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Ayurveda speaks the main cause of diseases is rooted in the impairment of the body's main fire, calledAgni, the fire of digestion. Ayurveda views the health of the body as the functioning of a biological fire-governing metabolism. If this essential part is functioning effectively,the whole body will be nourished, full of life and vibrancy. Altered digestive functioning can lead to the production ofAma, a toxic material that initiates and promotes disease processes throughout the body. In the same way, free radicals are also found to be the root cause of many diseases. The majority of free radicals that dAmage biological systems are oxygen-free radicals, and these are more generally known as “Reactive Oxygen Species” (ROS). These are the main by-products formed in the cells of aerobic organisms, and can initiate autocatalytic reactions so that molecules to which they react are themselves converted into free radicals to propagate the chain of dAmage. Here we shall discuss about properties of bothAmaand Free Radicals. The present article attempts to correlate the concept of Free radical with the concept ofAma.

The Hispanic/Latinx Inclusive Terminologies Project was in response to a series of calls to action by the Medical Library Association's Latinx Caucus in the summer of 2020. This endeavor included two project teams that reviewed Hispanic/Latinx terminology specific to the United States as a way to help capture and recognize the diversity of this population. Each team had two project leads, subject matter experts/mentors in residence and project members that were members of MLA and/or library/academic partners. Recognizing the labor that was undertaken by BIPOC information professionals on this project, this work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Amavatais one of the crippling diseases. It is the systemic disorder in which pathogenic constituents are mainlyAamaandVata. The symptoms ofAmavataare identical to Rheumatoid arthritis and Rheumatic fever. According to Ayurveda,Amavatais the disease which is mentioned under the category ofVata- Kaphaja vyadhi. Research has proven that Ayurvedic treatment is effective in the management ofAmavata. Present case study was done on the female patient ofAmavata, we found that Ayurvedic medicines improveJatharagniand leads to the formation of otherDhatuas well as stop the formationAam. In this study, patient is having many complaints such as B/L knee joint pain & joint stiffness, local warmness & swelling over both knee, anorexia, dryness of mouth, fever (on & off ) etc. Patient was given Ayurvedic medicines such asSihnad Guggul, AmavatariRasa, Erand snehaandShunthi jalwith local application ofVishagarbha tailandWaluka pottali Sweda. Patient was feeling much better than earlier and she felt that about 80% of her symptoms got decreased. From the modern aspect, the non-steroidal anti-inflammatory drugs (NSAID`S) and disease modifying anti-rheumatic drugs (DMARD`S) are the main stay in this condition, however they have serious adverse effects and have limitations for long term therapy. Continuous use of allopathic drugs leads to symptoms like constipation, nausea, abdominal discomfort. So we stopped the allopathic medicine and started above mentioned Ayurvedic treatment and gradually alleviated above symptoms.

Amavatais a disease caused due to the vitiation or aggravation ofVayuassociated withAma. VitiatedVayucirculates theAmaall over the body throughDhamanies, takes shelter in theShleshma Sthana (Amashaya, Sandhi, etc.), producing symptoms such as stiffness, swelling, and tenderness in small and big joints, making a person lame. The symptoms ofAmavataare identical to rheumatism, which include rheumatoid arthritis and rheumatic fever. It is observed that rheumatism is an autoimmune disorder, which is among the collagen disorders having strong and significant parlance withAmavata. Various drug trials were already carried out onAmavata, yet there is alacunain the management ofAmavata.Rheumatoid arthritis (RA), an auto-immune inflammatory disease is one of the challenging conditions for the physicians to handle due to its chronicity, incurability, complications, morbidity, etc. In spite of potent anti-inflammatory agents and powerful immune-suppressive agents, its prognosis is not good, as these drugs have certain limitations including dependency and other side effects restricting quality of life. Considering these inconveniences, alternatives are being searched from traditional systems. Ayurveda through its armamentarium can provide leads in the management of this condition that is similar toAmavatain its clinical presentation. A 42-year-old female with diagnosed history of RA was treated byAyurvedic medicines then improvement was observed in the overall effect of therapy.

In this thesis, I focus on two main identities and two main women’s organizations that I considered important for the development of a feminist challenge to the patriarchal society of 1930’s Spain. The two main identities and roles I focused on were the miliciana and the mother. Through an in-depth analysis of both roles, I explain how the war afforded women a new opportunity to challenge normative understandings of womanhood and how they performed their gender. Though seemingly at odds with each other, both the miliciana and the mother serve to further open society for women, allowing them to embody a new idea of what it meant to be a woman. In this thesis I also analyze two women’s organizations: the Agrupación de Mujeres Antifascistas (AMA) and the Mujeres Libres organization. By understanding and analyzing the main mission of both organizations, I explain how –like with the miliciana and the mother— women also had options in how and with who they participated. I argue that although these two organizations differed in their ideology –one for a social revolution now and the other for a social revolution later—their praxis was very similar and indicative of a communal effort by all women to challenge normative understandings of women’s involvement in politics, especially during this tumultuous time. In sum, this thesis approaches already established authors and their works in a way that explains how the image and practice of womanhood changed at the advent of the war.

Dans le moment précédent de notre réflexion, nous avons cherché à mettre au jour l’existence d’une tension structurant de l’intérieur la conception corbuséenne de la nature de l’architecture. Cette tension peut être exprimée en termes normatifs selon une articulation entre ce qui, d’une part relève de plein droit de la recherche réglée de normes et, d’autre part, ce qui nécessairement excède le domaine de la norme et que nous avons choisi de désigner d’un terme générique, à savoir le « hors-n...

Le Corbusier est un architecte qui non seulement construit, mais qui n’a de cesse de dire comment on doit construire. À travers une étude patiente et détaillée des textes de l’architecte, c’est la vision philosophique globale et paradoxale de l’un des grands créateurs de la modernité qui est rendue dans la multiplicité de ses dimensions et dans la complexité de son projet. Pour ce faire, l’ouvrage reprend à nouveaux frais de nombreuses questions récurrentes au sujet de Le Corbusier : reproche de dogmatisme ; d’application aveugle de recettes insensibles à la singularité des contextes ou des usages ; autoritarisme ; formulation d’une doctrine fonctionnaliste, etc. Sans tomber dans un exercice d’admiration stérile, il s’agit ici de faire justice à une expérience de pensée riche et complexe, en montrant que le parcours de Le Corbusier forme un système vivant, faisant place à ce qui excède les procédures de normalisation, dessinant ainsi le visage singulier d’une tentative de production normative du hors-norme.

