Au sortir de l'hôpital, comment renforcer la continuité de la prise en charge médicale [Discharge from hospital: how to improve continuity of medical care?].

Early readmission is the major success indicator of the transition between hospital and home. Patients admitted with heart failure reach a 20% rate. Potentially avoidable readmissions, defined as unpredictable and related to a known condition during index hospitalization, represent the improvement margin. For these latter, implementation of specific interventions can be effective. Complex interventions on transition, including several modalities and seeking to encourage patient autonomy seem more effective than others. We describe two models: a pragmatic one developed in a regional hospital, and a more complex one developed in a university hospital during the LEAR-HF study. In both cases, it is imperative to work on "medical liability": should it extend beyond discharge up to the threshold of the private practice?

ÉVALUATION DE LA PÉNIBILITÉ DE LA PRISE EN CHARGE DES PATIENTS SOUFFRANT DE TROUBLES PSYCHIQUES EN MILIEU PÉNITENTIAIRE

Contexte: Les Établissements de la Plaine de l'Orbe accueillent des patients souffrant de troubles psychiques sévères et incarcérés sous le coup d'une mesure pénale ou y purgeant une peine. Dans le cadre d'une étude des besoins, l'équipe du Service de Médecine et Psychiatrie Pénitentiaire (SMPP) souhaite développer un outil permettant d'évaluer la pénibilité de la prise en charge de ces patients difficiles. Il y a en effet dans ce contexte, une nécessité d'améliorer l'offre de soins qui est actuellement limitée. Ceci dans la perspective de l'ouverture en 2016 d'un Etablissement de Réinsertion Sécurisée (ERS) sur le site de Cery et de la création d'un Centre de Soins aux Etablissements de la Plaine de l'Orbe à l'horizon 2018. Objectifs: Déterminer les différents critères définissant la pénibilité Élaborer un outil pratique, facilement utilisable en clinique permettant d'évaluer la pénibilité d'un patient ou d'une cohorte L'outil devra avoir une utilité à un niveau individuel (meilleure représentation des problématiques d'un patient, évolutivité de la situation) ainsi que sur une cohorte de patients (aide à l'évaluation des ressources nécessaires ou à l'évaluation de la charge de travail pour une équipe)

Identification of metabolites and thermal transformation products of quinolones in raw cow milk by liquid chromatography coupled to high resolution mass spectrometry

The presence of residues of antibiotics, metabolites, and thermal transformation products (TPs), produced during thermal treatment to eliminate pathogenic microorganisms in milk, could represent a risk for people. Cow"s milk samples spiked with enrofloxacin (ENR), ciprofloxacin (CIP), difloxacin (DIF), and sarafloxacin (SAR) and milk samples from cows medicated with ENR were submitted to several thermal treatments. The milk samples were analyzed by liquid chromatography-mass spectrometry (LC-MS) to find and identify TPs and metabolites. In this work, 27 TPs of 4 quinolones and 24 metabolites of ENR were found. Some of these compounds had been reported previously, but others were characterized for the first time, including lactose-conjugated CIP, the formamidation reaction for CIP and SAR, and hydroxylation or ketone formation to produce three different isomers for all quinolones studied.

Análise de extratos de plantas por CCD: uma metodologia aplicada à disciplina "química orgânica"

extracts of the regional plants Annona squamosa and Annona muricata were analysed by silica gel thin-layer chromatography using adequate systems of solvents and spray reagents. Carbohydrates, amino acids, alkaloids, flavonoids and terpenoids were detected in both species. These data agree with those on the literature about phytochemistry of the Annonaceae.

Accounting for adsorption and desorption in Lattice Boltzmann simulations

We report a Lattice-Boltzmann scheme that accounts for adsorption and desorption in the calculation of mesoscale dynamical properties of tracers in media of arbitrary complexity. Lattice Boltzmann simulations made it possible to solve numerically the coupled Navier-Stokes equations of fluid dynamics and Nernst-Planck equations of electrokinetics in complex, heterogeneous media. With the moment propagation scheme, it became possible to extract the effective diffusion and dispersion coefficients of tracers, or solutes, of any charge, e.g., in porous media. Nevertheless, the dynamical properties of tracers depend on the tracer-surface affinity, which is not purely electrostatic and also includes a species-specific contribution. In order to capture this important feature, we introduce specific adsorption and desorption processes in a lattice Boltzmann scheme through a modified moment propagation algorithm, in which tracers may adsorb and desorb from surfaces through kinetic reaction rates. The method is validated on exact results for pure diffusion and diffusion-advection in Poiseuille flows in a simple geometry. We finally illustrate the importance of taking such processes into account in the time-dependent diffusion coefficient in a more complex porous medium.

