Le syndrome de Moebius

Renal osteodystrophy is an amalgam of a number of distinct pathological conditions, in particular, hyperparathyroidism and osteomalacia. In addition, there may be a change in the guantity of bone, i.e., osteopenia (osteoporosis) or osteosclerosis. While bone biopsy may be the most reliable method for detecting these lesions, it is not yet a routine procedure in many centers. Radiological assessment of the bones, therefore, is the most widely used method for assessing the type and severity of the bone lesions in patients with chronic renal failure. This article reviews the world literature and pays attention to conventional radiological techniques as well as macroradiography. In addition, studies in which radiological appearances are correlated with histological appearances are described. Mention is also made of the effects on radiological bone disease of dialysis and transplantation. Consideration is also given to the manifestations of soft-tissue calcification, both of the vascular and subcutaneous type, and to the effects of treatment.

The international multidisciplinary consensus conference on multimodality monitoring in neurocritical care: evidentiary tables : a statement for healthcare professionals from the neurocritical care society and the European society of intensive care medicine.

A variety of technologies have been developed to assist decision-making during the management of patients with acute brain injury who require intensive care. A large body of research has been generated describing these various technologies. The Neurocritical Care Society (NCS) in collaboration with the European Society of Intensive Care Medicine (ESICM), the Society for Critical Care Medicine (SCCM), and the Latin America Brain Injury Consortium (LABIC) organized an international, multidisciplinary consensus conference to perform a systematic review of the published literature to help develop evidence-based practice recommendations on bedside physiologic monitoring. This supplement contains a Consensus Summary Statement with recommendations and individual topic reviews on physiologic processes important in the care of acute brain injury. In this article we provide the evidentiary tables for select topics including systemic hemodynamics, intracranial pressure, brain and systemic oxygenation, EEG, brain metabolism, biomarkers, processes of care and monitoring in emerging economies to provide the clinician ready access to evidence that supports recommendations about neuromonitoring.

Identification of carotenoids using mass spectrometry

The present review compiles positive MS fragmentation data of selected carotenoids obtained using various ionization techniques and matrices. In addition, new experimental data from the analysis of carotenoids in transgenic maize and rice callus are provided. Several carotenes and oxygen-functionalized carotenoids containing epoxy, hydroxyl, and ketone groups were ionized by atmospheric pressure chemical ionization (APCI)-tandem mass spectrometry (MS/MS) in positive ion mode. Thus, on the basis of the information obtained from the literature and our own experiments, we identified characteristic carotenoid ions that can be associated to functional groups in the structures of these compounds. In addition, pigments with a very similar structure were differentiated through comparison of the intensities of their fragments. The data provide a basis for the structural elucidation of carotenoids by mass spectrometry (MS).

Tuberous sclerosis: literature review and case report

Tuberous sclerosis (TS) or Bourneville"s disease is a rare, multisystemic genetic disorder. It involves alterations to ectodermal and mesodermal cell differentiation and proliferation, causing benign hamartomatous tumors, neurofibromas and angiofibromas in the brain and other vital organs including the kidney, heart, eyes, lungs, skin and mucosa. It also affects the central nervous system and produces neurological dysfunctions such as seizures, mental retardation and behavior disorders. Tuberous (rootshaped) growths develop in the brain, and calcify over time, becoming hard and sclerotic, hence the name given to the disease. Although inheritance is autosomal dominant, 60-70% of cases occur through spontaneous mutations. The disease is related to some mutations or alterations in two genes, named TSC1 and TSC2. Discovered in 1997, TSC1 is located on chromosome 9q34 and produces a protein called hamartin. TSC2, discovered in 1993, is located on chromosome 16p13 and produces a protein called tuberin. The prevalence of the disease is 1/6000-10,000 live newborns, and it is estimated that there are 1-2 million sufferers worldwide. This paper presents a literature review and a family case report of a mother and two of her daughters with oral features of TS

Nosturivaihteiden kunnonvalvontajärjestelmän kehittäminen värähtelymittauksia käyttäen

