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Les ordinateurs de poche ont le potentiel de devenir un outil de travail indispensable pour le médecin praticien. De part une facilité d'utilisation toujours plus grande, un format ultra-portable, une grande capacité de stockage de l'information et de synchronisation à de multiples bases de données, ils permettent l'accès en tout temps et littéralement au lit du malade à une gamme complète de ressources médicales. Cet article se veut une lllustration des différentes possibilités d'utilisation de ces nouveaux outils, au travers de situations cliniques banales rencontrées par tout praticien.

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Therapeutic drug monitoring (TDM), i. e., the quantification of serum or plasma concentrations of medications for dose optimization, has proven a valuable tool for the patient-matched psychopharmacotherapy. Uncertain drug adherence, suboptimal tolerability, non-response at therapeutic doses, or pharmacokinetic drug-drug interactions are typical situations when measurement of medication concentrations is helpful. Patient populations that may predominantly benefit from TDM in psychiatry are children, pregnant women, elderly patients, individuals with intelligence disabilities, forensic patients, patients with known or suspected genetically determined pharmacokinetic abnormalities or individuals with pharmacokinetically relevant comorbidities. However, the potential benefits of TDM for optimization of pharmacotherapy can only be obtained if the method is adequately integrated into the clinical treatment process. To promote an appropriate use of TDM, the TDM expert group of the Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrie (AGNP) issued guidelines for TDM in psychiatry in 2004. Since then, knowledge has advanced significantly, and new psychopharmacologic agents have been introduced that are also candidates for TDM. Therefore the TDM consensus guidelines were updated and extended to 128 neuropsychiatric drugs. 4 levels of recommendation for using TDM were defined ranging from "strongly recommended" to "potentially useful". Evidence-based "therapeutic reference ranges" and "dose related reference ranges" were elaborated after an extensive literature search and a structured internal review process. A "laboratory alert level" was introduced, i. e., a plasma level at or above which the laboratory should immediately inform the treating physician. Supportive information such as cytochrome P450 substrate- and inhibitor properties of medications, normal ranges of ratios of concentrations of drug metabolite to parent drug and recommendations for the interpretative services are given. Recommendations when to combine TDM with pharmacogenetic tests are also provided. Following the guidelines will help to improve the outcomes of psychopharmacotherapy of many patients especially in case of pharmacokinetic problems. Thereby, one should never forget that TDM is an interdisciplinary task that sometimes requires the respectful discussion of apparently discrepant data so that, ultimately, the patient can profit from such a joint effort.

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BACKGROUND: Excessive drinking is a major problem in Western countries. AUDIT (Alcohol Use Disorders Identification Test) is a 10-item questionnaire developed as a transcultural screening tool to detect excessive alcohol consumption and dependence in primary health care settings. OBJECTIVES: The aim of the study is to validate a French version of the Alcohol Use Disorders Identification Test (AUDIT). METHODS: We conducted a validation cross-sectional study in three French-speaking areas (Paris, Geneva and Lausanne). We examined psychometric properties of AUDIT as its internal consistency, and its capacity to correctly diagnose alcohol abuse or dependence as defined by DSM-IV and to detect hazardous drinking (defined as alcohol intake >30 g pure ethanol per day for men and >20 g of pure ethanol per day for women). We calculated sensitivity, specificity, positive and negative predictive values and Receiver Operator Characteristic curves. Finally, we compared the ability of AUDIT to accurately detect "alcohol abuse/dependence" with that of CAGE and MAST. RESULTS: 1207 patients presenting to outpatient clinics (Switzerland, n = 580) or general practitioners' (France, n = 627) successively completed CAGE, MAST and AUDIT self-administered questionnaires, and were independently interviewed by a trained addiction specialist. AUDIT showed a good capacity to discriminate dependent patients (with AUDIT > or =13 for males, sensitivity 70.1%, specificity 95.2%, PPV 85.7%, NPV 94.7% and for females sensitivity 94.7%, specificity 98.2%, PPV 100%, NPV 99.8%); and hazardous drinkers (with AUDIT > or =7, for males sensitivity 83.5%, specificity 79.9%, PPV 55.0%, NPV 82.7% and with AUDIT > or =6 for females, sensitivity 81.2%, specificity 93.7%, PPV 64.0%, NPV 72.0%). AUDIT gives better results than MAST and CAGE for detecting "Alcohol abuse/dependence" as showed on the comparative ROC curves. CONCLUSIONS: The AUDIT questionnaire remains a good screening instrument for French-speaking primary care.