Extração e pré-concentração de compostos orgânicos voláteis por permeação em membrana para análise cromatográfica

This work discusses sample preparation processes for gas chromatography (GC) based on the technique of extraction through membrane permeation (MPE). The MPE technique may be easily coupled to GC via a relatively simple device, which is a module that holds the membrane and is directly connected to the GC column. The possibility of operational errors due to sample handling is substantially reduced in an MPE-GC system because the sample preparation and the chemical analysis are accomplished as a one-step process. The MPE technique is of relatively wide application as it can be used for aqueous samples, solid samples and gaseous samples. Depending on the type of sample the extraction is performed with the membrane in direct contact with the sample or in contact with its headspace. The MPE-GC technique is very useful in trace analysis, due to the time-dependent enrichment of the analyte. A typical application of MPE-GC is the analysis of VOCs present in water that may be accomplished with detection limits at the low ppb (mugL-1) level.

Identification of metabolites and thermal transformation products of quinolones in raw cow milk by liquid chromatography coupled to high resolution mass spectrometry.

The presence of residues of antibiotics, metabolites, and thermal transformation products (TPs), produced during thermal treatment to eliminate pathogenic microorganisms in milk, could represent a risk for people. Cow"s milk samples spiked with enrofloxacin (ENR), ciprofloxacin (CIP), difloxacin (DIF), and sarafloxacin (SAR) and milk samples from cows medicated with ENR were submitted to several thermal treatments. The milk samples were analyzed by liquid chromatography-mass spectrometry (LC-MS) to find and identify TPs and metabolites. In this work, 27 TPs of 4 quinolones and 24 metabolites of ENR were found. Some of these compounds had been reported previously, but others were characterized for the first time, including lactose-conjugated CIP, the formamidation reaction for CIP and SAR, and hydroxylation or ketone formation to produce three different isomers for all quinolones studied.

Garvey-Kelson relations for nuclear charge radii

The Garvey-Kelson relations (GKRs) are algebraic expressions originally developed to predict nuclear masses. In this letter we show that the GKRs provide a fruitful framework for the prediction of other physical observables that also display a slowly-varying dynamics. Based on this concept, we extend the GKRs to the study of nuclear charge radii. The GKRs are tested on 455 out of the approximately 800 nuclei whose charge radius is experimentally known. We find a rms deviation between the GK predictions and the experimental values of only 0.01 fm. This should be contrasted against some of the most successful microscopic models that yield rms deviations almost three times as large. Predictions -with reliable uncertainties- are provided for 116 nuclei whose charge radius is presently unknown.

Simulations of 3D Stripixel Detectors

Large Hadron Collider (LHC) is the main particle accelerator at CERN. LHC is created with main goal to search elementary particles and help science investigate our universe. Radiation in LHC is caused by charged particles circular acceleration, therefore detectors tracing particles in existed severe conditions during the experiments must be radiation tolerant. Moreover, further upgrade of luminosity (up to 1035 cm-2s-1) requires development of particle detector’s structure. This work is dedicated to show the new type 3D stripixel detector with serious structural improvement. The new type of radiation-hard detector has a three-dimensional (3D) array of the p+ and n+ electrodes that penetrate into the detector bulk. The electrons and holes are then collected at oppositely biased electrodes. Proposed 3D stripixel detector demonstrates that full depletion voltage is lower that that for planar detectors. Low depletion voltage is one of the main advantages because only depleted part of the device is active are. Because of small spacing between electrodes, charge collection distances are smaller which results in high speed of the detector’s response. In this work is also briefly discussed dual-column type detectors, meaning consisting both n+ and p+ type columnar electrodes in its structure, and was declared that dual-column detectors show better electric filed distribution then single sided radiation detectors. The dead space or in other words low electric field region in significantly suppressed. Simulations were carried out by using Atlas device simulation software. As a simulation results in this work are represented the electric field distribution under different bias voltages.

Desenvolvimento de um micro-aquecedor para sistemas de análise química em fluxo: determinação espectrofotométrica de manganês em plantas

In this work a micro-heater device to be used as an integral part of the flow analysis manifold is described. The usefulness of the device was demonstrated using it in the development of a multicommutated flow analysis procedure for the spectrophotometric determination of manganese in plant digest. The method was based on the manganese oxidation by periodate in phosphoric acid medium to form the permanganate anion. The reaction development is dependent on the temperature and it was observed that at 25 °C a time interval of ca. 15 min was necessary for the reaction to attain equilibrium. Setting the temperature to 70 ºC, this time interval could be decreased to ca. 30 s. This condition was easily attained employing the proposed micro-heater device coupled to the manifold. The procedure was applied to manganese determination in soybean digests and results compared with those obtained by inductively coupled argon plasma optical emission spectrometry (ICP-OES). No significant difference at 90% confidence level was observed. A linear response for sample concentrations ranging from 5.0 to 30.00 mg L-1 Mn2+; a relative standard deviation of 1.3% (n = 6) for a typical sample containing 6.3 mg L-1 Mn2+; a sampling rate of 22 determinations per hour; a low reagent consumption, of 12.0 mg NaIO4 per determination; and a detection limit of 1.2 mg L-1 were achieved.