Työssä selvitettiin värähtelymittauksien käyttömahdollisuuksia nosturivaihteiden ennakoivassa kunnonvalvonnassa. Työ on painottunut lähinnä värähtelymittausten mittaus- ja analyysiteknisten näkökohtien tarkasteluun ja toimii niiltä osin al-kuselvityksenä värähtelymittauspohjaisen kunnonvalvontajärjestelmän luomiselle. Kirjallisuuden mukaan yleisimpiä ja käyttökelpoisimpia värähtelyanalyysejä vaihteistojen kunnonvalvonnassa ovat spektri-, kepstri-, ja demodulointitekniik-kaan perustuvat analyysit, joita kokeiltiin vauriokokeilla. Työssä käsitellään myös iskusysäysmenetelmää ja aikatason tunnuslukuja. Vauriokokeilla saatiin tietoa hammasvaurioiden havaitsemisesta värähtelymittauksilla, mutta laakerivaurioista kaivataan sen sijaan vielä lisää tietoa. Hammasvaurioiden tarkastelussa spektri-analyysin ohella PeakVue -analyysi osoittautui tehokkaaksi, kun siinä käytettiin sopivaa suodatusaluetta. Lisäksi työhön on koottu kokemuksia nosturivaihteiden käytännön värähtelymittauksista ja annettu ohjeita niiden suorittamisesta. Työn tulokset osoittavat, että värähtelymittauspohjaisella kunnonvalvontajärjes-telmällä voidaan parantaa nostovaihteiden ennakoivaa kunnonvalvontaa. Nosto-vaihteiden värähtelymittauksia kannattaa siis ehdottomasti jatkaa ja kunnonval-vontajärjestelmää edelleen kehittää. Siirtovaihteiden valvonta värähtelymittauksilla on sen sijaan hankalaa niiden epävakaan kuormitustilan vuoksi.

Automatic target validation based on neuroscientific literature mining for tractography.

Target identification for tractography studies requires solid anatomical knowledge validated by an extensive literature review across species for each seed structure to be studied. Manual literature review to identify targets for a given seed region is tedious and potentially subjective. Therefore, complementary approaches would be useful. We propose to use text-mining models to automatically suggest potential targets from the neuroscientific literature, full-text articles and abstracts, so that they can be used for anatomical connection studies and more specifically for tractography. We applied text-mining models to three structures: two well-studied structures, since validated deep brain stimulation targets, the internal globus pallidus and the subthalamic nucleus and, the nucleus accumbens, an exploratory target for treating psychiatric disorders. We performed a systematic review of the literature to document the projections of the three selected structures and compared it with the targets proposed by text-mining models, both in rat and primate (including human). We ran probabilistic tractography on the nucleus accumbens and compared the output with the results of the text-mining models and literature review. Overall, text-mining the literature could find three times as many targets as two man-weeks of curation could. The overall efficiency of the text-mining against literature review in our study was 98% recall (at 36% precision), meaning that over all the targets for the three selected seeds, only one target has been missed by text-mining. We demonstrate that connectivity for a structure of interest can be extracted from a very large amount of publications and abstracts. We believe this tool will be useful in helping the neuroscience community to facilitate connectivity studies of particular brain regions. The text mining tools used for the study are part of the HBP Neuroinformatics Platform, publicly available at http://connectivity-brainer.rhcloud.com/.

