999 resultados para 163-988


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RESUME Cette thèse se situe à la frontière de la recherche en économie du développement et du commerce international et vise à intégrer les apports de l'économie géographique. Le premier chapitre s'intéresse aux effets de création et de détournement de commerce au sein des accords régionaux entre pays en développement et combine une approche gravitaire et une estimation non paramétrique des effets de commerce. Cette analyse confirme un effet de commerce non monotone pour six accords régionaux couvrant l'Afrique, l'Amérique Latine et l'Asie (AFTA, CAN, CACM, CEDEAO, MERCO SUR et SADC) sur la période 1960-1996. Les accords signés dans les années 90 (AFTA, CAN, MERCOSUR et SADC) semblent avoir induis une amélioration du bien-être de leurs membres mais avec un impact variable sur le reste du monde, tandis que les accords plus anciens (CEDEAO et CACM) semblent montrer que les effets de commerce et de bien-être se réduisent pour finir par s'annuler à mesure que le nombre d'années de participation des Etats membres augmente. Le deuxième chapitre pose la question de l'impact de la géographie sur les échanges Sud-Sud. Ce chapitre innove par rapport aux méthodes classiques d'estimation en dérivant une équation de commerce à partir de l'hypothèse d'Armington et en intégrant une fonction de coût de transport qui prend en compte la spécificité des pays de l'UEMOA. Les estimations donnent des effets convaincants quant au rôle de l'enclavement et des infrastructures: deux pays enclavés de l'UEMOA commercent 92% moins que deux autres pays quelconques, tandis que traverser un pays de transit au sein de l'espace UEMOA augmente de 6% les coûts de transport, et que bitumer toutes les routes inter-Etat de l'Union induirait trois fois plus de commerce intra-UEMOA. Le chapitre 3 s'intéresse à la persistance des différences de développement au sein des accords régionaux entre pays en développement. Il montre que la géographie différenciée des pays du Sud membres d'un accord induit un impact asymétrique de celui-ci sur ses membres. Il s'agit d'un modèle stylisé de trois pays dont deux ayant conclu un accord régional. Les résultats obtenus par simulation montrent qu'une meilleure dotation en infrastructure d'un membre de l'accord régional lui permet d'attirer une plus grande part industrielle à mesure que les coûts de transport au sein de l'accord régional sont baissés, ce qui conduit à un développement inégal entre les membres. Si les niveaux d'infrastructure domestique de transport sont harmonisés au sein des pays membres de l'accord d'intégration, leurs parts industrielles peuvent converger au détriment des pays restés hors de l'union. Le chapitre 4 s'intéresse à des questions d'économie urbaine en étudiant comment l'interaction entre rendements croissants et coûts de transport détermine la localisation des activités et des travailleurs au sein d'un pays ou d'une région. Le modèle développé reproduit un fait stylisé observé à l'intérieur des centres métropolitains des USA: sur une période longue (1850-1990), on observe une spécialisation croissante des centres urbains et de leurs périphéries associée à une évolution croissante puis décroissante de la population des centres urbains par rapport à leurs périphéries. Ce résultat peut se transférer dans un contexte en développement avec une zone centrale et une zone périphérique: à mesure que l'accessibilité des régions s'améliore, ces régions se spécialiseront et la région principale, d'abord plus importante (en termes de nombre de travailleurs) va finir par se réduire à une taille identique à celle de la région périphérique.

