Sepsis: time to reconsider the concept.

OBJECTIVE: To discuss the difficulty in using the concept of sepsis for clinical trials and propose new ways for designing future trials for severe infections. DESIGN: Short position statement. METHODS AND MAIN RESEARCH: Using a thorough evaluation of the recent literature in the field of severe sepsis and septic shock, the authors challenge the concept of sepsis as used in the past two decades and propose new ideas for designing future trials in this setting. The two main proposals are first to use a systematic assessment of the targeted inflammatory mediators when the study intends to counteract or replace those mediators (e.g., anti-tumor necrosis factor-alpha, activated protein C) and, second, to select more homogeneous populations, coming back to "precise infectious diseases," such as severe community-acquired pneumonia, severe peritonitis, or meningitis. CONCLUSIONS: The concept of sepsis has been useful to help clinicians to suspect and detect severe infections. Due to a considerable heterogeneity in the patients and type of infections included in the trials performed in the last two decades, it has not been useful in demonstrating the efficacy of new compounds. The authors propose a dramatic change in the design of future trials dealing with severe infections.

Concept of fat balance in human obesity revisited with particular reference to de novo lipogenesis.

The measurement of fat balance (fat input minus fat output) involves the accurate estimation of both metabolizable fat intake and total fat oxidation. This is possible mostly under laboratory conditions and not yet in free-living conditions. In the latter situation, net fat retention/mobilization can be estimated based on precise and accurate sequential body composition measurements. In case of positive balance, lipids stored in adipose tissue can originate from dietary (exogenous) lipids or from nonlipid precursors, mainly from carbohydrates (CHOs) but also from ethanol, through a process known as de novo lipogenesis (DNL). Basic equations are provided in this review to facilitate the interpretation of the different subcomponents of fat balance (endogenous vs exogenous) under different nutritional circumstances. One difficulty is methodological: total DNL is difficult to measure quantitatively in man; for example, indirect calorimetry only tracks net DNL, not total DNL. Although the numerous factors (mostly exogenous) influencing DNL have been studied, in particular the effect of CHO overfeeding, there is little information on the rate of DNL in habitual conditions of life, that is, large day-to-day fluctuations of CHO intakes, different types of CHO ingested with different glycemic indexes, alcohol combined with excess CHO intakes, etc. Three issues, which are still controversial today, will be addressed: (1) Is the increase of fat mass induced by CHO overfeeding explained by DNL only, or by decreased endogenous fat oxidation, or both? (2) Is DNL different in overweight and obese individuals as compared to their lean counterparts? (3) Does DNL occur both in the liver and in adipose tissue? Recent studies have demonstrated that acute CHO overfeeding influences adipose tissue lipogenic gene expression and that CHO may stimulate DNL in skeletal muscles, at least in vitro. The role of DNL and its importance in health and disease remain to be further clarified, in particular the putative effect of DNL on the control of energy intake and energy expenditure, as well as the occurrence of DNL in other tissues (such as in myocytes) in addition to hepatocytes and adipocytes.

L’envers du miroir: le verlan, une histoire d’ouf!

Des de ja fa uns quants anys existeix un fenomen lingüístic a França que encara avui dia no deixa de sorprendre ni de cridar l'atenció; es tracta d'una parla, o més aviat d’un argot que s’anomena verlan. El verlan, doncs, és un argot que troba el seu origen als barris marginals dels afores de les ciutats (les banlieues), i per la qual cosa s’associa normalment a la classe baixa i marginal d’aquestes. Així, aquest argot es va convertir en un autèntic “art del parlar” del sector juvenil del segle XX, el qual era utilitzat bàsicament per marcar una diferència de classe social i que els seu parlants es poguessin comunicar entre ells sense que ningú altre que no formés part del seu entorn pugui entendre el què deien. El verlan és un argot que es caracteritza per fer una inversió de les paraules, però tot i que sembli inventada, aquesta inversió de fonemes es fa segons unes regles i en funció del nombre de síl•labes del terme. Els mitjans de comunicació van contribuir molt en l’expansió d’aquest argot, però el moviment hip-hop va ser un dels principals mitjans d’expansió, ja que va "vulgaritzar" el verlan i va difondre’l a totes les capes de la societat a partir de les seves peculiars cançons. Així doncs, la pregunta que molts ens plantegem és la de si el verlan és realment una amenaça per al francès estàndard o no.