Kineettinen tarkastelu keskisakeusalueella toimivalle happivaiheelle

Työn tavoitteena oli tarkastella keskisakeudessa toimivan happidelignifioinnin kinetiikkaa ja vertailla sitä olemassa olevien kineettisten tutkimuksien kanssa. Lisäksi tutkittiin kuinka happivaiheen suodos vaikuttaa delignifiointiasteeseen sekä selektiivisyyteen. Työn kirjallisuusosassa perehdyttiin happidelignifioinnin kineettisiin malleihin, jotka on kehitetty ennustamaan alkalin, paineen, lämpötilan ja ajan vaikutusta ligniinin poistumiselle sekä hiilihydraattiketjujen katkeilulle. Delignifioituminen on nopeaa ensimmäisen kymmenen minuutin aikana ja hidastuu jäännösdelignifiointivaiheessa. Laboratoriotutkimuksissa selvitettiin kuinka prosessimuuttujat vaikuttavat kappaluvun ja viskositeetin muutokseen. Tuloksia tarkasteltiin lineaarisella regressioanalyysillä, jonka avulla muuttujien vaikutukset saadaan selkeästi esille. Happivaiheen ensimmäisessä vaiheessa suurin vaikutus delignifiointiasteeseen sekä viskositeetin alenemiseen on alkaliannoksella. Pienillä hapen annostuksella saavutettiin hyvä selektiivisyys, suurillakin alkaliannoksilla. Lämpötilan vaikutus on lähes olematon, kun paine on pieni. Kun paine kasvaa, kasvaa myös lämpötilan vaikutus delignifiointiasteeseen. Hiilihydraattien depolymerisoituminen lisääntyy lämpötilan kasvaessa lähes lineaarisesti, riippumatta paineesta. Hyvä loppuselektiivisyys saavutetaan kun ensimmäisen vaiheen selektiivisyys on hyvä. Ensimmäisessä vaiheessa saavutettiin hyvä selektiivisyys, kun alkali ei pääse kulumaan loppuun eikä delignifioituminen jatku liian pitkälle. Toisessa vaiheessa selektiivisyys säilyy parhaiten, kun lisättävä alkaliannos on pieni. Lämpötila ja paine vaikuttavat alkaliannokseen verrattuna hyvin vähän loppuselektiivisyyteen.

Involuntary outpatient treatment for mental health problems in Switzerland: a literature review.

BACKGROUND: In 2008, the Swiss Civil Code was amended. From 1 January 2013, each Swiss canton may propose specific provisions for involuntary outpatient treatment (community treatment orders (CTOs)) for individuals with mental disorders. AIM: This review catalogues the legal provisions of the various Swiss cantons for CTOs and outlines the differences between them. It sets this in the context of variations in clinical provisions between the cantons. METHODS: Databases were searched to obtain relevant publications about CTOs in Switzerland. The Swiss Medical Association, Swiss Federal Statistical Office, Swiss Health Observatory and all the 26 Cantonal medical officers were contacted to complete the information. Conférence des cantons en matière de protection des mineurs et des adultes (COPMA), the authority which monitors guardianship legislation, and Pro Mente Sana, a patients' right association, were also approached. RESULTS: Three articles about CTOs in Switzerland were identified. Psychiatric provisions vary considerably between cantons and only a few could provide complete or even partial figures for rates of compulsion in previous years. Prior to 2013, only 6 of the 20 cantons, for which information was returned, had any provision for CTOs. Now, every canton has some form of legal basis but the level of detail is often limited. In eight cantons, the powers of the measure are not specified (for example, use of medication). In 12 cantons, the maximum duration of the CTO is not specified. German speaking cantons and rural cantons are more likely to specify the details of CTOs. CONCLUSION: Highly variable Swiss provision for CTOs is being introduced despite the absence of convincing international evidence for their effectiveness or good quality data on current coercive practice. Careful monitoring and assessment of these new cantonal provisions are essential.