Dans la perspective d’une interrogation systématique de la problématique de la norme dans l’œuvre de Le Corbusier, le rapport qu’entretient l’architecte à l’histoire fait figure de point nodal, à la fois décisif et difficultueux. En effet, si toute l’œuvre de Le Corbusier apparaît comme une tentative de refondation radicale de la discipline architecturale sur des bases normatives nouvelles, toute aspiration révolutionnaire va à l’encontre d’un état de fait préexistant dans lequel elle s’inscr...

Dans cette troisième partie de notre travail, nous chercherons à montrer comment, à partir des grands manifestes, Le Corbusier reconnaîtra dans sa définition de l’architecture, une tension structurant l’ensemble de sa recherche. Le concept de beauté sera ici absolument central. Si tant est que l’architecture (à la différence de la simple construction) a pour objectif spécifique la production du beau, comment comprendre l’idée même d’une telle « production » de ce qui, de l’aveu même de l’arch...

L’opposition de Le Corbusier à la production architecturale de son temps, caractérisée par un académisme reposant sur un type de normativité imposant l’imitation formelle des styles hérités du passé, reposait pour une part sur sa conception d’un juste rapport à l’histoire en général. Mais, d’autre part et de manière tout aussi décisive, son rejet des normes anciennes était également très largement fondé sur des raisons relevant cette fois du constat de l’inadéquation foncière de la production...

Accurate modeling of damping effects in high-end MEMS devices is a major challenge due to low feature sizes and complex device geometries. By applying a finite network approach with specially derived compact models, we are able to simulate structures with varying perforation patterns and account for the impact of the transition regions between differently perforated areas. Simulations of exemplary test structures with different perforation sizes and patterns prove the feasibility of our approach, which perspectively improves the accuracy of damping estimation beyond state of the art.

Dans l’une de ses remarques mêlées consacrée à l’architecture, Ludwig Wittgenstein, affirmait la chose suivante : « Souviens-toi de l’impression que t’a faite une bonne architecture, à savoir l’impression qu’elle exprime une pensée. On aimerait lui répondre par un geste. » Nous avons nous aussi choisi de répondre à l’architecture de Le Corbusier par un geste, analytique et critique, dont le fruit est ce travail concernant le problème de la norme dans son œuvre théorique. Que l’on admire ou qu...

Par quoi Le Corbusier entend-il positivement remplacer le régime normatif de l’académisme ? Avant que d’en venir à la description et à l’examen des normes corbuséennes à proprement parler, il s’agira de chercher à analyser, en deçà de l’acte descriptif comme tel, ce sur quoi se fonde et ce qui justifie aux yeux de l’architecte l’adoption d’un nouveau régime de normativité et d’un nouvel ensemble de normes venant se substituer à l’imitation formelle des architectures du passé. Si la volonté de...

« Il ressort des considérations sur la confusion esthétique qu’il est très facile de spéculer sur l’essence de l’art et très difficile, devant les œuvres elles-mêmes, d’avoir une compréhension pénétrante. […] Comprendre une grande manifestation et lui faire justice exige beaucoup. » Konrad Fiedler Lorsqu’au début des années vingt, le jeune Charles-Édouard Jeanneret s’est lancé dans la carrière architecturale en adoptant le pseudonyme de Le Corbusier, il s’est d’abord imposé sur la scène inter...

Dans le chapitre précédent, il a été question du motif fondamental de l’échelle humaine considéré comme « norme des normes » au sein du dispositif normatif corbuséen. Bien plus qu’un simple mot d’ordre ou qu’un concept-valise dont le contenu serait avant tout arrimé à des impératifs rhétoriques, la question de la refondation de la discipline architecturale autour de la prise en compte de l’échelle humaine est bien une préoccupation absolument centrale aux yeux de Le Corbusier. Du point de vue...

Most of the people experience digestive problems like constipation, diarrhoea, acid eructations, loss of appetite etc. at some stage of life. These are the acute conditions that appear due to Agnimandya (reduced power of digestion, assimilation and metabolism). Conditions that may cause Agnimandya includes changes in diet and lifestyle and chronic diseased conditions. When the Agnimandya or the conditions that may cause Agnimandya persist for longer duration it turns into a life threatening disease. When Doshas (body humours) get aggravated, they affect the Agni (Power of digestion, assimilation and metabolism) and thus the food taken is not digested properly forming the Ama (morbid material). Ama when formed is accumulated in the body over the period of time, forming roots of many diseases. In the present case study the patient has Agnimandya, because of the chronic metabolic conditions. The Agnimandya and consequent nutritional deficiencies are addressed, while preparing the treatment protocol. The central focus of Ayurvedic treatment is the management of Agni and the Ama. The diet was advised on the line of Samsarjana Krama (Sequential administration of liquid diet to normal diet to kindle the Agni or digestive power) and the effect of treatment was analysed after 1 month. The symptoms of the diseases were reduced along with the improvement in the Agni and the nutritional status.

Vägledningen vänder sig till projektörer och projektledare som arbetar med att rusta upp och underhålla befintlig järnväg. Den ger rekommendationer om hur en bärighetsutredning samt projektering och utförande av bärighetsförbättring av befintlig bana bör genomföras. Bristen på data från gamla banor gör att det krävs god järnvägsgeoteknisk erfarenhet för att utvärdera underlag, identifiera åtgärdssträckor och välja lämpliga åtgärder. Det handlar om att göra praktiska ingenjörsmässiga bedömningar, baserade på ett ofullständigt underlag. Vägledningen beskriver lämpliga konstruktionstekniska principer samt bakgrund och motiv till dem. Behovet av bärighetsförbättring ökar i takt med att järnvägsanläggningen ska klimatanpassas. Vägledningen rekommenderar en stegvis arbetsgång från inventering av befintlig information fram till uppföljning av utförda åtgärder. Den beskriver också den information som kan hämtas från Trafikverkets databaser och övriga informationskällor. Genom vägledningen implementeras resultat från ett forskningsprojekt som utfördes 2015–2018 på uppdrag av Trafikverket, med exempel från projektets åtgärder på sträckan mellan Frövi och Ställdalen. Texten baseras på rapporten Förbättring av bärighet hos befintliga järnvägsanläggningar – Teori och praktik (Dehlbom B, Håkansson S & Berggren E, Statens geotekniska institut, 2018).

