Impact des techniques de fermeture utérine lors de la césarienne

Contexte: La césarienne est une procédure chirurgicale qui survient dans plus du quart des accouchements en Amérique du Nord. Les techniques chirurgicales de fermeture de l’utérus lors de la césarienne sont variées, influencent la cicatrisation et le risque de complications chez la femme à court et long terme. Il a été suggéré que la fermeture en un plan barré augmentait le risque de rupture de l’utérus et de défaut de cicatrisation de l’utérus. Cependant, en l’absence d’un haut niveau d’évidence, cette technique est toujours pratiquée au Canada et en Amérique du Nord. Objectif: Comparer l’impact des différentes techniques de fermeture de l’utérus lors de la césarienne sur les complications maternelles à court et long terme. Méthode : Trois revues systématiques et méta-analyses d’études observationnelles ou d’essais randomisés contrôlés (ECR) ont été réalisées. La prévalence des défauts de cicatrisation et les issues à court et long terme ont été comparées entre les techniques de fermeture de l’utérus. Par la suite, un essai randomisé contrôlé a évalué trois techniques de fermeture de l’utérus : un plan barré, deux plans barrés et deux plans non barrés excluant la déciduale, chez 81 femmes avec une césarienne primaire élective à ≥ 38 semaines de grossesse. L’épaisseur du myomètre résiduel a été mesurée six mois après la césarienne à l’aide d’une échographie transvaginale et comparée par un test t de Student. Résultats : Les résultats des revues systématiques et méta-analyses ont montré que 37% à 59% des femmes présentaient un défaut de cicatrisation de l’utérus après leur césarienne. Concernant les complications à court terme, les types de fermeture de l’utérus étudiés sont comparables, à l’exception de la fermeture en un plan barré qui est associée à un temps opératoire plus court que celle en deux plans (-6.1 minutes, 95% intervalle de confiance (IC) -8.7 à -3.4, p<0.001). Les fermetures de l’utérus en un plan barré sont associées à plus de risque de rupture utérine qu’une fermeture en deux plans barrés (rapport de cote 4.96; IC 95%: 2.58–9.52, P< 0.001). L’ECR a également démontré que la fermeture de l’utérus en un plan barré était associée à une épaisseur du myomètre résiduel plus mince que la fermeture en deux plans non barrés excluant la déciduale (3.8 ± 1.6 mm vs 6.1 ± 2.2 mm; p< 0.001). Finalement, aucune différence significative n’a été détectée concernant la fréquence des points d’hémostases entre les techniques (p=1.000). Conclusion : Lors d’une césarienne élective primaire à terme, une fermeture en deux plans non barrés est associée à un myomètre plus épais qu’une fermeture en un plan barré, sans augmenter le recours à des points d’hémostase. De plus, il est suggéré que la fermeture en deux plans réduirait le risque de rupture utérine lors d’une prochaine grossesse. Finalement, la fermeture chez les femmes en travail doit être plus étudiée.

Applications of Microwave Antenna Array for Wireless Power Transmission and Radar Imaging in Complex Environment

Thesis (Ph.D.)--University of Washington, 2016-08

Sobre (vivência) e mortalidade de pequenos negócios: o caso de mercados varejistas potiguares

