à l’initiation du traitement du VHC. Ces résultats suggèrent que ces services jouent leur rôle de point d’entrée au traitement. Alternativement, les UDIs ayant initié un traitement du VHC, auraient possiblement adopté une attitude proactive quant à l'amélioration de leur santé globale. D’autre part, l’incarcération ressort comme un obstacle à la gestion de l’infection au VHC.

Évaluation du besoin et de la pertinence de l'implantation d'un service d'injection supervisée en Montérégie

This research project aimed to conduct a strategic analysis of the implementation of a supervised injecting facility (SIF) in Montérégie. Using a mixed design, we first completed a portrait of the injection drug user (IDU) population. We then explored the perceptions of IDU and stakeholders with regard to the relevance of implementing a SIF in the region. Although some similarities were found with the IDU populations of Montreal and the province of Quebec, this population in Montérégie is characterized by a lower frequency of injections in public, less homeless people and lower rates of HIV and HCV infections. Despite these differences, the IDU population in Montérégie was found to have important physical and psychosocial needs. Although the relevance of a SIF in Montérégie is undeniable, improvements regarding the accessibility, continuity and appreciation of the actual services dedicated to IDU remain a priority.

Influence of Angle of Air Injection and Particles in Bed Hydrodynamics of Swirling Fluidized Bed

The thesis presented here unveils an experimental study of the hydrodynamic characteristics of swirling fluidized bed viz. pressure drop across the distributor and the bed, minimum fluidizing velocity, bed behaviour and angle of air injection. In swirling fluidized bed the air is admitted to the bed at an angle 'Ѳ' to the horizontal. The vertical component of the velocity v sin Ѳ causes fluidization and the horizontal component v cos Ѳ contributes to swirl motion of the bed material.The study was conducted using spherical particles having sizes 3.2 mm, 5.5 mm & 7.4 mm as the bed materials. Each of these particles was made from high density polyethylene, nylon and acetal having relative densities of 0.93, 1.05 and 1.47 respectively.The experiments were conducted using conidour type distributors having four rows of slits. Altogether four distributors having angles of air injection (Φ)- 0°, 5°, 10° & 15° were designed and fabricated for the study. The total number of slits in each distributor was 144. The area of opening was 6220 mm2 making the percentage area of opening to 9.17. But the percentage useful area of opening of the distributor was 96.The experiments on the variation of distributor pressure drop with superficial velocity revealed that the distributor pressure drop decreases with angle of air injection. Investigations related to bed hydrodynamics were conducted using 2.5 kg of bed material. The bed pressure drop measurements were made along the radial direction of the distributor at distances of 60 mm, 90 mm, 120 mm & 150 mm from the centre of the distributor. It was noticed that after attaining minimum fluidizing velocity, the bed pressure drop increases along the radial direction of the distributor. But at a radial distance of 90 mm from the distributor centre, after attaining minimum fluidizing velocity the bed pressure drop remains almost constant. It was also observed that the bed pressure drop varies inversely with particle size as well as particle density.An attempt was made to determine the effect of various parameters on minimum fluidizing velocity. It was noticed that the minimum fluidizing velocity varies directly with angle of air injection (Φ), particle size and particle density.The study on the bed behaviour showed that the superficial velocity required for initiating various bed phenomena (such as swirl motion and separation of particles from the cone at the centre) increase with increase in particle size as well as particle density. It was also observed that the particle size and particle density directly influence the superficial velocity required for various regimes of bed behaviour such as linear variation of bed pressure drop, constant bed pressure drop and sudden increase or decrease in bed pressure drop.Experiments were also performed to study the effect of angle of air injection (Φ). It was noticed that the bed pressure drop decreases with angle of air injection. It was also noticed that the angle of air injection directly influence the superficial velocity required for initiating various bed phenomena as well as the various regimes of bed behaviour.

Dynamic Injection of Scribble Features into Graphical Diagram Editors

Almost everyone sketches. People use sketches day in and day out in many different and heterogeneous fields, to share their thoughts and clarify ambiguous interpretations, for example. The media used to sketch varies from analog tools like flipcharts to digital tools like smartboards. Whereas analog tools are usually affected by insufficient editing capabilities like cut/copy/paste, digital tools greatly support these scenarios. Digital tools can be grouped into informal and formal tools. Informal tools can be understood as simple drawing environments, whereas formal tools offer sophisticated support to create, optimize and validate diagrams of a certain application domain. Most digital formal tools force users to stick to a concrete syntax and editing workflow, limiting the user’s creativity. For that reason, a lot of people first sketch their ideas using the flexibility of analog or digital informal tools. Subsequently, the sketch is "portrayed" in an appropriate digital formal tool. This work presents Scribble, a highly configurable and extensible sketching framework which allows to dynamically inject sketching features into existing graphical diagram editors, based on Eclipse GEF. This allows to combine the flexibility of informal tools with the power of formal tools without any effort. No additional code is required to augment a GEF editor with sophisticated sketching features. Scribble recognizes drawn elements as well as handwritten text and automatically generates the corresponding domain elements. A local training data library is created dynamically by incrementally learning shapes, drawn by the user. Training data can be shared with others using the WebScribble web application which has been created as part of this work.