Exploring transparent approaches to the authentication of signatures on artwork

This thesis is composed of three main parts. The first consists of a state of the art of the different notions that are significant to understand the elements surrounding art authentication in general, and of signatures in particular, and that the author deemed them necessary to fully grasp the microcosm that makes up this particular market. Individuals with a solid knowledge of the art and expertise area, and that are particularly interested in the present study are advised to advance directly to the fourth Chapter. The expertise of the signature, it's reliability, and the factors impacting the expert's conclusions are brought forward. The final aim of the state of the art is to offer a general list of recommendations based on an exhaustive review of the current literature and given in light of all of the exposed issues. These guidelines are specifically formulated for the expertise of signatures on paintings, but can also be applied to wider themes in the area of signature examination. The second part of this thesis covers the experimental stages of the research. It consists of the method developed to authenticate painted signatures on works of art. This method is articulated around several main objectives: defining measurable features on painted signatures and defining their relevance in order to establish the separation capacities between groups of authentic and simulated signatures. For the first time, numerical analyses of painted signatures have been obtained and are used to attribute their authorship to given artists. An in-depth discussion of the developed method constitutes the third and final part of this study. It evaluates the opportunities and constraints when applied by signature and handwriting experts in forensic science. A brief summary covering each chapter allows a rapid overview of the study and summarizes the aims and main themes of each chapter. These outlines presented below summarize the aims and main themes addressed in each chapter. Part I - Theory Chapter 1 exposes legal aspects surrounding the authentication of works of art by art experts. The definition of what is legally authentic, the quality and types of the experts that can express an opinion concerning the authorship of a specific painting, and standard deontological rules are addressed. The practices applied in Switzerland will be specifically dealt with. Chapter 2 presents an overview of the different scientific analyses that can be carried out on paintings (from the canvas to the top coat). Scientific examinations of works of art have become more common, as more and more museums equip themselves with laboratories, thus an understanding of their role in the art authentication process is vital. The added value that a signature expertise can have in comparison to other scientific techniques is also addressed. Chapter 3 provides a historical overview of the signature on paintings throughout the ages, in order to offer the reader an understanding of the origin of the signature on works of art and its evolution through time. An explanation is given on the transitions that the signature went through from the 15th century on and how it progressively took on its widely known modern form. Both this chapter and chapter 2 are presented to show the reader the rich sources of information that can be provided to describe a painting, and how the signature is one of these sources. Chapter 4 focuses on the different hypotheses the FHE must keep in mind when examining a painted signature, since a number of scenarios can be encountered when dealing with signatures on works of art. The different forms of signatures, as well as the variables that may have an influence on the painted signatures, are also presented. Finally, the current state of knowledge of the examination procedure of signatures in forensic science in general, and in particular for painted signatures, is exposed. The state of the art of the assessment of the authorship of signatures on paintings is established and discussed in light of the theoretical facets mentioned previously. Chapter 5 considers key elements that can have an impact on the FHE during his or her2 examinations. This includes a discussion on elements such as the skill, confidence and competence of an expert, as well as the potential bias effects he might encounter. A better understanding of elements surrounding handwriting examinations, to, in turn, better communicate results and conclusions to an audience, is also undertaken. Chapter 6 reviews the judicial acceptance of signature analysis in Courts and closes the state of the art section of this thesis. This chapter brings forward the current issues pertaining to the appreciation of this expertise by the non- forensic community, and will discuss the increasing number of claims of the unscientific nature of signature authentication. The necessity to aim for more scientific, comprehensive and transparent authentication methods will be discussed. The theoretical part of this thesis is concluded by a series of general recommendations for forensic handwriting examiners in forensic science, specifically for the expertise of signatures on paintings. These recommendations stem from the exhaustive review of the literature and the issues exposed from this review and can also be applied to the traditional examination of signatures (on paper). Part II - Experimental part Chapter 7 describes and defines the sampling, extraction and analysis phases of the research. The sampling stage of artists' signatures and their respective simulations are presented, followed by the steps that were undertaken to extract and determine sets of characteristics, specific to each artist, that describe their signatures. The method is based on a study of five artists and a group of individuals acting as forgers for the sake of this study. Finally, the analysis procedure of these characteristics to assess of the strength of evidence, and based on a Bayesian reasoning process, is presented. Chapter 8 outlines the results concerning both the artist and simulation corpuses after their optical observation, followed by the results of the analysis phase of the research. The feature selection process and the likelihood ratio evaluation are the main themes that are addressed. The discrimination power between both corpuses is illustrated through multivariate analysis. Part III - Discussion Chapter 9 discusses the materials, the methods, and the obtained results of the research. The opportunities, but also constraints and limits, of the developed method are exposed. Future works that can be carried out subsequent to the results of the study are also presented. Chapter 10, the last chapter of this thesis, proposes a strategy to incorporate the model developed in the last chapters into the traditional signature expertise procedures. Thus, the strength of this expertise is discussed in conjunction with the traditional conclusions reached by forensic handwriting examiners in forensic science. Finally, this chapter summarizes and advocates a list of formal recommendations for good practices for handwriting examiners. In conclusion, the research highlights the interdisciplinary aspect of signature examination of signatures on paintings. The current state of knowledge of the judicial quality of art experts, along with the scientific and historical analysis of paintings and signatures, are overviewed to give the reader a feel of the different factors that have an impact on this particular subject. The temperamental acceptance of forensic signature analysis in court, also presented in the state of the art, explicitly demonstrates the necessity of a better recognition of signature expertise by courts of law. This general acceptance, however, can only be achieved by producing high quality results through a well-defined examination process. This research offers an original approach to attribute a painted signature to a certain artist: for the first time, a probabilistic model used to measure the discriminative potential between authentic and simulated painted signatures is studied. The opportunities and limits that lie within this method of scientifically establishing the authorship of signatures on works of art are thus presented. In addition, the second key contribution of this work proposes a procedure to combine the developed method into that used traditionally signature experts in forensic science. Such an implementation into the holistic traditional signature examination casework is a large step providing the forensic, judicial and art communities with a solid-based reasoning framework for the examination of signatures on paintings. The framework and preliminary results associated with this research have been published (Montani, 2009a) and presented at international forensic science conferences (Montani, 2009b; Montani, 2012).