This paper‟s starting point was the objective of understanding the relation between the reasons pointed out by small businesses owners for the continuity or shutdown of their businesses, and the reasons presented by the Environmental Theories. The paper discusses the Environmental Theories understand that it is supported by a systemic metaphor speech, discussing the theme in terms of organizational survival and mortality . The text reviews the literature showing the changes in the administrative thinking regarding the organization versus environment relation, and presenting general ideas about the micro and small businesses. In methodological terms, the qualitative approach was used in the research. Regarding the data collection technique, an in-depth thematic interview was used. It was carried out considering the elements of the techniques of life history and oral history, always giving priority to real world related narratives told by the interviewed subjects. The empirical corpus of the research was made up of seven owners of small retail businesses in two Potiguar cities: Natal and Mossoró. The interpretative and analytical process focused, at first, on the reflexive dialogue with each one of the owners‟ professional life history and business management experience, constituting the first level of analysis: reflections on individual narratives; and, afterwards, the interpretative process was developed through the analysis of all the subjects‟ statements, identifying the recurring themes and constituting the second level of analysis: reflection on the totalizing narrative. The themes identified in the totalizing narrative, that refer to the continuity of the businesses are: evolution, control, fidelity, liking what one does for a living. The themes that came up as reasons for shutdown are: lack of empathy with the business, lack of evolution, competition problems, suppliers and the government. The text synthesizes its comprehensions affirming that the reasons associated with continuity and shutdown of small markets, for this group of owners specifically, come up as a permanent tension between the volunteerism (quite human) and the determinism (systemic). The tension is shown in testimonies that at the same time evoke the organicist systemic logic through the themes evolution/no evolution, and also counterpoints with themes related to the interested human action, based on desires, feelings and personal convictions such as: liking what one does/ lack of empathy. As for the reflexive dialogue between the postulates of the Environmental Theories and the narratives, the results make it possible to affirm that, differently from the tension expressed by the subjects while talking about their reasons, the reasons associated with survival and mortality of businesses according to the Environmental Theories are theoretically polarized, seeming to preach options that are stagnated and shaping towards the subjects involved in the organization-environment relation

O papel do bilinguismo no processo de difusão das línguas

O presente estudo propõe-se estudar as representações de alunos bilingues e não bilingues acerca do papel do bilinguismo no processo de difusão das línguas. Para dar resposta a este objetivo, desenhámos um projeto de intervenção que compreendeu a utilização de duas técnicas de recolha de dados: a entrevista e o inquérito por questionário, que implementámos a alunos do distrito de Aveiro. Os resultados obtidos permitiram concluir que, de forma geral, os alunos consideram que os falantes são os principais responsáveis pela difusão das línguas, contribuindo para o aumento de utilizadores da mesma e, portanto, para a sua expansão.

Protocol to design techniques for implementing software development best practices

Software engineering best practices allow significantly improving the software development. However, the implementation of best practices requires skilled professionals, financial investment and technical support to facilitate implementation and achieve the respective improvement. In this paper we proposes a protocol to design techniques to implement best practices of software engineering. The protocol includes the identification and selection of process to improve, the study of standards and models, identification of best practices associated with the process and the possible implementation techniques. In addition, technical design activities are defined in order to create or adapt the techniques of implementing best practices for software development.

Asynchronus design for improved EMC behavior of ICs

International audience

Optimisation of digitally coded test vectors for mixed-signal components

International audience

Early analysis of fault-attack effects for cryptographic hardware

International audience

A Methodology for estimating energy consumption of QDI asynchronous circuits

International audience

Comparison of High Q microresonators operating on a thin plate mode : the Lamé-mode

International audience

Improving DPA and DFA resistance of circuits using asynchronous logic

International audience

An algorithm for the inclusion of RC compact models of packages into board level thermal simulation tools

International audience

Gait analysis of the hind limb in Labrador Retrievers with and without cranial cruciate ligament disease