La construcción narrativa de la identidad en un contexto educativo intercultural = The narrative construction of identity in a intercultural educative setting

En este trabajo se expone e ilustra un modelo teórico para entender las funciones de la identidad, así como los mecanismospsicosociales asociados a su construcción: “Modelo Evolutivo y Funcional de la Identidad Mediada” (MEBIM). La identidad, mediada narrativamente, cumple una función personal orientada a la dirección de la propia vida, así como una función sociocultural vinculada a la búsqueda de reconocimiento de los derechos de los grupos sociales a los que uno se siente apegado. Se ilustran los factores asociados a la construcción de la identidad personal (sí mismos posibles, transiciones vitales, vínculo afectivo) y sociocultural (acción-transformación e identificación simbólica) a partir de 12 historias de vida realizadas con mestizos e indígenasde la Universidad Intercultural de Chiapas (México). Se sugiere que en contextos educativos formales, como la escuela o la Universidad, se deben propiciar narrativas personales y socioculturales con el objetivo de optimizar la identidad en un mundo a la vez globalizado y plural

Energy gap in the aetiology of body weight gain and obesity: a challenging concept with a complex evaluation and pitfalls.

The concept of energy gap(s) is useful for understanding the consequence of a small daily, weekly, or monthly positive energy balance and the inconspicuous shift in weight gain ultimately leading to overweight and obesity. Energy gap is a dynamic concept: an initial positive energy gap incurred via an increase in energy intake (or a decrease in physical activity) is not constant, may fade out with time if the initial conditions are maintained, and depends on the 'efficiency' with which the readjustment of the energy imbalance gap occurs with time. The metabolic response to an energy imbalance gap and the magnitude of the energy gap(s) can be estimated by at least two methods, i.e. i) assessment by longitudinal overfeeding studies, imposing (by design) an initial positive energy imbalance gap; ii) retrospective assessment based on epidemiological surveys, whereby the accumulated endogenous energy storage per unit of time is calculated from the change in body weight and body composition. In order to illustrate the difficulty of accurately assessing an energy gap we have used, as an illustrative example, a recent epidemiological study which tracked changes in total energy intake (estimated by gross food availability) and body weight over 3 decades in the US, combined with total energy expenditure prediction from body weight using doubly labelled water data. At the population level, the study attempted to assess the cause of the energy gap purported to be entirely due to increased food intake. Based on an estimate of change in energy intake judged to be more reliable (i.e. in the same study population) and together with calculations of simple energetic indices, our analysis suggests that conclusions about the fundamental causes of obesity development in a population (excess intake vs. low physical activity or both) is clouded by a high level of uncertainty.

Highway Maintenance Concept Vehicle Final Report: Phase Three, 2001

This report documents Phase III of a four-phase project. The goals of the project are to study the feasibility of using advanced technology from other industries to improve he efficiency and safety of winter highway maintenance vehicle operations, and to provide travelers with the level of service defined by policy during the winter season at the least cost to the taxpayers. The results of the first phase of the research were documented in the Concept Highway Maintenance Vehicle Final Report: Phase One dated April 1997, which describes the desirable functions of a concept maintenance vehicle and evaluates its feasibility. Phase I concluded by establishing the technologies that would be assembled and tested on the prototype vehicles in Phase II. The primary goals of phase II were to install the selected technologies on the prototype winter maintenance vehicles and to conduct proof of concept in advance of field evaluations planned for Phase III. This Phase III final report documents the work completed since the end of Phase II. During this time period, the Phase III work plan was completed and the redesigned friction meter was field tested. A vendor meeting was held to discuss future private sector participation and the new design for the Iowa vehicle. In addition, weather and roadway condition data were collected from the roadway weather information systems at selected sites in Iowa and Minnesota, for comparison to the vehicles' onboard temperature sensors. Furthermore, the team received new technology, such as the mobile Frensor unit, for bench testing and later installation.