Some authors have recently suggested that it is time to consider rights for robots. These suggestions are based on the claim that the question of robot rights should not depend on a standard set of conditions for ‘moral status’; but instead, the question is to be framed in a new way, by rejecting the is/ought distinction, making a relational turn, or assuming a methodological behaviourism. We try to clarify these suggestions and to show their highly problematic consequences. While we find the suggestions ultimately unmotivated, the discussion shows that our epistemic condition with respect to the moral status of others does raise problems, and that the human tendency to empathise with things that do not have moral status should be taken seriously—we suggest that it produces a “derived moral status”. Finally, it turns out that there is typically no individual in real AI that could even be said to be the bearer of moral status. Overall, there is no reason to think that robot rights are an issue now.

Nitrogen (N2) accumulation in the blood and tissues can occur due to breath-hold (BH) diving. Post-dive venous gas emboli have been documented in commercial BH divers (Ama) after repetitive dives with short surface intervals. Hence, BH diving can theoretically cause decompression illness (DCI). “Taravana,” the diving syndrome described in Polynesian pearl divers by Cross in the 1960s, is likely DCI. It manifests mainly with cerebral involvements, especially stroke-like brain attacks with the spinal cord spared. Neuroradiological studies on Ama divers showed symptomatic and asymptomatic ischemic lesions in the cerebral cortex, subcortex, basal ganglia, brainstem, and cerebellum. These lesions localized in the external watershed areas and deep perforating arteries are compatible with cerebral arterial gas embolism. The underlying mechanisms remain to be elucidated. We consider that the most plausible mechanisms are arterialized venous gas bubbles passing through the lungs, bubbles mixed with thrombi occlude cerebral arteries and then expand from N2 influx from the occluded arteries and the brain. The first aid normobaric oxygen appears beneficial. DCI prevention strategy includes avoiding long-lasting repetitive dives for more than several hours, prolonging the surface intervals. This article provides an overview of clinical manifestations of DCI following repetitive BH dives and discusses possible mechanisms based on clinical and neuroimaging studies.

Identification of changes in biochemical parameters of liver functional activity during screening studies requires additional examination of the patient in order to determine the genesis of the disease. In recent years, in routine practice, the most frequently used is an isolated definition of the level of transaminases (ALT, AST), which does not allow timely detection of latent cholestasis syndrome. Primary biliary cholangitis (PBC), previously referred to as primary biliary cirrhosis, is a relatively rare chronic autoimmune cholesthetic liver disease, predominantly affecting middle-aged women and prone to progressing liver cirrhosis. The recommendations of AASLD and EASL note the need for long-term monitoring of patients with ongoing UDCA therapy and regular diagnostic studies to identify signs of disease progression. A clinical example of successful treatment of a patient with PBC with the Russian drug Exhol® is described.

Précisément étudiés par les historiens du Moyen Âge et de la période contemporaine, les faubourgs demeurent assez méconnus à la période moderne : il s’agit ici de la première étude d’ampleur consacrée aux espaces suburbains de la modernité. Situés en dehors des limites de la ville, matérialisées le plus souvent par des fortifications ou des promenades, les faubourgs apparaissent pourtant essentiels au développement urbain. Loin de constituer des aires de relégation, ils étaient à l’époque moderne le lieu d’une réelle dynamique, concurrençant parfois les villes. À l’aide de nombreux fonds d’archives, l’auteur se penche sur les rapports complexes entre la ville, les faubourgs et les campagnes, dégageant peu à peu la spécificité et la diversité de ces territoires en marge. Par la variété des sources mobilisées et des approches adoptées (la démographie, les migrations, les secteurs économiques, les catégories socioprofessionnelles des faubouriens ou encore l’architecture), l’ouvrage déploie une fine analyse de ces espaces en mouvement constant, illustrant l’intérêt qu’ils présentent pour les recherches actuelles, dans une perspective tant historique que sociale.

Prioritization decisions using the Army Modernization and Analysis (AMA)-developed Trade-Space Decision Exploration System (TRADES) does not address programmatic variance related to cost and schedule growth. This study offers an improved methodology for modeling cost risk by employing sound cost estimation principles, distribution fitting, Monte Carlo simulations, and cost/benefit analysis to assist strategic decision makers and the acquisitions community. To that end, this approach follows a five-step methodology that (1) collects and screens cost data from the Cost Assessment Database Enterprise (CADE), (2) determines normalized cost growth factors, (3) identifies and constructs the appropriate distributions for modeling, (4) simulates cost variance among the entire program portfolio, and (5) recommends the necessary contingency cash reserve quantity associated with a decision maker’s confidence level. The result is a credible, repeatable, and effectual cost estimating methodology that promotes commodity-based models for predicting cost growth and measuring risk. Major, United States Army Approved for public release. Distribution is unlimited.

56 p. -- Bibliogr.: p. 23-26 Esparru kontzeptuala eta justifikazioa: Urtero jaioberri goiztiarren eta pixu baxukoen jaiotze tasak gero eta gehiago handitzen dira. Ondorioz, hauek, neonatologia unitateetan ospitaleratuak izaten dira, zainketa bereziak jaso ahal izateko. Honek osasun sisteman zein guraso eta jaioberriengan eragin desiragaitzak sortu ditzake; kostua, karga, estresa… Hau hobetzeko, kanguru metodoa nagusitzen da, jaioberriak gurasoen azal azaleko kontaktua izanik. Beraz, urteetan zehar teknikak onura ugari dituela ikusita, erizainentzako hau ezagutzea garrantzitsua litzateke zainketa egokiak eskaintzeko. Helburua: Kanguru metodoak neonatologia unitatean ospitaleratutako jaioberri eta gurasoengan duen eragina aztertzea. Metodologia: Helburua zehaztu eta hemendik kontzeptu nagusiak aukeratu dira. Ondoren, datu base desberdinak kontsultatu dira; Medline, CINHAL, IME, CUIDEN Cochrane Liburutegia eta RNAO. Eskuzko bilaketak ere egin dira, Elsevier eta Science Direct aldizkaiertan. Azkenean, barneratze eta kanporatze irizpideak eta irakurketa kritikoko gidoia kontutan izanik, 15 artikulu lortu dira, horietatik 8 entsegu kliniko, 3 ikerketa kuasi-esperimental, 3 ikerketa prospektibo eta kohortezko ikerketa bat. Emaitzak: Jaioberrien kasuan, metodoak prozedura mingarrien aurrean mina murrizten duela ikusteaz gain, minak eragindako erantzun fisiologikoak egonkortzen dituela ikusi da. Metodoari esker, edoskitze naturalaren luzapena, produkzioa handitzea eta jaioberrien parametro fisiologikoan egonkortzea lortu da (bihotz eta arnas maiztasuna murriztuz, eta tenperatura, pisu eta taila handituz). Gurasoei dagokienez, hauen ongizate psikologikoa eskuratzeko baliagarria dela frogatu da, estresa zein antsietatea murriztuz. Hiru banakoen arteko harremanak hobetu eta sendotzeko eragina duela ere ikusi da. Ondorioak: Kanguru metodoak eragin positibo ugari dituela ikusi da guraso zein jaioberriengan. Honako hau kontutan izanik, eragin positibo hauek batez ere epe laburrean oinarritzen dira. Hala ere, epe luzera dituen onurak aztertzen jarraitu beharra dagoela ikusi da. Horretarako, garrantzitsua da erizainek formakuntza egokia izatea, metodoa bultzatu, indartu eta ikustarazteko.