Cranial cruciate ligament (CCL) deficiency is the leading cause of lameness affecting the stifle joints of large breed dogs, especially Labrador Retrievers. Although CCL disease has been studied extensively, its exact pathogenesis and the primary cause leading to CCL rupture remain controversial. However, weakening secondary to repetitive microtrauma is currently believed to cause the majority of CCL instabilities diagnosed in dogs. Techniques of gait analysis have become the most productive tools to investigate normal and pathological gait in human and veterinary subjects. The inverse dynamics analysis approach models the limb as a series of connected linkages and integrates morphometric data to yield information about the net joint moment, patterns of muscle power and joint reaction forces. The results of these studies have greatly advanced our understanding of the pathogenesis of joint diseases in humans. A muscular imbalance between the hamstring and quadriceps muscles has been suggested as a cause for anterior cruciate ligament rupture in female athletes. Based on these findings, neuromuscular training programs leading to a relative risk reduction of up to 80% has been designed. In spite of the cost and morbidity associated with CCL disease and its management, very few studies have focused on the inverse dynamics gait analysis of this condition in dogs. The general goals of this research were (1) to further define gait mechanism in Labrador Retrievers with and without CCL-deficiency, (2) to identify individual dogs that are susceptible to CCL disease, and (3) to characterize their gait. The mass, location of the center of mass (COM), and mass moment of inertia of hind limb segments were calculated using a noninvasive method based on computerized tomography of normal and CCL-deficient Labrador Retrievers. Regression models were developed to determine predictive equations to estimate body segment parameters on the basis of simple morphometric measurements, providing a basis for nonterminal studies of inverse dynamics of the hind limbs in Labrador Retrievers. Kinematic, ground reaction forces (GRF) and morphometric data were combined in an inverse dynamics approach to compute hock, stifle and hip net moments, powers and joint reaction forces (JRF) while trotting in normal, CCL-deficient or sound contralateral limbs. Reductions in joint moment, power, and loads observed in CCL-deficient limbs were interpreted as modifications adopted to reduce or avoid painful mobilization of the injured stifle joint. Lameness resulting from CCL disease affected predominantly reaction forces during the braking phase and the extension during push-off. Kinetics also identified a greater joint moment and power of the contralateral limbs compared with normal, particularly of the stifle extensor muscles group, which may correlate with the lameness observed, but also with the predisposition of contralateral limbs to CCL deficiency in dogs. For the first time, surface EMG patterns of major hind limb muscles during trotting gait of healthy Labrador Retrievers were characterized and compared with kinetic and kinematic data of the stifle joint. The use of surface EMG highlighted the co-contraction patterns of the muscles around the stifle joint, which were documented during transition periods between flexion and extension of the joint, but also during the flexion observed in the weight bearing phase. Identification of possible differences in EMG activation characteristics between healthy patients and dogs with or predisposed to orthopedic and neurological disease may help understanding the neuromuscular abnormality and gait mechanics of such disorders in the future. Conformation parameters, obtained from femoral and tibial radiographs, hind limb CT images, and dual-energy X-ray absorptiometry, of hind limbs predisposed to CCL deficiency were compared with the conformation parameters from hind limbs at low risk. A combination of tibial plateau angle and femoral anteversion angle measured on radiographs was determined optimal for discriminating predisposed and non-predisposed limbs for CCL disease in Labrador Retrievers using a receiver operating characteristic curve analysis method. In the future, the tibial plateau angle (TPA) and femoral anteversion angle (FAA) may be used to screen dogs suspected of being susceptible to CCL disease. Last, kinematics and kinetics across the hock, stifle and hip joints in Labrador Retrievers presumed to be at low risk based on their radiographic TPA and FAA were compared to gait data from dogs presumed to be predisposed to CCL disease for overground and treadmill trotting gait. For overground trials, extensor moment at the hock and energy generated around the hock and stifle joints were increased in predisposed limbs compared to non predisposed limbs. For treadmill trials, dogs qualified as predisposed to CCL disease held their stifle at a greater degree of flexion, extended their hock less, and generated more energy around the stifle joints while trotting on a treadmill compared with dogs at low risk. This characterization of the gait mechanics of Labrador Retrievers at low risk or predisposed to CCL disease may help developing and monitoring preventive exercise programs to decrease gastrocnemius dominance and strengthened the hamstring muscle group.