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PURPOSE: Intraoperative adverse events significantly influence morbidity and mortality of laparoscopic colorectal resections. Over an 11-year period, the changes of occurrence of such intraoperative adverse events were assessed in this study. METHODS: Analysis of 3,928 patients undergoing elective laparoscopic colorectal resection based on the prospective database of the Swiss Association of Laparoscopic and Thoracoscopic Surgery was performed. RESULTS: Overall, 377 intraoperative adverse events occurred in 329 patients (overall incidence of 8.4 %). Of 377 events, 163 (43 %) were surgical complications and 214 (57 %) were nonsurgical adverse events. Surgical complications were iatrogenic injury to solid organs (n = 63; incidence of 1.6 %), bleeding (n = 62; 1.6 %), lesion by puncture (n = 25; 0.6 %), and intraoperative anastomotic leakage (n = 13; 0.3 %). Of note, 11 % of intraoperative organ/puncture lesions requiring re-intervention were missed intraoperatively. Nonsurgical adverse events were problems with equipment (n = 127; 3.2 %), anesthetic problems (n = 30; 0.8 %), and various (n = 57; 1.5 %). Over time, the rate of intraoperative adverse events decreased, but not significantly. Bleeding complications significantly decreased (p = 0.015), and equipment problems increased (p = 0.036). However, the rate of adverse events requiring conversion significantly decreased with time (p < 0.001). Patients with an intraoperative adverse event had a significantly higher rate of postoperative local and general morbidity (41.2 and 32.9 % vs. 18.0 and 17.2 %, p < 0.001 and p < 0.001, respectively). CONCLUSIONS: Intraoperative surgical complications and adverse events in laparoscopic colorectal resections did not change significantly over time and are associated with an increased postoperative morbidity.

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Ethyl glucuronide (EtG) is a minor and direct metabolite of ethanol. EtG is incorporated into the growing hair allowing retrospective investigation of chronic alcohol abuse. In this study, we report the development and the validation of a method using gas chromatography-negative chemical ionization tandem mass spectrometry (GC-NCI-MS/MS) for the quantification of EtG in hair. EtG was extracted from about 30 mg of hair by aqueous incubation and purified by solid-phase extraction (SPE) using mixed mode extraction cartridges followed by derivation with perfluoropentanoic anhydride (PFPA). The analysis was performed in the selected reaction monitoring (SRM) mode using the transitions m/z 347-->163 (for the quantification) and m/z 347-->119 (for the identification) for EtG, and m/z 352-->163 for EtG-d(5) used as internal standard. For validation, we prepared quality controls (QC) using hair samples taken post mortem from 2 subjects with a known history of alcoholism. These samples were confirmed by a proficiency test with 7 participating laboratories. The assay linearity of EtG was confirmed over the range from 8.4 to 259.4 pg/mg hair, with a coefficient of determination (r(2)) above 0.999. The limit of detection (LOD) was estimated with 3.0 pg/mg. The lower limit of quantification (LLOQ) of the method was fixed at 8.4 pg/mg. Repeatability and intermediate precision (relative standard deviation, RSD%), tested at 4 QC levels, were less than 13.2%. The analytical method was applied to several hair samples obtained from autopsy cases with a history of alcoholism and/or lesions caused by alcohol. EtG concentrations in hair ranged from 60 to 820 pg/mg hair.

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In vitro and in vivo activity of amoxicillin and penicillin G alone or combined with a penicillinase inhibitor (clavulanate) were tested against five isogenic pairs of methicillin-resistant Staphylococcus aureus (MRSA) producing or not producing penicillinase. Loss of the penicillinase plasmid caused an eight times or greater reduction in the MICs of amoxicillin and penicillin G (from greater than or equal to 64 to 8 micrograms/ml), but not of the penicillinase-resistant drugs methicillin and cloxacillin (greater than or equal to 64 micrograms/ml). This difference in antibacterial effectiveness correlated with a more than 10 times greater penicillin-binding protein 2a affinity of amoxicillin and penicillin G than of methicillin and a greater than or equal to 90% successful amoxicillin treatment of experimental endocarditis due to penicillinase-negative MRSA compared with cloxacillin, which was totally ineffective (P less than .001). Amoxicillin was also effective against penicillinase-producing parent MRSA, provided it was combined with clavulanate. Penicillinase-sensitive beta-lactam antibiotics plus penicillinase inhibitors might offer a rational alternative treatment for MRSA infections.