Quand la droite nationaliste montre les minarets : la médiatisation ambigüe d'une initiative populaire en Suisse

This contribution addresses the anti-minaret referendum accepted by the Swiss people in 2009, using data drawn from the main television news program in French-speaking Switzerland. The analysis tries to point out ambiguities in the media coverage of this referendum and to show how increasing the Muslims' visibility worked against their public recognition. The clarification of the concept of visibility pays attention to the ways in which certain actors (politicians of the nationalist right) force others (the Muslims of Switzerland) to appear in the public sphere, creating controversy and publicizing their identity aspirations. This investigation leads to an inquiry on the normative conditions necessary for democratic debate. Cette contribution revient sur l'initiative anti-minarets acceptée par le peuple suisse en 2009, à partir de matériau provenant du principal journal de la Télévision suisse romande. L'analyse tente de ressaisir les ambiguïtés inhérentes à la médiatisation de cette initiative et de montrer comment la visibilisation des musulmans a joué en défaveur de leur reconnaissance publique. L'élucidation du concept de visibilité se veut attentive à certaines formes d'instrumentalisation par des acteurs (des politiciens de la droite nationaliste) qui en forcent d'autres (les musulmans de Suisse) à apparaître dans l'espace public, afin de susciter une controverse et publiciser leur programme identitaire. L'enquête débouche sur une interrogation relative aux conditions normatives nécessaires à la tenue d'un débat démocratique.

U.S. 151 Cascade to Dubuque, Dubuque County : project concept and assessment of impacts, 1994

This project concept and assessment of impacts includes information on future four-lane construction of U.S. 151 from the existing four-lane section near Cedar Rapids to Dubuque.

Speed-cohesion trade-offs in collective decision making in ants and the concept of precision in animal behaviour

In decision making, speed-accuracy trade-offs are well known and often inevitable because accuracy depends on being well informed and gathering information takes time. However, trade-offs between speed and cohesion, that is the degree to which a group remains together as a single entity, as a result of their decision making, have been comparatively neglected. We combine theory and experimentation to show that in decision-making systems, speed-cohesion trade-offs are a natural complement to speed-accuracy trade-offs and are therefore of general importance. We then analyse the decision performance of 32 rock ant, Temnothorax albipennis, colonies in experiments in which accuracy of collective decision making was held constant, but time urgency varied. These experiments reveal for the first time an adaptive speed-cohesion trade-off in collective decision making and how this is achieved. In accord with different time constraints, colonies can decide quickly, at the cost of social unity, or they can decide slowly with much greater cohesion. We discuss the similarity between cohesion and the term precision as used in statistics and engineering. This emphasizes the generality of speed versus cohesion/precision trade-offs in decision making and decision implementation in other fields within animal behaviour such as sexually selected motor displays and even certain aspects of birdsong. We also suggest that speed versus precision trade-offs may occur when individuals within a group need to synchronize their activity, and in collective navigation, cooperative hunting and in certain escape behaviours.

Concept Highway Maintenance Vehicle, Final Report, Phase One, 1997

The state Departments of Transportation (DOTs) of Iowa, Michigan, and Minnesota formed a consortium to define and develop the next generation highway maintenance vehicle. The Center for Transportation Research and Education of Iowa State University provided staff support to the concept highway maintenance vehicle project, which focused on winter maintenance activities. Phase I of the three-phase project focused on describing the desirable functions of a concept maintenance vehicle. Phase II will include the development, operation, and evaluation of prototype winter maintenance vehicles. Phase III is envisioned to be a comprehensive fleet evaluation of prototype winter maintenance vehicles. This report covers the activities of Phase I. Phase I included conducting a literature review of materials related to winter highway maintenance activities, identifying ideal capabilities of a winter maintenance vehicle, inviting private sector equipment and technology providers to join the project and commit equipment and expertise for Phase II, and determining the specific equipment and technology to be included on the three prototype vehicles for the winter of 1996-1997. Phase I concluded by establishing that assembling the three prototype vehicles would be beneficial to the project and to the three state DOTs.

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What is a virtual person? What is it used for? What is its added value? Virtual persons sometimes describe avatars and new forms of identities in online games. They also appear in other contexts; some authors use them in the legal domain. Within FIDIS, the concept of virtual person has been extended in order to better describe and understand new forms of identities in the Information Society in relation to rights, duties, obligations and responsibilities. Virtual persons, as other virtual entities, exist in the virtual world, the collection of all (abstract) entities which are or have been the product of the mind or imagination. The virtual world -not to be confused with the digital world- allows a unified description of many identity-related concepts that are usually defined separately without taking into consideration their similarities: avatars, pseudonyms, categories, profiles, legal persons, etc. The legal system has a long experience of using abstract entities to define rules, categories, etc., in order to associate legal rights, obligations, and responsibilities to persons that can be considered instances of these abstract entities in specific situations. The model developed within FIDIS intentionally uses a similar construction. n this chapter, after having explained the model, we apply it to pseudonyms. Then we explore the concept of virtual persons from a legal perspective. Eventually, we introduce trust in the light of virtual persons.