Current literature regarding systemic autoimmune diseases in X-chromosome aneuploidies is scarce and limited to case reports. Our aim was to evaluate the frequency of anti-nuclear (ANAs), extractable nuclear (ENA), anti-double-stranded DNA (dsDNAs), anti-smooth muscle (ASMAs) and anti-mitochondrial (AMAs) antibodies in a large cohort of adults with Klinefelter's syndrome (KS, 47,XXY) and rare higher-grade sex chromosome aneuploidies (HGAs) for the first time. Sera from 138 X-chromosome aneuploid patients [124 adult patients with 47,XXY KS and 14 patients with HGA (six children, eight adults)] and 50 age-matched 46,XY controls were recruited from the Sapienza University of Rome (2007–17) and tested for ANAs, ENAs, anti-dsDNAs, ASMAs and AMAs. Non-organ-specific immunoreactivity was found to be significantly higher in patients with 47,XXY KS (14%) than in the controls (2%, p = 0.002). Among all the antibodies investigated, only ANAs were observed significantly more frequently in patients with 47,XXY KS (12.1%) than in the controls (2%, p = 0.004). No anti-dsDNA immunoreactivity was found. Stratifying by testosterone replacement therapy (TRT), non-organ-specific autoantibody frequencies were higher in TRT-naive (p = 0.01) and TRT-treated groups than in controls. No patients with HGA were found positive for the various autoantibodies. Non-organ-specific autoantibodies were significantly present in 47,XXY adult patients. Conversely, HGAs did not appear to be target of non-organ-specific immunoreactivity, suggesting that KS and HGAs should be considered as two distinct conditions. The classification and diagnosis of systemic autoimmune diseases is frequently difficult. To support a correct clinical evaluation of KS disease and to prevent eventual secondary irreversible immune-mediated damages, we highlight the importance of screening for non-organ-specific autoimmunity in Klinefelter's syndrome.

Background & aims Obeticholic acid (OCA) is the second-line treatment approved for patients with primary biliary cholangitis (PBC) and an inadequate response or intolerance to ursodeoxycholic acid. We aimed to evaluate the effectiveness and safety of OCA under real-world conditions. Methods Patients were recruited into the Italian PBC Registry, a multicentre, observational cohort study that monitors patients with PBC at national level. The primary endpoint was the biochemical response according to Poise criteria; the secondary endpoint was the biochemical response according to normal range criteria, defined as normal levels of bilirubin, alkaline phosphatase (ALP), and alanine aminotransferase (ALT) at 12 months. Safety and tolerability were also assessed. Results We analysed 191 patients until at least 12 months of follow-up. Median age was 57 years, 94% female, 61 (32%) had cirrhosis, 28 (15%) had histologically proven overlap with autoimmune hepatitis (PBC-AIH). At 12 months, significant median reductions of ALP (-32.3%), ALT (-31.4%), and bilirubin (-11.2%) were observed. Response rates were 42.9% according to Poise criteria, and 11% by normal range criteria. Patients with cirrhosis had lower response than patients without cirrhosis (29.5% vs. 49.2%, p = 0.01), owing to a higher rate of OCA discontinuation (30% vs. 12%, p = 0.004), although with similar ALP reduction (29.4% vs. 34%, p = 0.53). Overlap PBC-AIH had a similar response to pure PBC (46.4% vs. 42.3%, p = 0.68), with higher ALT reduction at 6 months (-38% vs. -29%, p = 0.04). Thirty-three patients (17%) prematurely discontinued OCA because of adverse events, of whom 11 experienced serious adverse events. Treatment-induced pruritus was the leading cause of OCA discontinuation (67%). Conclusions Effectiveness and safety of OCA under real-world conditions mirror those in the Poise trial. Patients with cirrhosis had lower tolerability. Overlap PBC-AIH showed higher ALT reduction at 6 months compared with patients with pure PBC. Lay summary Obeticholic acid (OCA) was shown to be effective in more than one-third of patients not responding to ursodeoxycholic acid in a real-world context in Italy. Patients with cirrhosis had more side effects with OCA, and this led to suspension of the drug in one-third of patients. OCA was also effective in patients who had overlap between autoimmune hepatitis and primary biliary cholangitis., Graphical abstract, Highlights • Under real-world conditions, OCA was effective in ~43% of patients who were non-responders to UDCA, according to Poise criteria. • Patients with cirrhosis showed lower efficacy (29.5%), mainly attributed to reduced tolerability and higher discontinuation rate. • Patients with overlap AIH-PBC showed a comparable efficacy to pure PBC, with a higher ALT reduction at 6 months. • Most patients with PBC are still in need of additional therapy if aiming to normalise liver biochemistry.

The objective of this article is to discuss how the concept living with the drought is incorporated into the AMA mineral water brand project. Managed by the AMBEV brewery and with the slogan “more than a water, a cause” it proposes the use of its profit to finance the construction of cisterns, solar panels and water supply structures for poor communities throughout the Brazilian semiarid regions. Based on a mapping of partnerships, foundations and NGOs, the legitimization of AMA as a “Social business” is perceivable, the result of a double movement: first, it presents itself as a business trying to conciliate profit with social and environmental purpose, results from an absorption of the critics against the capitalism system in the central countries. Second, AMA’s proposal is aligned with criticisms on the State’s plan to combat droughts prevalent in the last century in Brazil. AMA thus inserts a “new spirit” of coexistence with the semiarid regions, of efficient and ideological legitimation: a proposal to live with droughts which has an elective affinity with values linked to foundations that are linked to the financial market and risk management startups. In the conclusions this article discusses a moral / market relationship and the kind of “hydric citizenship” that private initiatives such as AMA’s aim to take place the vacuum of a dismantling in the public policies made for the poor communities in the rural areas of the Brazilian semiarid.