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The study reports a set of forty proteinogenic histidine-containing dipeptides as potential carbonyl quenchers. The peptides were chosen to cover as exhaustively as possible the accessible chemical space, and their quenching activities toward 4-hydroxy-2-nonenal (HNE) and pyridoxal were evaluated by HPLC analyses. The peptides were capped at the C-terminus as methyl esters or amides to favor their resistance to proteolysis and diastereoisomeric pairs were considered to reveal the influence of configuration on quenching. On average, the examined dipeptides are less active than the parent compound carnosine (βAla + His) thus emphasizing the unfavorable effect of the shortening of the βAla residue as confirmed by the control dipeptide Gly-His. Nevertheless, some peptides show promising activities toward HNE combined with a remarkable selectivity. The results emphasize the beneficial role of aromatic and positively charged residues, while negatively charged and H-bonding side chains show a detrimental effect on quenching. As a trend, ester derivatives are slightly more active than amides while heterochiral peptides are more active than their homochiral diastereoisomer. Overall, the results reveal that quenching activity strongly depends on conformational effects and vicinal residues (as evidenced by the reported QSAR analysis), offering insightful clues for the design of improved carbonyl quenchers and to rationalize the specific reactivity of histidine residues within proteins.

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There are a number of morphological analysers for Polish. Most of these, however, are non-free resources. What is more, different analysers employ different tagsets and tokenisation strategies. This situation calls for a simpleand universal framework to join different sources of morphological information, including the existing resources as well as user-provided dictionaries. We present such a configurable framework that allows to write simple configuration files that define tokenisation strategies and the behaviour of morphologicalanalysers, including simple tagset conversion.

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This work describes a simulation tool being developed at UPC to predict the microwave nonlinear behavior of planar superconducting structures with very few restrictions on the geometry of the planar layout. The software is intended to be applicable to most structures used in planar HTS circuits, including line, patch, and quasi-lumped microstrip resonators. The tool combines Method of Moments (MoM) algorithms for general electromagnetic simulation with Harmonic Balance algorithms to take into account the nonlinearities in the HTS material. The Method of Moments code is based on discretization of the Electric Field Integral Equation in Rao, Wilton and Glisson Basis Functions. The multilayer dyadic Green's function is used with Sommerfeld integral formulation. The Harmonic Balance algorithm has been adapted to this application where the nonlinearity is distributed and where compatibility with the MoM algorithm is required. Tests of the algorithm in TM010 disk resonators agree with closed-form equations for both the fundamental and third-order intermodulation currents. Simulations of hairpin resonators show good qualitative agreement with previously published results, but it is found that a finer meshing would be necessary to get correct quantitative results. Possible improvements are suggested.

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Tämän tutkimustyön kohteena on TietoEnator Oy:n kehittämän Fenix-tietojärjestelmän kapasiteettitarpeen ennustaminen. Työn tavoitteena on tutustua Fenix-järjestelmän eri osa-alueisiin, löytää tapa eritellä ja mallintaa eri osa-alueiden vaikutus järjestelmän kuormitukseen ja selvittää alustavasti mitkä parametrit vaikuttavat kyseisten osa-alueiden luomaan kuormitukseen. Osa tätä työtä on tutkia eri vaihtoehtoja simuloinnille ja selvittää eri vaihtoehtojen soveltuvuus monimutkaisten järjestelmien mallintamiseen. Kerätyn tiedon pohjaltaluodaan järjestelmäntietovaraston kuormitusta kuvaava simulaatiomalli. Hyödyntämällä mallista saatua tietoa ja tuotantojärjestelmästä mitattua tietoa mallia kehitetään vastaamaan yhä lähemmin todellisen järjestelmän toimintaa. Mallista tarkastellaan esimerkiksi simuloitua järjestelmäkuormaa ja jonojen käyttäytymistä. Tuotantojärjestelmästä mitataan eri kuormalähteiden käytösmuutoksia esimerkiksi käyttäjämäärän ja kellonajan suhteessa. Tämän työn tulosten on tarkoitus toimia pohjana myöhemmin tehtävälle jatkotutkimukselle, jossa osa-alueiden parametrisointia tarkennetaan lisää, mallin kykyä kuvata todellista järjestelmää tehostetaanja mallin laajuutta kasvatetaan.

