Liste des Diagnosis Related Groups et hiérarchie des interventions chirurgicales par MDC

Travaux effectués dans le cadre de l'étude "Case Mix" menée par l'Institut universitaire de médecine sociale et préventive de Lausanne et le Service de la santé publique et de la planification sanitaire du canton de Vaud, en collaboration avec les cantons de Berne, Fribourg, Genève, Jura, Neuchâtel, Soleure, Tessin et Valais

Robust Detection of Incumbents in Cognitive Radio Networks Using Groups

Cognitive radio is a wireless technology aimed at improvingthe efficiency use of the radio-electric spectrum, thus facilitating a reductionin the load on the free frequency bands. Cognitive radio networkscan scan the spectrum and adapt their parameters to operate in the unoccupiedbands. To avoid interfering with licensed users operating on a givenchannel, the networks need to be highly sensitive, which is achieved byusing cooperative sensing methods. Current cooperative sensing methodsare not robust enough against occasional or continuous attacks. This articleoutlines a Group Fusion method that takes into account the behavior ofusers over the short and long term. On fusing the data, the method is basedon giving more weight to user groups that are more unanimous in their decisions.Simulations have been performed in a dynamic environment withinterferences. Results prove that when attackers are present (both reiterativeor sporadic), the proposed Group Fusion method has superior sensingcapability than other methods.

Comments on "On the relationship between fractal dimension and the performance of multi-resonant dipole antennas using Koch curves"

Comentaris referits a l'article següent: K. J. Vinoy, J. K. Abraham, and V. K. Varadan, “On the relationshipbetween fractal dimension and the performance of multi-resonant dipoleantennas using Koch curves,” IEEE Transactions on Antennas and Propagation, 2003, vol. 51, p. 2296–2303.

Maahanmuuttajaoppilaat erityiskouluissa

Immigrant Pupils in Special Education Schools The study focused on the opinions of immigrant pupils in the 1st–9th grades of basic education in four special education schools of the City of Turku and in need of special support about the following: 1. Their difficulties in going to school in general education before the transfer to a special education school. 2. Their opinions about the transfer process to special education and the changes in their school practice after being transferred to a special education school. 3. Their experiences about their school and coping in special education school. The study strengthened the idea that immigrant pupils need positive special treatment, linguistic support, individual guidance, small teaching groups and operating models that promote well-being on their integration and education path. The central educational idea of inclusive education is based on deconstructing the power structures concerning gender, ethnicity and “race” and approval of differences in the pupils. Shifting the emphasis from the pupil to working on the learning environment has resulted in special education no longer being primarily separate special education tied to a certain place, but directing the teaching more towards individuality. The central dimension of intercultural competence of a teacher working in a multicultural class seems to be the attitudes and approaches to a different pupil; the teacher must be interculturally sensitive when facing children and young people from a foreign culture. Education and teaching affect every sector of the pupil’s well-being. Learning and learning results have a connection with teaching, education and well-being. Every sector is important for the going to school and integration of an immigrant pupil in need of special support. The basis of the study is the equality of opportunities and the humanistic idea of the human being in the Finnish education policy. The immigrant pupils selected for the study represented the following language groups: Arabian, Albanian, Somali, Russian and Vietnamese. In the four special education schools, the number of immigrant pupils belonging to these language groups (2004) totalled 104. A total of 89 pupils i.e. 86% answered the questionnaire, which is sufficient considering the generalisation of the study. Although this is basically a quantitative study, the interviewing method was used in part of the study, because the questionnaires were in Finnish and consequently, it was difficult for some immigrant pupils to understand them. Understanding the questions was also affected by the fact that the age distribution in the study was very wide (7–18). According to the results of the study, the immigrants felt that the biggest drawbacks in general education were their inability to speak Finnish and lack of concentration. The actual process of being transferred to a special education class remained unclear for immigrant pupils, and they could do very little about the transfer themselves. The results show that immigrant pupils coped well in special education school; they felt that their learning ability and concentration improved in the small groups of the special education school. They considered the individual support given in the special education schools to be useful. The lower-grade immigrant pupils had a more positive attitude towards special education school than the upper-grade immigrant pupils. In all the special education schools the immigrant pupils experienced that they were in a good position in the class; girls felt this even a little more strongly than boys. The teacher-pupil-relationship was felt to be good. School bullying being so common was a negative feature experienced by immigrant pupils, who were often targets or bullies themselves. Immigrant pupils believed in their success at school and in the opportunities offered by special education schools. Generally they were of the opinion that pupils are not labelled by special school; however, upper-grade immigrant pupils were more hesitant than lower-grade immigrant pupils. This study aimed at bringing out the immigrant pupils’ own opinions. Teaching immigrant pupils in special education schools has not been very much studied in Finland, which made the topic new and even more challenging.