Background: A patient decides to leave the hospital against medical advice. Is this an erratic eccentric behavior of the patient, or a gap in the quality of care provided by the hospital? With a significant and increasing prevalence of up to 1–2% of all hospital admissions, leaving against medical advice affects both the patient and the healthcare provider. We hereby explore this persistent problem in the healthcare system. We searched Medline and PubMed within the last 10 years, using the keywords “discharge against medical advice,” “DAMA,” “leave against medical advice,” and “AMA.” We retrospectively reviewed 49 articles in our project. Ishikawa fishbone root cause analysis (RCA) was employed to explore reasons for leaving against medical advice (AMA). This report presents the results of the RCA and highlights the consequences of discharge against medical advice (DAMA). In addition, the article explores preventive strategies, as well as interventions to ameliorate leaving AMA.

Many of the most recent publications in the embedded MPC field choose to use first-order algorithms as a solution to the complexity of accelerating second-order algorithms in systems with restricted computing resources. Thus, the purpose of this project consist on evaluating the response of these first order algorithms and compare their performance with second-order algorithms to have consistent criteria to design specific accelerators optimized in the development of SoCs with application to the high performance embedded MPC. To aim this objective, the first part of the text focuses on explaining a background needed to understand the approach of the optimization algorithms in the solution of a reformulated MPC problem arising from a state-space model. In this chapter, definitions such as Shift and Delta discretisation, System Variable and Dynamics Stacking, and Sparse and Dense formulation are explained. Once the related background is presented, it is analysed in detail the application to the MPC of the most current and efficient first order algorithms, making a study of the proposals published in recent years. In this section, definitions such as optimality, stopping conditions and convergence will be taken into account. After this analysis, the application of these algorithms will be adapted to different MPC formulation options where it will be evaluated their computational performance in different scenarios. Lastly, the results obtained of the previous evaluation will be compared with the performance of the second order algorithms, particularly using a simplified Interior Point which it is optimised for an embedded MPC implementation. This comparison will allow to take appropriate design decisions in the implementation of MPC in embedded systems considering aspects such as hardware simplicity, computational performance and numerical characteristics. Laburpena: MPC txertatuaren arloko argitalpen berrienetako askok lehen mailako algoritmoak erabiltzen dituzte baliabide informatiko mugatuak dituzten sistemetan bigarren mailako algoritmoen azelerazioaren konplexutasunari aurre egiteko. Beraz, proiektu honen helburua lehen mailako algoritmo horien erantzuna ebaluatzea eta haien errendimendua bigarren mailako algoritmoekin alderatzen da. Horrela, eraginkortasun handiko MPC kontrolagailu txertatuak gauzatzeko SoC arkitektura berriak diseinatzeko beharrezkoak diren azeleragailuak diseinatzeko irizpideak lortu nahi dira. Helburu hori lortzeko, lan honen lehen atalean, egoera-espazioko eredutik sortzen den birformulatutako MPC problemen ebazpenerako beharrezko diren optimizazioalgoritmoen planteamendua ulertzeko beharrezkoak diren aurrekariak azaltzen dira. Kapitulu honetan, zenbait definizio azaltzen dira, hala nola Shift eta Delta diskretizazioa, aldagaien eta sistemen dinamikaren pilaketa, eta formulazio trinko eta sakabanatuak. Aurrekariak aurkeztu ondoren, lehen mailako algoritmo berri eta eraginkorrenak MPC-aren arloan nola aplikatu diren aztertzen da, horretarako azken urteetako argitalpen zientifikoetan agertutako proposamenak aztertuz. Atal honetan optimizazioa, bukaera-baldintzak eta konbergentzia bezalako kontzeptuak kontuan hartuko dira. Ondoren, algoritmo horien aplikazioa MPCren formulazio-aukera desberdinetara egokituko da, haien errendimendu konputazionala hainbat egoera esanguratsuetan ebaluatuz. Azkenik, aurreko ebaluaziotik lortutako emaitzak bigarren mailako algoritmoen errendimenduarekin konparatuko dira, bereziki sistema txertatuetan erabiltzeko optimizatua izan den IP (Interior Point) algoritmo sinplifikatu bat erabilita, MPC txertatua ezartzeko optimizatuta dagoena. Konparazio horri esker, diseinu-erabaki egokiak hartu ahal izango dira sistema txertatuetan MPCa ezartzeko, ondorengo alderdi hauek kontuan hartuta: hardwarearen sinpletasuna, errendimendu konputazionala eta zenbakizko ezaugarriak. Resumen: Muchas de las publicaciones más recientes en el campo del MPC embebido optan por utilizar algoritmos de primer orden como solución a la complejidad de la aceleración de los algoritmos de segundo orden en sistemas con recursos informáticos restringidos. Por lo tanto, el propósito de este proyecto consiste en evaluar la respuesta de estos algoritmos de primer orden y comparar su rendimiento con los algoritmos de segundo orden con la finalidad de tener criterios consistentes para diseñar aceleradores específicos optimizados en el desarrollo de SoCs con aplicación al MPC embebido de alto rendimiento. Para lograr este objetivo, la primera parte del texto se centra en explicar los antecedentes necesarios para entender el enfoque de los algoritmos de optimización en la solución de un problema de MPC reformulado que surge de un modelo en espacio de estados. En este capítulo, se explican definiciones como la discretización Shift y Delta, el apilamiento de las variables y de la dinámica del sistema, y las formulaciones densa y dispersa. Una vez presentados los antecedentes, se analiza en detalle la aplicación al MPC de los algoritmos de primer orden más actuales y eficientes, haciendo un estudio de las propuestas publicadas en los últimos años. En este apartado se tendrán en cuenta definiciones como la optimización, las condiciones de parada y la convergencia. Tras este análisis, la aplicación de estos algoritmos se adaptará a las diferentes opciones de formulación de MPC donde se evaluará su rendimiento computacional en diferentes escenarios. Por último, los resultados obtenidos de la evaluación anterior se compararán con el rendimiento de los algoritmos de segundo orden, en particular utilizando un IP simplificado que está optimizado para una implementación MPC embebida. Esta comparación permitirá tomar decisiones de diseño adecuadas en la implementación de MPC en sistemas embebidos considerando aspectos como la simplicidad del hardware, el rendimiento computacional y las características numéricas.