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BACKGROUND AND STUDY AIMS: To summarize the published literature on assessment of appropriateness of colonoscopy for screening for colorectal cancer (CRC) in asymptomatic individuals without personal history of CRC or polyps, and report appropriateness criteria developed by an expert panel, the 2008 European Panel on the Appropriateness of Gastrointestinal Endoscopy, EPAGE II. METHODS: A systematic search of guidelines, systematic reviews, and primary studies regarding colonoscopy for screening for colorectal cancer was performed. The RAND/UCLA Appropriateness Method was applied to develop appropriateness criteria for colonoscopy in these circumstances. RESULTS: Available evidence for CRC screening comes from small case-controlled studies, with heterogeneous results, and from indirect evidence from randomized controlled trials (RCTs) on fecal occult blood test (FOBT) screening and studies on flexible sigmoidoscopy screening. Most guidelines recommend screening colonoscopy every 10 years starting at age 50 in average-risk individuals. In individuals with a higher risk of CRC due to family history, there is a consensus that it is appropriate to offer screening colonoscopy at < 50 years. EPAGE II considered screening colonoscopy appropriate above 50 years in average-risk individuals. Panelists deemed screening colonoscopy appropriate for younger patients, with shorter surveillance intervals, where family or personal risk of colorectal cancer is higher. A positive FOBT or the discovery of adenomas at sigmoidoscopy are considered appropriate indications. CONCLUSIONS: Despite the lack of evidence based on randomized controlled trials (RCTs), colonoscopy is recommended by most published guidelines and EPAGE II criteria available online (http://www.epage.ch), as a screening option for CRC in individuals at average risk of CRC, and undisputedly as the main screening tool for CRC in individuals at moderate and high risk of CRC.

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RESUME Les fibres textiles sont des produits de masse utilisés dans la fabrication de nombreux objets de notre quotidien. Le transfert de fibres lors d'une action délictueuse est dès lors extrêmement courant. Du fait de leur omniprésence dans notre environnement, il est capital que l'expert forensique évalue la valeur de l'indice fibres. L'interprétation de l'indice fibres passe par la connaissance d'un certain nombre de paramètres, comme la rareté des fibres, la probabilité de leur présence par hasard sur un certain support, ainsi que les mécanismes de transfert et de persistance des fibres. Les lacunes les plus importantes concernent les mécanismes de transfert des fibres. A ce jour, les nombreux auteurs qui se sont penchés sur le transfert de fibres ne sont pas parvenus à créer un modèle permettant de prédire le nombre de fibres que l'on s'attend à retrouver dans des circonstances de contact données, en fonction des différents paramètres caractérisant ce contact et les textiles mis en jeu. Le but principal de cette recherche est de démontrer que la création d'un modèle prédictif du nombre de fibres transférées lors d'un contact donné est possible. Dans le cadre de ce travail, le cas particulier du transfert de fibres d'un tricot en laine ou en acrylique d'un conducteur vers le dossier du siège de son véhicule a été étudié. Plusieurs caractéristiques des textiles mis en jeu lors de ces expériences ont été mesurées. Des outils statistiques (régression linéaire multiple) ont ensuite été utilisés sur ces données afin d'évaluer l'influence des caractéristiques des textiles donneurs sur le nombre de fibres transférées et d'élaborer un modèle permettant de prédire le nombre de fibres qui vont être transférées à l'aide des caractéristiques influençant significativement le transfert. Afin de faciliter la recherche et le comptage des fibres transférées lors des expériences de transfert, un appareil de recherche automatique des fibres (liber finder) a été utilisé dans le cadre de cette recherche. Les tests d'évaluation de l'efficacité de cet appareil pour la recherche de fibres montrent que la recherche automatique est globalement aussi efficace qu'une recherche visuelle pour les fibres fortement colorées. Par contre la recherche automatique perd de son efficacité pour les fibres très pâles ou très foncées. Une des caractéristiques des textiles donneurs à étudier est la longueur des fibres. Afin de pouvoir évaluer ce paramètre, une séquence d'algorithmes de traitement d'image a été implémentée. Cet outil permet la mesure de la longueur d'une fibre à partir de son image numérique à haute résolution (2'540 dpi). Les tests effectués montrent que les mesures ainsi obtenues présentent une erreur de l'ordre du dixième de millimètre, ce qui est largement suffisant pour son utilisation dans le cadre de cette recherche. Les résultats obtenus suite au traitement statistique des résultats des expériences de transfert ont permis d'aboutir à une modélisation du phénomène du transfert. Deux paramètres sont retenus dans le modèle: l'état de la surface du tissu donneur et la longueur des fibres composant le tissu donneur. L'état de la surface du tissu est un paramètre tenant compte de la quantité de fibres qui se sont détachées de la structure du tissu ou qui sont encore faiblement rattachées à celle-ci. En effet, ces fibres sont les premières à se transférer lors d'un contact, et plus la quantité de ces fibres par unité de surface est importante, plus le nombre de fibres transférées sera élevé. La longueur des fibres du tissu donneur est également un paramètre important : plus les fibres sont longues, mieux elles sont retenues dans la structure du tissu et moins elles se transféreront. SUMMARY Fibres are mass products used to produce numerous objects encountered everyday. The transfer of fibres during a criminal action is then very common. Because fibres are omnipresent in our environment, the forensic expert has to evaluate the value of the fibre evidence. To interpret fibre evidence, the expert has to know some parameters as frequency of fibres,' probability of finding extraneous fibres by chance on a given support, and transfer and persistence mechanisms. Fibre transfer is one of the most complex parameter. Many authors studied fibre transfer mechanisms but no model has been created to predict the number of fibres transferred expected in a given type of contact according to parameters as characteristics of the contact and characteristics of textiles. The main purpose of this research is to demonstrate that it is possible to create a model to predict the number of fibres transferred during a contact. In this work, the particular case of the transfer of fibres from a knitted textile in wool or in acrylic of a driver to the back of a carseat has been studied. Several characteristics of the textiles used for the experiments were measured. The data obtained were then treated with statistical tools (multiple linear regression) to evaluate the influence of the donor textile characteristics on the number of úbers transferred, and to create a model to predict this number of fibres transferred by an equation containing the characteristics having a significant influence on the transfer. To make easier the searching and the counting of fibres, an apparatus of automatic search. of fibers (fiber finder) was used. The tests realised to evaluate the efficiency of the fiber finder shows that the results obtained are generally as efficient as for visual search for well-coloured fibres. However, the efficiency of automatic search decreases for pales and dark fibres. One characteristic of the donor textile studied was the length of the fibres. To measure this parameter, a sequence of image processing algorithms was implemented. This tool allows to measure the length of a fibre from it high-resolution (2'540 dpi) numerical image. The tests done shows that the error of the measures obtained are about some tenths of millimetres. This precision is sufficient for this research. The statistical methods applied on the transfer experiment data allow to create a model of the transfer phenomenon. Two parameters are included in the model: the shedding capacity of the donor textile surface and the length of donor textile fibres. The shedding capacity of the donor textile surface is a parameter estimating the quantity of fibres that are not or slightly attached to the structure of the textile. These fibres are easily transferred during a contact, and the more this quantity of fibres is high, the more the number of fibres transferred during the contact is important. The length of fibres is also an important parameter: the more the fibres are long, the more they are attached in the structure of the textile and the less they are transferred during the contact.