Probing functional groups at the gas-aerosol interface using heterogeneous titration reactions: a tool for predicting aerosol health effects?

The complex chemical and physical nature of combustion and secondary organic aerosols (SOAs) in general precludes the complete characterization of both bulk and interfacial components. The bulk composition reveals the history of the growth process and therefore the source region, whereas the interface controls--to a large extent--the interaction with gases, biological membranes, and solid supports. We summarize the development of a soft interrogation technique, using heterogeneous chemistry, for the interfacial functional groups of selected probe gases [N(CH(3))(3), NH(2)OH, CF(3)COOH, HCl, O(3), NO(2)] of different reactivity. The technique reveals the identity and density of surface functional groups. Examples include acidic and basic sites, olefinic and polycyclic aromatic hydrocarbon (PAH) sites, and partially and completely oxidized surface sites. We report on the surface composition and oxidation states of laboratory-generated aerosols and of aerosols sampled in several bus depots. In the latter case, the biomarker 8-hydroxy-2'-deoxyguanosine, signaling oxidative stress caused by aerosol exposure, was isolated. The increase in biomarker levels over a working day is correlated with the surface density N(i)(O3) of olefinic and/or PAH sites obtained from O(3) uptakes as well as with the initial uptake coefficient, γ(0), of five probe gases used in the field. This correlation with γ(0) suggests the idea of competing pathways occurring at the interface of the aerosol particles between the generation of reactive oxygen species (ROS) responsible for oxidative stress and cellular antioxidants.

Nucleophile-Catalyzed Additions to Activated Triple Bonds. Protection of Lactams, Imides, and Nucleosides with MocVinyl and Related Groups

Additions of lactams, imides, (S)-4-benzyl-1,3-oxazolidin-2-one, 2-pyridone, pyrimidine-2,4-diones (AZT derivatives), or inosines to the electron-deficient triple bonds of methyl propynoate, tert-butyl propynoate, 3-butyn-2-one, N-propynoylmorpholine, or N-methoxy-N-methylpropynamide in the presence of many potential catalysts were examined. DABCO and, second, DMAP appeared to be the best (highest reaction rates and E/Z ratios), while RuCl3, RuClCp*(PPh3)2, AuCl, AuCl(PPh3), CuI, and Cu2(OTf)2 were incapable of catalyzing such additions. The groups incorporated (for example, the 2-(methoxycarbonyl)ethenyl group that we name MocVinyl) serve as protecting groups for the above-mentioned heterocyclic CONH or CONHCO moieties. Deprotections were accomplished via exchange with good nucleophiles: the 1-dodecanethiolate anion turned out to be the most general and efficient reagent, but in some particular cases other nucleophiles also worked (e.g., MocVinyl-inosines can be cleaved with succinimide anion). Some structural and mechanistic details have been accounted for with the help of DFT and MP2 calculations.

Orthogonal protecting groups in the synthesis of tryptophanyl-hexahydropyrroloindoles

The synthesis of various polycyclic systems containing a C3aNi bond between a hexahydropyrrolo[2,3-b]indole and an indole tryptophan is described here. A series of experiments were performed to determine the best combination of five orthogonal protecting groups and the best reaction conditions for formation of said bond, which is a common feature among many recently discovered marine natural products.