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The relationship between inflammation and cancer is well established in several tumor types, including bladder cancer. We performed an association study between 886 inflammatory-gene variants and bladder cancer risk in 1,047 cases and 988 controls from the Spanish Bladder Cancer (SBC)/EPICURO Study. A preliminary exploration with the widely used univariate logistic regression approach did not identify any significant SNP after correcting for multiple testing. We further applied two more comprehensive methods to capture the complexity of bladder cancer genetic susceptibility: Bayesian Threshold LASSO (BTL), a regularized regression method, and AUC-Random Forest, a machine-learning algorithm. Both approaches explore the joint effect of markers. BTL analysis identified a signature of 37 SNPs in 34 genes showing an association with bladder cancer. AUC-RF detected an optimal predictive subset of 56 SNPs. 13 SNPs were identified by both methods in the total population. Using resources from the Texas Bladder Cancer study we were able to replicate 30% of the SNPs assessed. The associations between inflammatory SNPs and bladder cancer were reexamined among non-smokers to eliminate the effect of tobacco, one of the strongest and most prevalent environmental risk factor for this tumor. A 9 SNP-signature was detected by BTL. Here we report, for the first time, a set of SNP in inflammatory genes jointly associated with bladder cancer risk. These results highlight the importance of the complex structure of genetic susceptibility associated with cancer risk.

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Drug-nanoparticle conjugates: The anticancer drug camptothecin (CPT) was covalently linked at the surface of ultrasmall superparamagnetic iron oxide nanoparticles (USPIOs) via a linker, allowing drug release by cellular esterases. Nanoparticles were hierarchically built to achieve magnetically-enhanced drug delivery to human cancer cells and antiproliferative activity.The linking of therapeutic drugs to ultrasmall superparamagnetic iron oxide nanoparticles (USPIOs) allowing intracellular release of the active drug via cell-specific mechanisms would achieve tumor-selective magnetically-enhanced drug delivery. To validate this concept, we covalently attached the anticancer drug camptothecin (CPT) to biocompatible USPIOs (iron oxide core, 9-10 nm; hydrodynamic diameter, 52 nm) coated with polyvinylalcohol/polyvinylamine (PVA/aminoPVA). A bifunctional, end-differentiated dicarboxylic acid linker allowed the attachment of CPT to the aminoPVA as a biologically labile ester substrate for cellular esterases at one end, and as an amide at the other end. These CPT-USPIO conjugates exhibited antiproliferative activity in vitro against human melanoma cells. The intracellular localization of CPT-USPIOs was confirmed by transmission electron microscopy (iron oxide core), suggesting localization in lipid vesicles, and by fluorescence microscopy (CPT). An external static magnetic field applied during exposure increased melanoma cell uptake of the CPT-USPIOs.