As the uncommon combination of ethicist and surgeon, I have great compassion for my colleagues in the proverbial trenches. Recent articles in social and print media have moved me by their emotion and passionate pleas for recognition of the current plight of healthcare workers. Articles identifying the lack of personal protective equipment, physicians contracting “COVID-19,” and a lack of action on the part of hospitals and government entities are commonplace in the media.[i] Healthcare media predictions of a mass resignation by healthcare workers present seductive doomsday imagery. While I agree with many reports, others are specious and mere vacuous recriminations. I disagree with reports that compare COVID-19 and its impact on humanity, mortality, and morbidity with war,[ii] and Ebola, and that fail to articulate the obligations of physicians to provide care in a crisis. There is no rational reason for the comparison except to stoke fear of the contagion. In war, the enemy is not a natural event. In war, the enemy is human and the conflict is volitional, grounded in ideology, finances, power, or plain ego.[iii] Unlike the manmade factors that lead to war, the virus is an unthinking entity living only for its survival; we happen to be in its way. I have seen and heard comparisons to soldiers in war such as, “Allowing physicians and nurses to treat patients with COVID-19 without proper personal protective equipment (PPE) is like sending soldiers to war without adequate equipment.” I take some pause at the latter as the father of two Marine veterans. We currently find ourselves in an environment where reason is inconvenient, annoying, and aggravating. I read articles with emotional pleas “that any mortality is unacceptable.” However, reason is of great importance when making decisions that impact society. The comparison between war and COVID-19 is an unintentional straw man argument. The premise is that the virus is somehow evil and has intent and purpose making it easier to hate and attack. Comparisons made to Ebola, which created great fear in this country partly due to models predicting millions of deaths,[iv] serve to emotionally impact the reader to support the author’s conclusions and recommendations. In the Ebola panic, only two Americans died, proving the model’s failings. COVID-19 modelling has revealed a similar lack of accuracy.[v] Perhaps the impact of Ebola is an unfair comparison, but the fear was similar. Comparing COVID-19 to Ebola is an “ends justify the means” argument, fraught with moral pitfalls, and uses inaccurate imagery creating anger and fear in an already vulnerable population. Another argument propelled by the media is an argument veiled and subdued in practically all current articles identifying the risk to physicians. The media fails to recognize the balance between physicians pressing hospitals to provide the right gear and the obligation of physicians to provide care. I have deliberately excluded other hospital workers that have never taken an oath for there is universal agreement that they are not bound by the same obligations. Opinion 8.3 of the American Medical Association ( AMA) code of Medical Ethics sets an ethical framework for physician action in epidemics, disasters, or terrorism. "First and foremost is the obligation to provide urgent medical care during disasters," an obligation that holds "even in the face of greater than usual risk to physicians' own safety, health or life."[vi] Opinion 8.3 recognizes that the physician workforce itself is not an unlimited resource. “The risks of providing care to individual patients today should be evaluated against the ability to provide care in the future." It is rarely, almost never, acceptable to refuse to put yourself in harm’s way and especially unacceptable if no other physician is available. I suggest our colleagues are reminded of the duties imposed by the profession they chose. Doctors can always stay home and find others to take up the torch, a phenomenon occurring throughout the world. Refusal can be considered when the physician has a condition of such high risk that the doctor patient interaction would be a suicidal one. Institutions, governing bodies, and administrative entities have responsibilities to physicians’ safety and we must hold them accountable. It is our obligation to take an activist role and request, even demand, assistance with PPE, isolation, and support from our superiors. However, we must interact in good faith and resist the appearance of self-indulgence and vacuous recrimination. Society holds physicians, nurses, and all healthcare workers on a high pedestal. We should pay a price for that exalted position, although rarely with our life. No physician should be forced to risk his life but, in extraordinary circumstances, when the risk is accepted, we should accept it gracefully, humbly, and readily. I will try to counsel my anxious colleagues to the best of my ability but, I also must refer to our code of ethics above and fulfill my moral obligation. In the past 24 hours an evolving situation brought a mist to my eyes and is an example of courage and commitment to our vocation. A 35 year old man with a pregnant wife and no prior medical problems had not responded to conventional therapy. He was on a ventilator with no further increase of oxygen possible. All available medications used to treat COVID-19 and one experimental medication on clinical trial had failed to improve his condition. His only chance to allow his lungs to heal was extracorporeal membrane oxygenation (ECMO), a complex, highly intense medical modality that provides oxygen directly to the bloodstream, bypassing the lungs. Selfless acts by nurses, intensivists, social workers, administrators and, yes, ethicists created the environment for the young man’s survival. Ten associates manually moved him from prone to supine until ECMO was initiated. I heard no complaints, I heard no recriminations, I heard no whining. I heard only, “Let’s do it, Doc.'' The ten individuals acting to save the young man epitomize the principles laid down in the AMA code of Medical Ethics. I thank them for their service, and I pray they will someday be rewarded. We will not run out of providers. They will show up as they always have and provide patient care with dignity and compassion for their dedication to duty is boundless. Photo by Luis Melendez on Unsplash [i] Kirsch, Thomas, MD: “What happens if healthcare workers stop showing up?” , The Atlantic March 24,2020, https://www.theatlantic.com/ideas/archive/2020/03/were-failing-doctors/608662/ [ii] Stat Reports, “We don’t send soldiers to war without weapons” https://www.statnews.com/2020/03/21/give-doctors-what-they-need-to-fight-covid-19/ [iii] Optiv: “Using “MICE” to understand your adversary, https://www.optiv.com/blog/using-mice-to-understand-your-adversary [iv] Ebola Infections Fewer Than Predicted by Disease Models https://www.scientificamerican.com/article/ebola-infections-fewer-than-predicted-by-disease-models/ [v] How mortality predictions in a leading coronavirus model dropped over time https://www.washingtonpost.com/politics/2020/04/14/how-mortality-predictions-leading-coronavirus-model-dropped-over-time/ [vi] AMA(American Medical Association) Code of Ethics, 8.3, Physicians’ responsibilities in disaster response and preparedness https://www.ama-assn.org/delivering-care/ethics/physicians- responsibilities-disaster-response-preparedness, Voices in Bioethics, Vol 6 (2020)

Le terrain parisien est propice à l’observation des architectes, notamment sous le régime de Vichy. La profession n’a alors aucune homogénéité, et la création de l’Ordre en décembre 1940 vise précisément à discipliner l’usage du titre. L’enquête sur les architectes a l’avantage de tisser des liens entre l’amont et l’aval de Vichy, et donc de mettre en valeur des continuités qui échappent souvent à l’attention en raison du compartimentage politique des études. Il s’agit donc, en suivant des tr...