Comparison of firmness meters for measuring ‘Hass’ avocado fruit firmness

The temporal passage of fruit through the supply chain and the selection of consumable fruit by shoppers depend primarily upon fruit firmness. Traditionally, fruit firmness measuring methods, like Effegi and conical probes, are relatively inefficient and destructive. Simple, accurate and non-damaging methods of measuring fruit firmness are ideally required to help assure eating quality to the consumer without fruit wastage. The firmness of 'Hass' avocado fruit at a range of ripening stages was measured with the various different firmness measuring techniques of the Sinclair iQ Firmness Tester (SIQFT), the Electronic Firmometer (EF), the Analogue Firmness Meter (AFM) and hand squeezing. Measurements were made by each method at different points on the same fruit. Destructive bruise assessment was performed 48 h later, thereby allowing sufficient time for fruit to express any bruising resulting from the act of firmness measurements. Non-linear relationships were determined between fruit firmness values measured with the different techniques. The adjusted R2 for the relationship between the SIQFT and the EF was 91.6%. For the SIQFT and the AFM, the adjusted R2 was 73.7%. It was 77.7% for the SIQFT and hand squeezing. A significantly (P<0.05) high incidence of bruising was associated with firmness assessment by the EF as compared with either the SIQFT or the AFM. Among the methods compared, the SIQFT was non-damaging compared with the EF and relatively efficient for measuring the firmness. This instrument merits consideration as a quality control tool of choice in 'Hass' avocado supply chains.

Report of the Workshop on Growth-increment Chronologies in Marine Fish: climate-ecosystem interactions in the North Atlantic 2 (WKGIC2). 18-22 April 2016 Esporles, Mallorca, Spain

Over the past several decades, thousands of otoliths, bivalve shells, and scales have been collected for the purposes of age determination and remain archived in European and North American fisheries laboratories. Advances in digital imaging and computer software combined with techniques developed by tree-ring scientists provide a means by which to extract additional levels of information in these calcified structures and generate annually resolved (one value per year), multidecadal time-series of population-level growth anomalies. Chemical and isotopic properties may also be extracted to provide additional information regarding the environmental conditions these organisms experienced.Given that they are exactly placed in time, chronologies can be directly compared to instrumental climate records, chronologies from other regions or species, or time-seriesof other biological phenomena. In this way, chronologies may be used to reconstruct historical ranges of environmental variability, identify climatic drivers of growth, establish linkages within and among species, and generate ecosystem-level indicators. Following the first workshop in Hamburg, Germany, in December 2014, the second workshop on Growth increment Chronologies in Marine Fish: climate-ecosystem interactions in the North Atlantic (WKGIC2) met at the Mediterranean Institute for Advanced Studies headquarters in Esporles, Spain, on 18–22 April 2016, chaired by Bryan Black (USA) and Christoph Stransky (Germany).Thirty-six participants from fifteen different countries attended. Objectives were to i) review the applications of chronologies developed from growth-increment widths in the hard parts (otoliths, shells, scales) of marine fish and bivalve species ii) review the fundamentals of crossdating and chronology development, iii) discuss assumptions and limitations of these approaches, iv) measure otolith growth-increment widths in image analysis software, v) learn software to statistically check increment dating accuracy, vi) generate a growth increment chronology and relate it to climate indices, and vii) initiate cooperative projects or training exercises to commence after the workshop.The workshop began with an overview of tree-ring techniques of chronology development, including a hands-on exercise in cross dating. Next, we discussed the applications of fish and bivalve biochronologies and the range of issues that could be addressed. We then reviewed key assumptions and limitations, especially those associated with short-lived species for which there are numerous and extensive otolith archives in European fisheries labs. Next, participants were provided with images of European plaice otoliths from the North Sea and taught to measure increment widths in image analysis software. Upon completion of measurements, techniques of chronology development were discussed and contrasted to those that have been applied for long-lived species. Plaice growth time-series were then related to environmental variability using the KNMI Climate Explorer. Finally, potential future collaborations and funding opportunities were discussed, and there was a clear desire to meet again to compare various statistical techniques for chronology development using a range existing fish, bivalve, and tree growth-increment datasets. Overall, we hope to increase the use of these techniques, and over the long term, develop networks of biochronologies for integrative analyses of ecosystem functioning and relationships to long-term climate variability and fishing pressure.