Ultra-trace monitoring of copper in environmental and biological samples by inductively coupled plasma atomic emission spectrometry after separation and preconcentration by using octadecyl silica membrane disks modified by a new schiff's base

Ultra-trace amounts of Cu(II) were separated and preconcentrated by solid phase extraction on octadecyl-bonded silica membrane disks modified with a new Schiff,s base (Bis- (2-Hydroxyacetophenone) -2,2-dimethyl-1,3-propanediimine) (SBTD) followed by elution and inductively coupled plasma atomic emission spectrometric detection. The method was applied as a separation and detection method for copper(II) in environmental and biological samples. Extraction efficiency and the influence of sample matrix, flow rate, pH, and type and minimum amount of stripping acid were investigated. The concentration factor and detection limit of the proposed method are 500 and 12.5 pg mL-1, respectively.

Effect of long-range Coulomb interaction on shot-noise suppression in ballistic transport

We present a microscopic analysis of shot-noise suppression due to long-range Coulomb interaction in semiconductor devices under ballistic transport conditions. An ensemble Monte Carlo simulator self-consistently coupled with a Poisson solver is used for the calculations. A wide range of injection-rate densities leading to different degrees of suppression is investigated. A sharp tendency of noise suppression at increasing injection densities is found to scale with a dimensionless Debye length related to the importance of space-charge effects in the structure.

Lysine-based surfactants in nanovesicle formulations: the role of cationic charge position and hydrophobicity in in vitro cytotoxicity and intracellular delivery

Understanding nanomaterial interactions within cells is of increasing importance for assessing their toxicity and cellular transport. Here, we developed nanovesicles containing bioactive cationic lysine-based amphiphiles, and assessed whether these cationic compounds increase the likelihood of intracellular delivery and modulate toxicity. We found different cytotoxic responses among the formulations, depending on surfactant, cell line and endpoint assayed. The induction of mitochondrial dysfunction, oxidative stress and apoptosis were the general mechanisms underlying cytotoxicity. Fluorescence microscopy analysis demonstrated that nanovesicles were internalized by HeLa cells, and evidenced that their ability to release endocytosed materials into cell cytoplasm depends on the structural parameters of amphiphiles. The cationic charge position and hydrophobicity of surfactants determine the nanovesicle interactions within the cell and, thus, the resulting toxicity and intracellular behavior after cell uptake of the nanomaterial. The insights into some toxicity mechanisms of these new nanomaterials contribute to reducing the uncertainty surrounding their potential health hazards.

Flow analysis by using solenoid valves for As(III) determination in natural waters by an on-line separation and pre-concentration system coupled to a tungsten coil atomizer

A flow system coupled to a tungsten coil atomizer in an atomic absorption spectrometer (TCA-AAS) was developed for As(III) determination in waters, by extraction with sodium diethyldithiocarbamate (NaDDTC) as complexing agent, and by sorption of the As(III)-DDTC complex in a micro-column filled with 5 mg C18 reversed phase (10 µL dry sorbent), followed by elution with ethanol. A complete pre-concentration/elution cycle took 208 s, with 30 s sample load time (1.7 mL) and 4 s elution time (71 µL). The interface and software for the synchronous control of two peristaltic pumps (RUN/ STOP), an autosampler arm, seven solenoid valves, one injection valve, the electrothermal atomizer and the spectrometer Read function were constructed. The system was characterized and validated by analytical recovery studies performed both in synthetic solutions and in natural waters. Using a 30 s pre-concentration period, the working curve was linear between 0.25 and 6.0 µg L-1 (r = 0.9976), the retention efficiency was 94±1% (6.0 µg L-1), and the pre-concentration coefficient was 28.9. The characteristic mass was 58 pg, the mean repeatability (expressed as the variation coefficient) was 3.4% (n=5), the detection limit was 0.058 µg L-1 (4.1 pg in 71 µL of eluate injected into the coil), and the mean analytical recovery in natural waters was 92.6 ± 9.5 % (n=15). The procedure is simple, economic, less prone to sample loss and contamination and the useful lifetime of the micro-column was between 200-300 pre-concentration cycles.