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« Notices sur quelques manuscrits arabes, par M. Woepke (fol. 1) ; — Notices sur quelques mss. sanscrits, par M. Fauriel (fol. 6) ; — Notices sur quelques mss. sanscrits (fol. 40) ; — Notices sur quelques mss. sanscrits en caractère bengali, par M. Loiseleur Deslongchamps (fol. 58) ; — Notices sur quelques mss. arabes, par M. Hassler (fol. 94) ; — Notices sur quelques mss. arabes, par M. Reinaud (fol. 99) ; — Catalogue des mss. orientaux de l'ancienne maison de la Sorbonne, par M. Reinaud (fol. 126) ; — Catalogue des mss. orientaux de l'ancien couvent de l'Oratoire, par M. Reinaud (fol. 136) ; — Catalogue des mss. orientaux des différentes bibliothèques publiques de Paris (fol. 146) ; — Liste des livres et des mss. orientaux venus d'Alger et adressés à la Bibliothèque royale, le 30 nov. 1832 (fol. 152) ; — Note de quelques mss. orientaux appartenant à M. Wahl (fol. 156) ; — Mss. orientaux provenant de feu M. Schultz (fol. 157 et 159) ; — Mss., papiers et autres objets provenant de feu M. Schultz (fol. 163) ; — Collection Asselin (fol. 165 et 270) ; — Lettres et pièces relatives au fonds Asselin (fol. 263) ; — Mss. arabes, persans, samskrits et hindous tanys, cédés à la Bibliothèque du Roi par M. de Polier (fol. 291 et 293) ; — Évaluation de 47 mss. arabes, persans, maures, bengalis, etc., provenant de feu Ouessant, interprète de la Compagnie de Pondichéry (fol. 295) ; — Mss. arabes, turcs et persans de M. Ducaurroy (fol. 298) ; — Collection des mss. orientaux appartenant à la succession de feu M. le baron Rousseau, consul général à Tripoly de Barbarie (fol. 303) ; — Liste des mss. tamouls cédés à la Bibliothèque du Roi par M. Ducler (fol. 309) ; — Liste des mss. tamouls donnés à la Bibliothèque du Roi par M. Reydelet (fol. 311) ; — Mss, arabes et berbères de M. Delaporte père, 4848 (fol. 314) ; — État sommaire de quelques mss. réputés venir de feu M. Huet,... trouvés dans la maison Kerboeuf (fol. 323) ; — Mss. orientaux distraits du fonds Renaudot (fol. 324) ; — Mss. arabes rapportés d'Égypte par le citoyen Raiye (fol. 325) ; — Cinq volumes arabes mss. offerts à la Bibliothèque royale par S. A. R. Mgr le duc de Nemours (fol. 326) ; — Liste des livres qu'on a envoyés à Mrs de la Compagnie, en tamoul, 14 déc. 1729 (fol. 327) ; — Catalogue des mss. indiens de la Bibliothèque du Roi (fol. 328) ; — « Mémoire concernant l'acquisition des mss. persiens qu'il conviendroit de faire aux Indes pour la Bibliothèque du Roy » (fol. 362) ; — Mémoire de livres à rechercher dans le Levant pour la Bibliothèque du Roy (fol. 366) ; — État des mss. à rechercher à Constantinople pour la Bibliothèque impériale (fol. 384) ; — Catalogue des mss. orientaux appartenant à M. R. Johnson, 1806 (fol. 386) ; — Liste des mss. orientaux de la bibliothèque de sir Thomas Phillipps à Middlehill, 1829 (fol. 396) ; — Indication des mss. arabes les plus importants de la bibliothèque d'Alger (fol. 398) ; — Liste des livres et mss. venus d'Alger (fol. 402) ; — Liste des bibliothèques turques de Constantinople, 1854 (fol. 404) ; — Bibliothèque du sultan Ahmet III, au vieux sérail : catalogue des livres d'histoire, 1854 (fol. 408) ; — Note des mss. orientaux extraits de la bibliothèque de Vienne, que le conservatoire de la Bibliothèque impériale juge entièrement inutiles (fol. 416) ; — Notice par Ascari de l'ancien ms. syriaque 13 (fol. 418) ; — Manuscrits persans historiques de l'Indoustan, et livres en langue samscretam, apportés à la Bibliothèque du Roi en 1778 » (fol. 420).

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The prescribing of antibiotics for uncomplicated skin abscesses and diverticulitis has no benefit. Some antibiotics are more at risk of causing a Clostridium difficile infection. The tests used to exclude a history of a penicillin allergy are safe. A threshold of D-dimer adjusted for the age significantly improves the specificity of the test without affecting the sensitivity. The prescription of paraclinics tests is not an effective "treatment" for the patient's anxiety. In the sleep apnea syndrome, treatment with CPAP (Continuous positive airway pressure) appears to have more benefits compared to the mandibular advancement prosthesis. The work of primary care physicians can be supported by the work of advanced practice nurses. The limitation placed on the working hours of doctors in hospitals seems to affect their ability to spend time with their patients.