En Bretagne, le débat d’idées sur l’architecture et ses institutions fut largement tributaire des idéologies régionaliste et autonomiste, qui s’étaient sans cesse affermies depuis la fin du xixe siècle. Ce courant de pensée s’était élargi et diversifié : en 1911, un groupuscule avait ainsi diffusé une plaquette subversive, Pour le séparatisme : manifeste du Parti nationaliste breton. En 1919, une poignée de jeunes gens avait repris ce flambeau, donnant naissance à un Groupe régionaliste breto...

Installé dans le Loiret le 25 juin 1940, le nouveau préfet, Jacques Morane, s’attelle à la reconstruction administrative mais aussi économique et matérielle de sa région. Très actif, cet ancien X-Pont lance très rapidement la reconstruction architecturale et urbaine du département en s’entourant de techniciens (Jean Kérisel), d’urbanistes (Jean Royer) et d’architectes (Léon-Émile Bazin), qui travaillent dès les premiers mois qui suivent la débâcle de 1940 au relèvement des différentes villes ...

En 1987, l’historien Henry Rousso cernait les contours de ce qu’il nommait le « syndrome de Vichy » dans le discours politique français et dans la recherche historique sur la Seconde Guerre mondiale. Plus de trente années ont passé, et les manifestations de ce syndrome n’ont guère été considérées dans le champ de l’architecture, tout se passant comme si, à part les procès hâtivement instruits contre certains protagonistes, tels que Le Corbusier, aucun chercheur n’osait aborder dans son ensemb...

Qu’en fut-il de l’architecture et de l’urbanisme sous l’Occupation ? Si les travaux sur la France de Vichy foisonnent, le champ architectural et urbain est longtemps resté ignoré. Les politiques conduites en la matière ne sauraient se mesurer à la quantité d’édifices réalisés, mais plutôt à l’ampleur des réorganisations administratives – telle la création de l’Ordre des architectes en décembre 1940 – ou à l’abondante production de textes et de plans. Les architectes furent-ils majoritairement collaborateurs et profiteurs de guerre, dans des contextes allant de la spoliation des biens des Juifs à la pressante reconstruction des villes détruites ? Quel rôle jouèrent des architectes comme Le Corbusier ou Auguste Perret ? Quelle place les langages architecturaux ont-ils réservé au moderne et à la tradition ? Quel enseignement dispensait-on dans les écoles ? Sans prétendre en dévoiler toutes les continuités et les ruptures, l’ouvrage pose de front la question des politiques architecturales et urbaines mises en oeuvre sous le régime de Vichy, de leurs origines et de leur héritage.

Introduction La première génération des travaux historiques engagés dès l’après-guerre sur les années 1940-1944 a mis en valeur les divergences existant au plan social et économique entre le régime de Vichy et les débats de la Résistance engagés à Londres puis à Alger. L’État français apparaissait moins relever de la continuité des débats de l’entre-deux-guerres que d’une parenthèse de l’histoire achevée avec la libération du joug allemand. La seconde génération des travaux historiques sur le...

La création de la direction des services de l’Architecture en 1940 s’inscrit dans le fil de la politique de centralisation des Bâtiments civils conduite par l’État depuis le début du xxe siècle. Initialement timide, cette politique s’avère plus résolue à la veille de la Seconde Guerre mondiale et pendant les années de Vichy. La question relève en fait d’une histoire bien plus longue et son origine remonte à la fin du xviiie siècle. À la veille de la Révolution, la responsabilité des édifices ...

Les années noires virent les paysagistes français soutenir l’idéologie de la Révolution nationale, tout en continuant d’aligner leurs ambitions professionnelles sur celles de leurs confrères belges, italiens et allemands. La politique des espaces verts, la question du tracé et des plantations des autoroutes, le tourisme, la forêt et les sports firent l’objet de nombreux articles dans les revues telles qu’Urbanisme, Reconstruction, Domus et Gartenschönheit, reflétant à la fois le désir d’élarg...

La part visible Je commencerai par cette remarque historiographique : alors que, depuis la soutenance de ma thèse de doctorat en 1984, les témoins interrogés ont presque tous disparu (sauf Pierre Soulages), des textes, des ouvrages et des expositions ont considérablement renouvelé la recherche, au diapason des intérêts qui changent et des mentalités qui varient. À cet égard, je voudrais montrer en quoi l’histoire compose avec nos sensibilités et avec notre façon de considérer les sources. Pou...

Les archives des années 1939-1945 de l’École spéciale d’architecture sont remarquablement vides. On n’a retrouvé aucun compte rendu de réunion de l’assemblée générale ou du conseil d’administration — l’École est une institution privée, dotée de statuts d’association —, aucun discours de rentrée, ni même aucun programme pédagogique, alors que ces pièces sont abondantes dans la période qui précède. Rien ne permet d’affirmer qu’elles ont existé ni, dans l’affirmative, de savoir ce qu’elles sont ...

Tout au long de l’entre-deux-guerres, les architectes avaient tenté de réglementer leur profession pour en protéger le titre et en écarter les constructeurs — ingénieurs organisés depuis 1934, géomètres, entrepreneurs — à l’œuvre sans avoir un diplôme spécifique, ni posséder la mention DPLG (diplômé par le gouvernement). C’est pourquoi la création de l’Ordre à l’automne 1940 sembla réaliser leurs vœux. Dans le cadre de la suppression des organisations syndicales décidée par Vichy, cette nouve...

La déclinaison de l’adage « quand le bâtiment va, tout va » dans le domaine de l’édition pourrait être « quand le papier va, tout va ». Or l’édition d’architecture dans la France de Vichy ne satisfait à aucune de ces conditions, puisqu’elle cumule deux pénuries : celle de production bâtie et celle de papier. Il n’y a plus ni contenu (des édifices à commenter) ni contenant (du papier sur lequel imprimer). Dans L’Édition française sous l’Occupation, Pascal Fouché rappelle que le poids de papier...

Tous les aspects de la politique du régime de Vichy dans le champ de l’architecture sont loin d’avoir été explorés en détail. L’une des lacunes les plus évidentes pouvant être recensées porte sur l’enseignement, notamment au sein de sa principale institution parisienne, l’École nationale supérieure des beaux-arts (Ensba). Il est vrai que, si les recherches sur l’histoire de l’École ont été assez significatives pour ce qui est du xixe siècle et sont désormais bien engagées sur les nouveaux éta...

La direction puis le secrétariat général des Beaux-Arts sous le régime de Vichy constituent un tournant fondamental du parcours intellectuel et professionnel de Louis Hautecœur, qui s’explique à la lumière de ses multiples expériences d’entre-deux-guerres. Son intérêt pour l’enseignement et les métiers de l’architecture, son engagement en faveur de la protection du patrimoine, son regard sur la production artistique et musicale, son attention à la muséographie, doivent être situés dans le dro...