Kankaanpään yhdyskuntalietteestä tehdyn kompostituotteen hyödyntämismahdollisuudet ja niiden taloudellisuus

Tämän diplomityön tarkoituksena on etsiä Kankaanpään yhdyskuntalietteestä kompostoidulle tuotteelle hyödyntämis- ja myyntimahdollisuuksia, joilla saataisiin lietteen käsittely kannattavaksi toiminnaksi. Työssä tarkastellaan eri hyödyntämisvaihtoehtojen sopivuutta Kankaanpäähän ja lasketaan eri vaihtoehtojen kannattavuutta. Lisäksi tarkastellaan kompostituotteen hyödyntämistä koskevaa lainsäädäntöä ja kompostituotteen hyödyntämisen nykytilannetta. Työssä on tutkittu eri mahdollisuuksia, joita lietteestä valmistetun kompostin hyödyntämiselle on olemassa ja näiden asettamia vaatimuksia. Hieman on myös tutkittu kirjallisuudesta kehitteillä olevia uusia hyödyntämismahdollisuuksia sekä hyödyntämistä rajoittavia tekijöitä. Esimerkkilaitosten pohjalta on puolestaan tutustuttu käytännössä kompostituotteen tämän hetkiseen hyödyntämiseen ja toiminnan kaupalliseen puoleen. Kankaanpään kompostointilaitoksen mahdollisuuksiin on perehdytty tarkastelemalla Kankaanpään alueellisia seikkoja kuten elinkeinorakennetta, polttolaitoksia, tulossa olevia rakennuskohteita sekä naapurikuntien tilannetta. Näiden sekä kompostointilaitoksen tietojen pohjalta on lähdetty miettimään Kankaanpäälle sopivimpia hyödyntämisvaihtoehtoja ottaen huomioon myös tuotteen laatu. Vaihtoehdoille on laskettu kustannuksia laitokselle tarvittavien uudistusten ja muutosten mukaan ja niiden sekä oletettujen markkinanäkymien pohjalta on koottu kassavirtalaskelmia. Näiden laskelmien pohjalta on saatu Kankaanpäälle sopivimmiksi vaihtoehdoiksi koko kompostimäärän myynti irtotuotteena viherrakennukseen maanparannusaineena tai valmiina kasvualustana tai vaihtoehtoisesti osan tuotteesta pussittaminen kasvualustana tai rakeistettuna ja lopun kompostin myynti irtotuotteena viherrakennukseen. Tuotteen arvoa voidaan nostaa hyvän palvelun kautta eli esimerkiksi tarjoamalla kuljetusta kompostille, laajalla tuotevalikoimalla ja tuotteen korkealla laadulla.