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PURPOSE: We evaluated the attitude in using chemotherapy near the end of life in advanced pancreatic adenocarcinoma (PAC). Clinical and laboratory parameters recorded at last chemotherapy administration were analyzed, in order to identify risk factors for imminent death. METHODS: Retrospective analysis of patients who underwent at least one line of palliative chemotherapy was made. Data concerning chemotherapy (regimens, lines, and date of last administration) were collected. Clinical and laboratory factors recorded at last chemotherapy administration were: performance status, presence of ascites, hemoglobin, white blood cell (WBC), platelets, total bilirubin, albumin, LDH, C-reactive protein (C-rp), and Ca 19.9. RESULTS: We analyzed 231 patients: males/females, 53/47 %; metastatic/locally advanced disease, 80/20 %; and median age, 66 years (range 32-85). All patients died due to disease progression. Median overall survival was 6.1 months (95 % CI 5.1-7.2). At the last chemotherapy delivery, performance status was 0-1 in 37 % and 2 in 63 %. Fifty-nine percent of patients received one chemotherapy line, while 32, 8, and 1 % had second-, third-, and fourth line, respectively. The interval between last chemotherapy administration and death was <4 weeks in 24 %, ≥4-12 in 47 %, and >12 in 29 %. Median survival from last chemotherapy to death was 7.5 weeks (95 % CI 6.7-8.4). In a univariate analysis, ascites, elevated WBC, bilirubin, LDH, C-rp and Ca 19.9, and reduced albumin were found to predict shorter survival; however, none of them remained significant in a multivariate analysis. CONCLUSIONS: A significant proportion of patients with advanced PAC received chemotherapy within the last month of life. The clinical and laboratory parameters recorded at last chemotherapy delivery did not predict shorter survival.

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The authors summarise their state of knowledge about wood ants and their role in the forest ecosystem. They also describe the situation in Switzerland, their past development and their conservation status. In several re- gions, mainly in the Plateau, wood ants seem to diminish, despite their total protection since 1966. The reasons for this regression are not well known, but the fragmentation of forest habitats in the Plateau region and direct damage to ant nests seem to play a certain role. A new project in which the development of wood ant nests is monitored in Swiss forest reserves (Formica-Forêts-CH) was recently started in the Swiss national park. It is to be extended, in collaboration with the forest services, over the whole of Switzerland.

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Intrusion of deicing materials and surface water into concrete bridge decks is a main contributor in deck reinforcing steel corrosion and concrete delamination. Salt, spread on bridge decks to melt ice, dissolves in water and permeates voids in the concrete deck. When the chloride content of the concrete in contact with reinforcing steel reaches a high enough concentration, the steel oxidizes. In Iowa, the method used to reduce bridge deck chloride penetration is the application of a low slump dense concrete overlay after the completion of all Class A and Class B floor repairs. A possible alternative to the use of dense concrete overlays, developed by Poly-Carb, Inc., is the MARK-163 FLEXOGRID Overlay System. FLEXOGRID is a two component system of epoxy and urethane which is applied on a bridge deck to a minimum thickness of ¼ inch. An aggregate mixture of silica quartz and aluminum oxide is broadcast onto the epoxy at a prescribed rate to provide deck protection and superior friction properties. The material is mixed on site and applied to the deck in a series of lifts (usually two) until the desired overlay thickness has been attained.

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Cet article prend pour objet les aspects pragmatiques de la carte géographique à travers un référentiel épistémologique ternaire explicite. Ainsi le regard sur la structure de la carte fait référence à une logique de juxtaposition|superposition/imbrication permettant d'aborder les questions d'échelle et de légende, les deux axes coordonnateurs structurant le champ de la représentation du territoire en carte. Leur interaction commande l'émergence, dans l'espace de l'entre-deux, du tiers concept diagonal, celui de l'implantation cartographique, la carte elle-même, obéissant à ses propres règles de représentation schématique.