Comparación entre analgesia epidural continua vs bloqueo nervio periférico en niños llevados a cirugía múltiple de miembros inferiores

Las cirugías reconstructivas múltiples de miembros inferiores son intervenciones quirúrgicas que implican un difícil manejo analgésico en el postoperatorio, actualmente la técnica analgésica usada es la analgesia peridural; sin embargo los efectos adversos asociados a esta no la hacen una técnica ideal para manejo de dolor. Los bloqueos de nervio periférico han aparecido como una alternativa para el manejo del dolor; pero no se ha difundido ampliamente su uso. Se pretende evaluar la disminución de efectos adversos con el uso de bloqueos de nervio periférico sobre la analgesia epidural. Este estudio piloto inicial se realizo para verificar efectividad técnicas a usar y problemas que se pudieran presentar. Se aplico el protocolo en 23 pacientes que fueron llevados a cirugía de miembros inferiores, se dividieron en 2 grupos 11 recibieron bloqueos de nervio periférico y 12 analgesia epidural. Se les realizo seguimiento por 48 horas y se evaluó el control del dolor, consumo de opioides y efectos adversos. El tiempo de colocación del bloqueo fue similar en ambos grupos, el grupo de bloqueos presento menos episodios de dolor y menos episodios de dolor severo. No se presento retención urinaria en ningún paciente pero en el grupo de epidural se presento mayor incidencia de nausea y vomito (60% vs 45%). Se encontró que los bloqueos de nervio periférico son una adecuada opción para el manejo del dolor en este tipo de cirugías; y al parecer disminuye la incidencia de eventos adversos asociados a la analgesia epidural.

Injection of adult mouse mesenchymal stem cells into the developing chick inner ear

This series of experiments attempted to characterize the abilities of stem cells derived from bone marrow and adipose tissue to integrate into the sensory epithelium of the inner ear and to differentiate into hair cells or neural cell types.

The climatic effects of the direct injection of water vapour into the stratosphere by large volcanic eruptions

We describe a novel mechanism that can significantly lower the amplitude of the climatic response to certain large volcanic eruptions and examine its impact with a coupled ocean-atmosphere climate model. If sufficiently large amounts of water vapour enter the stratosphere, a climatically significant amount of water vapour can be left over in the lower stratosphere after the eruption, even after sulphate aerosol formation. This excess stratospheric humidity warms the tropospheric climate, and acts to balance the climatic cooling induced by the volcanic aerosol, especially because the humidity anomaly lasts for a period that is longer than the residence time of aerosol in the stratosphere. In particular, northern hemisphere high latitude cooling is reduced in magnitude. We discuss this mechanism in the context of the discrepancy between the observed and modelled cooling following the Krakatau eruption in 1883. We hypothesize that moist coignimbrite plumes caused by pyroclastic flows travelling over ocean rather than land, resulting from an eruption close enough to the ocean, might provide the additional source of stratospheric water vapour.

Rheology of milk foams produced by steam injection

Rheology of milk foams generated by steam injection was studied during the transient destabilization process using steady flow and dynamic oscillatory techniques: yield stress (τ_y) values were obtained from a stress ramp (0.2 to 25 Pa) and from strain amplitude sweep (0.001 to 3 at 1 Hz of frequency); elastic (G') and viscous (G") moduli were measured by frequency sweep (0.1 to 150 Hz at 0.05 of strain); and the apparent viscosity (η_a) was obtained from the flow curves generated from the stress ramp. The effect of plate roughness and the sweep time on τ_y was also assessed. Yield stress was found to increase with plate roughness whereas it decreased with the sweep time. The values of yield stress and moduli—G' and G"—increased during foam destabilization as a consequence of the changes in foam properties, especially the gas volume fraction, φ, and bubble size, R_32 (Sauter mean bubble radius). Thus, a relationship between τ_y, φ, R_32, and σ (surface tension) was established. The changes in the apparent viscosity, η, showed that the foams behaved like a shear thinning fluid beyond the yield point, fitting the modified Cross model with the relaxation time parameter (λ) also depending on the gas volume fraction. Overall, it was concluded that the viscoelastic behavior of the foam below the yield point and liquid-like behavior thereafter both vary during destabilization due to changes in the foam characteristics.

Chapter 4: Simulation of reaction injection moulding

Reaction Injection Moulding is a technology that enables the rapid production of complex plastic parts directly from a mixture of two reactive materials of low viscosity. The reactants are mixed in specific quantities and injected into a mould. This process allows large complex parts to be produced without the need for high clamping pressures. This chapter explores the simulation of the complex processes involved in reaction injection moulding. The reaction processes mean that the dynamics of the material in the mould are in constant evolution and an effective model which takes full account of these changing dynamics is introduced and incorporated in to finite element procedures, which are able to provide a complete simulation of the cycle of mould filling and subsequent curing.

Production of milk foams by steam injection: the effects of steam pressure and nozzle design

Foam properties depend on the physico-chemical characteristics of the continuous phase, the method of production and process conditions employed; however the preparation of barista-style milk foams in coffee shops by injection of steam uses milk as its main ingredient which limits the control of foam properties by changing the biochemical characteristics of the continuous phase. Therefore, the control of process conditions and nozzle design are the only ways available to produce foams with diverse properties. Milk foams were produced employing different steam pressures (100-280 kPa gauge) and nozzle designs (ejector, plunging-jet and confined-jet nozzles). The foamability of milk, and the stability, bubble size and texture of the foams were investigated. Variations in steam pressure and nozzle design changed the hydrodynamic conditions during foam production, resulting in foams having a range of properties. Steam pressure influenced foam characteristics, although the net effect depended on the nozzle design used. These results suggest that, in addition to the physicochemical determinants of milk, the foam properties can also be controlled by changing the steam pressure and nozzle design.