Convergent Approaches for the Synthesis of the Anti-tumoral Peptide, Kahalalide F. Study of Orthogonal Protecting Groups

Kahalalide compounds are peptides that are isolated from a Hawaiian herbivorous marine species of mollusc, Elysia rufescens, and its diet, the green alga Bryopsis sp. Kahalalide F and its synthetic analogues are the most promising compounds of the Kahalalide family because they show anti-tumoral activity. Linear solid-phase syntheses of Kahalalide F have been reported. Here we describe several new improved synthetic routes based on convergent approaches with distinct orthogonal protection schemes for the preparation of Kahaladide analogues. These strategies allow a better control and characterization of the intermediates because more reactions are performed in solution. Five derivatives of Kahalalide F were synthesized using several convergent approaches.

Integral cohomology of finite postnikov towers

Depuis le séminaire H. Cartan de 1954-55, il est bien connu que l'on peut trouver des éléments de torsion arbitrairement grande dans l'homologie entière des espaces d'Eilenberg-MacLane K(G,n) où G est un groupe abélien non trivial et n>1. L'objectif majeur de ce travail est d'étendre ce résultat à des H-espaces possédant plus d'un groupe d'homotopie non trivial. Dans le but de contrôler précisément le résultat de H. Cartan, on commence par étudier la dualité entre l'homologie et la cohomologie des espaces d'Eilenberg-MacLane 2-locaux de type fini. On parvient ainsi à raffiner quelques résultats qui découlent des calculs de H. Cartan. Le résultat principal de ce travail peut être formulé comme suit. Soit X un H-espace ne possédant que deux groupes d'homotopie non triviaux, tous deux finis et de 2-torsion. Alors X n'admet pas d'exposant pour son groupe gradué d'homologie entière réduite. On construit une large classe d'espaces pour laquelle ce résultat n'est qu'une conséquence d'une caractéristique topologique, à savoir l'existence d'un rétract faible X K(G,n) pour un certain groupe abélien G et n>1. On généralise également notre résultat principal à des espaces plus compliqués en utilisant la suite spectrale d'Eilenberg-Moore ainsi que des méthodes analytiques faisant apparaître les nombres de Betti et leur comportement asymptotique. Finalement, on conjecture que les espaces qui ne possédent qu'un nombre fini de groupes d'homotopie non triviaux n'admettent pas d'exposant homologique. Ce travail contient par ailleurs la présentation de la « machine d'Eilenberg-MacLane », un programme C++ conçu pour calculer explicitement les groupes d'homologie entière des espaces d'Eilenberg-MacLane. <br/><br/>By the work of H. Cartan, it is well known that one can find elements of arbitrarilly high torsion in the integral (co)homology groups of an Eilenberg-MacLane space K(G,n), where G is a non-trivial abelian group and n>1. The main goal of this work is to extend this result to H-spaces having more than one non-trivial homotopy groups. In order to have an accurate hold on H. Cartan's result, we start by studying the duality between homology and cohomology of 2-local Eilenberg-MacLane spaces of finite type. This leads us to some improvements of H. Cartan's methods in this particular case. Our main result can be stated as follows. Let X be an H-space with two non-vanishing finite 2-torsion homotopy groups. Then X does not admit any exponent for its reduced integral graded (co)homology group. We construct a wide class of examples for which this result is a simple consequence of a topological feature, namely the existence of a weak retract X K(G,n) for some abelian group G and n>1. We also generalize our main result to more complicated stable two stage Postnikov systems, using the Eilenberg-Moore spectral sequence and analytic methods involving Betti numbers and their asymptotic behaviour. Finally, we investigate some guesses on the non-existence of homology exponents for finite Postnikov towers. We conjecture that Postnikov pieces do not admit any (co)homology exponent. This work also includes the presentation of the "Eilenberg-MacLane machine", a C++ program designed to compute explicitely all integral homology groups of Eilenberg-MacLane spaces. <br/><br/>Il est toujours difficile pour un mathématicien de parler de son travail. La difficulté réside dans le fait que les objets qu'il étudie sont abstraits. On rencontre assez rarement un espace vectoriel, une catégorie abélienne ou une transformée de Laplace au coin de la rue ! Cependant, même si les