Background Hospitalized persons who inject drugs are at a greater risk of adverse hospital outcomes including discharge against medical advice, inpatient illicit drug use, overdose, and death. However, there are limited data on the frequency and outcomes of these events in the United States. Methods This retrospective analysis included patients with injection-related infections receiving a protocol for injection drug use (IDU) at University of Alabama at Birmingham Hospital from 2016 to 2017. In-hospital IDU was suspected or reported drug usage plus confirmatory drug screen, and documented discharges “against medical advice” were deemed patient-directed discharges (PDD). We analyzed the frequency of and associations between in-hospital IDU, PDD, 30-day readmission, and deaths (between 2016 and 2019) using McNemar’s tests. Logistic regression models evaluated the association between PDD, in-hospital IDU, readmission, and death. Results Overall, 83 patients met inclusion criteria: 28 (34%) with in-hospital IDU, 12 (14%) PDD, 9 (11%) died, and 12 (14%) 30-day readmission. In-hospital IDU was significantly associated with PDD (P = .003), 30-day readmission (P = .005), and death (P = .0003). Patient-directed discharges and 30-day readmission were not significantly associated with death nor with each other. Conclusions In a cohort of patients receiving inpatient care for injection-related infections, illicit drug use, PDD, 30-day readmissions, and death were common. Furthermore, patients who use illicit drugs while hospitalized are significantly more likely to leave early, be readmitted, and/or die. We must design models of care that prevent adverse outcomes, including drug use and PDD, to reduce barriers to evidence-based treatment of infections., In hospitalized patients with injection related infections, we found that illicit drug use, premature discharge, readmissions and death were common. Further, those who use illicit drugs while hospitalized are significantly more likely to leave early, be readmitted and die.

Metabolic profiling studies have recently indicated dysfunctional mitochondria in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). This includes an impaired function of pyruvate dehydrogenase complex (PDC), possibly driven by serum factor(s), which leads to inadequate adenosine triphosphate generation and excessive lactate accumulation. A reminiscent energy blockade is likely to occur in primary biliary cholangitis (PBC), caused by anti-PDC autoantibodies, as recently proposed. PBC is associated with fatigue and post-exertional malaise, also signifying ME/CFS. We herein have investigated whether ME/CFS patients have autoreactive antibodies that could interfere with mitochondrial function. We found that only 1 of 161 examined ME/CFS patients was positive for anti-PDC, while all PBC patients (15/15) presented significant IgM, IgG, and IgA anti-PDC reactivity, as previously shown. None of fibromyalgia patients (0/14), multiple sclerosis patients (0/29), and healthy blood donors (0/44) controls showed reactivities. Anti-mitochondrial autoantibodies (inner and outer membrane) were negative in ME/CFS cohort. Anti-cardiolipin antibody levels in patients did not differ significantly from healthy blood donors. In conclusion, the impaired mitochondrial/metabolic dysfunction, observed in ME/CFS, cannot be explained by presence of circulating autoantibodies against the tested mitochondrial epitopes.

Este trabalho tem como propósito apresentar um estudo comparativo de duas traduções brasileiras da peça Romeu e Julieta, de William Shakespeare, com enfoque no Ato 1, Cena 3, na qual constam as falas da personagem secundária Ama, que são carregadas de comicidade e certo teor sexual. Para esse propósito, serão feitas algumas breves considerações sobre o elo entre o humor e a tradução e sobre essa personagem secundária, cujas características cômicas se assemelham ao clown, figura bastante recorrente na literatura dramática medieval e que foi transposta para o palco renascentista. As duas traduções utilizadas para este trabalho analítico são de Bárbara Heliodora (1997) e Beatriz Viégas-Faria (2016). A análise demonstra que ambas as tradutoras buscaram, cada uma à sua maneira, lidar com a comicidade da personagem de modo criativo, sem perder de vista o teor cômico presente no texto-fonte.

The mitochondrial electron transport chain consists of the classical protein complexes (I–IV) that facilitate the flow of electrons and coupled oxidative phosphorylation to produce metabolic energy. The canonical route of electron transport may diverge by the presence of alternative components to the electron transport chain. The following study comprises the bioinformatic identification and functional characterization of a putative alternative oxidase in the smut fungus Sporisorium reilianum f. sp. zeae. This alternative respiratory component has been previously identified in other eukaryotes and is essential for alternative respiration as a response to environmental and chemical stressors, as well as for developmental transitionaoxs during the life cycle of an organism. A growth inhibition assay, using specific mitochondrial inhibitors, functionally confirmed the presence of an antimycin-resistant/salicylhydroxamic acid (SHAM)-sensitive alternative oxidase in the respirasome of S. reilianum. Gene disruption experiments revealed that this enzyme is involved in the pathogenic stage of the fungus, with its absence effectively reducing overall disease incidence in infected maize plants. Furthermore, gene expression analysis revealed that alternative oxidase plays a prominent role in the teliospore developmental stage, in agreement with favoring alternative respiration during quiescent stages of an organism’s life cycle.

Purpose of Review The purpose of this review is to discuss reasons why immunosuppressive therapy so far failed in Primary Biliry Cholangitis. Recent Findings Even targeted immunosuppressive therapy seems ineffective or potentially harmful. Summary Bile acid-mediated cholangiocyte damage, facilitated by insufficient bicarbonate secretion, seems to attenuate the anti-inflammatory and anti-fibrotic actions of immunosuppressant and immunomodulatory drugs in a clinically significant way.

1. Interprétation (P. E.) Cette dernière phase, qui va de la fin du XVIIe siècle à nos jours, n’a été que partiellement abordée. Le secteur est toujours resté une zone agricole jusqu’à la construction actuelle. La fruiticulture est restée prépondérante durant le XXe siècle, où ce sont des pruniers qui ont succédé aux vignes, après l’inondation du terrain causé par la rupture du barrage du Malpasset. La ferme n’apparaît qu’en 1825, sur une carte anonyme, puis sur le cadastre napoléonien de 182...

1. Préparation des échantillons Les sédiments sont tamisés en recueillant les fractions 50-125 µ et 125-315 µ. Chaque fraction est nettoyée par l’acide chlorhydrique bouillant. La décantation sur le bromoforme permet de recueillir les minéraux lourds (d 2,89) et d’écarter les minéraux légers (quartz, feldspaths, micas). Les minéraux lourds sont montés entre lames et lamelles dans le Beaume de Canada. 2. Observation et détermination au microscope polarisant Les deux fractions séparées sont obs...