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Objective: To assess the possibility of Dentists being able to screen patients with higher risk of vascular diseases. Materials: Kodak 8000C Orthopantomographer, eco-Doppler Logiq-500 General Electric at the Lisbon Hospital Particular. Methods: Assessment of orthopantomographies made to 142 patients aged 50 or more, as well as the existing risk factors. Conduction of carotid eco-Doppler to patients who appear to have calcified plaques of the atheroma. Results: Strong dependence between dichotomised age and having the pathology (p = 0.02).Smokers are twice more likely to present plaques (OR= 2). Being hypertensive increases in about 1.4 the likelihood of having a stroke (OR= 1.4). Of the 27 individuals who presented calcifications in the Orthopantomography, they were all submitted to an eco-Doppler and 21 had the pathology confirmed. 27 individuals, who did not show any plaques in the Orthopantomography, were randomly selected to be the control group. They were submitted to an eco-Doppler. And 23 confirmed the non-existence of plaques. Conclusions: Orthopantomography used for assessing the oral cavity reveals more information which should be the object of the Dentist"s attention

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In this master's thesis a mechanical model that is driven with variable speed synchronous machine was developed. The developed mechanical model simulates the mechanics of power transmission and its torsional vibrations. The mechanical model was developed for the need of the branched mechanics of a rolling mill and the propulsion system of a tanker. First, the scope of the thesis was to clarify the concepts connected to the mechanical model. The clarified concepts are the variable speed drive, the mechanics of power transmission and the vibrationsin the power transmission. Next, the mechanical model with straight shaft line and twelve moments of inertia that existed in the beginning was developed to be branched considering the case of parallel machines and the case of parallel rolls. Additionally, the model was expanded for the need of moreaccurate simulation to up to thirty moments of inertia. The model was also enhanced to enable three phase short circuit situation of the simulated machine. After that the mechanical model was validated by comparing the results of the developed simulation tool to results of other simulation tools. The compared results are the natural frequencies and mode shapes of torsional vibration, the response of the load torque step and the stress in the mechanical system occurred by the permutation of the magnetic field that is arisen from the three phase short circuit situation. The comparisons were accomplished well and the mechanical model was validated for the compared cases. Further development to be made is to develop the load torque to be time-dependent and to install two frequency converters and two FEM modeled machines to be simulated parallel.