objets mathématiques sont difficiles à cerner pour un non-mathématicien, les méthodes pour les étudier sont essentiellement les mêmes que celles utilisées dans les autres disciplines scientifiques. On décortique les objets complexes en composantes plus simples à étudier. On dresse la liste des propriétés des objets mathématiques, puis on les classe en formant des familles d'objets partageant un caractère commun. On cherche des façons différentes, mais équivalentes, de formuler un problème. Etc. Mon travail concerne le domaine mathématique de la topologie algébrique. Le but ultime de cette discipline est de parvenir à classifier tous les espaces topologiques en faisant usage de l'algèbre. Cette activité est comparable à celle d'un ornithologue (topologue) qui étudierait les oiseaux (les espaces topologiques) par exemple à l'aide de jumelles (l'algèbre). S'il voit un oiseau de petite taille, arboricole, chanteur et bâtisseur de nids, pourvu de pattes à quatre doigts, dont trois en avant et un, muni d'une forte griffe, en arrière, alors il en déduira à coup sûr que c'est un passereau. Il lui restera encore à déterminer si c'est un moineau, un merle ou un rossignol. Considérons ci-dessous quelques exemples d'espaces topologiques: a) un cube creux, b) une sphère et c) un tore creux (c.-à-d. une chambre à air). a) b) c) Si toute personne normalement constituée perçoit ici trois figures différentes, le topologue, lui, n'en voit que deux ! De son point de vue, le cube et la sphère ne sont pas différents puisque ils sont homéomorphes: on peut transformer l'un en l'autre de façon continue (il suffirait de souffler dans le cube pour obtenir la sphère). Par contre, la sphère et le tore ne sont pas homéomorphes: triturez la sphère de toutes les façons (sans la déchirer), jamais vous n'obtiendrez le tore. Il existe un infinité d'espaces topologiques et, contrairement à ce que l'on serait naïvement tenté de croire, déterminer si deux d'entre eux sont homéomorphes est très difficile en général. Pour essayer de résoudre ce problème, les topologues ont eu l'idée de faire intervenir l'algèbre dans leurs raisonnements. Ce fut la naissance de la théorie de l'homotopie. Il s'agit, suivant une recette bien particulière, d'associer à tout espace topologique une infinité de ce que les algébristes appellent des groupes. Les groupes ainsi obtenus sont appelés groupes d'homotopie de l'espace topologique. Les mathématiciens ont commencé par montrer que deux espaces topologiques qui sont homéomorphes (par exemple le cube et la sphère) ont les même groupes d'homotopie. On parle alors d'invariants (les groupes d'homotopie sont bien invariants relativement à des espaces topologiques qui sont homéomorphes). Par conséquent, deux espaces topologiques qui n'ont pas les mêmes groupes d'homotopie ne peuvent en aucun cas être homéomorphes. C'est là un excellent moyen de classer les espaces topologiques (pensez à l'ornithologue qui observe les pattes des oiseaux pour déterminer s'il a affaire à un passereau ou non). Mon travail porte sur les espaces topologiques qui n'ont qu'un nombre fini de groupes d'homotopie non nuls. De tels espaces sont appelés des tours de Postnikov finies. On y étudie leurs groupes de cohomologie entière, une autre famille d'invariants, à l'instar des groupes d'homotopie. On mesure d'une certaine manière la taille d'un groupe de cohomologie à l'aide de la notion d'exposant; ainsi, un groupe de cohomologie possédant un exposant est relativement petit. L'un des résultats principaux de ce travail porte sur une étude de la taille des groupes de cohomologie des tours de Postnikov finies. Il s'agit du théorème suivant: un H-espace topologique 1-connexe 2-local et de type fini qui ne possède qu'un ou deux groupes d'homotopie non nuls n'a pas d'exposant pour son groupe gradué de cohomologie entière réduite. S'il fallait interpréter qualitativement ce résultat, on pourrait dire que plus un espace est petit du point de vue de la cohomologie (c.-à-d. s'il possède un exposant cohomologique), plus il est intéressant du point de vue de l'homotopie (c.-à-d. il aura plus de deux groupes d'homotopie non nuls). Il ressort de mon travail que de tels espaces sont très intéressants dans le sens où ils peuvent avoir une infinité de groupes d'homotopie non nuls. Jean-Pierre Serre, médaillé Fields en 1954, a montré que toutes les sphères de dimension >1 ont une infinité de groupes d'homotopie non nuls. Des espaces avec un exposant cohomologique aux sphères, il n'y a qu'un pas à franchir...

Exploration of the social dimension of corporate responsibility in a welfare state

This study focuses on corporate social responsibility (or CSR)as the latest dimension to emerge in the corporate responsibility and sustainability agenda, which in the recent past has rapidly risen to the top of the list of concerns for civil societies worldwide. Despite the continuing debates and discussions about the scope, benefits, and impacts of CSR to business and community in various sectors, levels, and types of society, many companies have moved forward to confront the opportunities and challenges of CSR. Thus, this study is about those proactive companies with a focus on the importance of CSR and its management inside and outside the company. It is an exploration and learning from the experience of Finnish companies, as well as other actors interested or involved in shaping the course of CSR, locally and globally. It also looks closely at how national culture affects the views, thinking, and management of CSR in a welfare state. This dissertation primarily draws on the analyses of information collected from a series of qualitative interviews and the existing literature in the area. This is complemented by an analysis of written and published documents on CSR from various sources. The results of the study give insightful information and detailed descriptions of a roadmap useful in learning and understanding CSR in Finnish companies. Despite the varying conceptual connotations, essential roadmap indicators point to the importance of framing CSR within the corporate responsibility concept, Finnish development and the welfare state system, globalization, stakeholders, and the pursuit of sustainable development as the main drivers of CSR, the remarkable progress of CSR in companies, and identification of key management areas and practices relevant to CSR. Similarly,the study reveals the importance of culture as essential in understanding and learning CSR. Finnish culture has a positive influence on the views, thinking, and management practices of CSR issues. Such a positive influence of culture, therefore, makes it easy for business people to discuss and understand CSR, because those CSR issues are already considered common and taken-for-granted by Finns and are implicit in the welfare state provisions. The experience of Finnish companies in implementing CSR policies in the supply chain is a concrete proactive step in advancing the message of CSR, that is, to bring companies and suppliers together to work on improving and strengthening relationships towards socially responsible practices worldwide. Such a forward step to deal with CSR issues in the supply chain reflects the companies' commitments and belief that CSR can be managed with the suppliers and gain positive benefits. Despite the problems and complexities, particularly in the global supply chain, managing CSR for Finnish companies presents new opportunities and challenges that are expected to intensify in the near future. The focus on CSR policy implementation inthe supply chain points to the importance of companies taking initiatives and forging cooperation with suppliers with the aim of addressing and improving CSR questions in the supply chains. The proactive stance of Finnish companies toward CSR is complemented by the active supporting role of important societalactors such as the government and NGOs. These actors carry out various promotional efforts and campaigns, thus bringing CSR into the mainstream of Finnish companies and strengthening the synergistic learning about CSR within the Finnish business and civil circles. The efforts of the government and NGOs to promote CSR are indicative of the importance of multipartite involvement and the emergence of better civil regulations. Likewise, their drive to learn from each other, exchange experiences, and contribute in CSR debates facilitated the evolution of CSRnetworks in the country. The results of this study add to the mounting evidence that CSR, in general, has created a new dimension in managing corporate sustainability. This study provides compelling empirical evidence and some direct quotations about CSR in the Finnish context. This information can be used to learn and gain new useful insights, approaches, and concepts for managing CSR.