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In the frame of R&D activities about composites inspection, Safran investigated alternative methods to waterjet through transmission ultrasonic testing for an industrial application on nacelles components.For aerospace applications, such developments are usually performed according to the Technology Readiness Level (TRL) assessment. This study led to the selection of infrared thermography and the industrial validation of IRIS, InfraRed Inspection System, in Burnley (UK) at Safran Nacelles’ factory. This paper explains the different steps of the project and how the equipment works

The purpose of this study was to examine mineral diagenesis at Alwyn using the computational code KINDIS in order to simulate mineral dissolution and precipitation, the chemical evolution of the formation water, and the evolution of the host rock during its progressive reaction with the evolving formation water. Mass and volumetric balances are calculated from the simulations. Petrographic study indicates an extensive kaolinitization followed by significant illitization in Alwyn South. In contrast, secondary illite is almost absent at Alwyn North. Quartz precipitation and K-feldspar dissolution are observed in both the Alwyn North and the Alwyn South areas. The simulated interaction between Alwyn South water or Alwyn North water between 90 and 120°C and an idealized sandstone yields significant dissolution of kaolinite, significant to complete dissolution of K-feldspar and significant precipitation of illite. These simulated reactions correspond well with those recognized at Alwyn South reservoirs but fail to reproduce the observations at Alwyn North, where secondary illite is almost absent. Additional simulations indicate that solutions supposed to be supersaturated with respect to quartz or more acidic do not lead to the formation of illite. However, the origin of these chemical conditions remain to be explained. In these simulations K-feldspar and kaolinite are the secondary precipitates.

Les 40es Journées de la SFSPM se sont tenues à Avignon du 7 au 9 novembre 2018. Le thème abordé—Cancer du sein : optimisation du parcours de soins — a réuni plus de 1 200 participants sous les voûtes du Palais des Papes. La fluidité de chaque segment du parcours a été analysée en termes de risques de rupture de continuité des soins tant au sein du segment lui-même qu’en amont et en aval. Dans un parcours par essence pluridisciplinaire et plurimétiers, la nécessité d’une réflexion globale et d’une coordination active réalisées par des professionnels formés a été rappelée à chaque session. Chacun des intervenants a esquissé de potentiels indicateurs de qualité tenant compte à la fois de son implication dans son segment d’intervention, mais tenant compte aussi d’une vision plus globale de ce que devrait être le parcours au travers de la maladie et des soins. La parole a été très largement partagée entre soignants et associations de malades, entre paramédicaux et acteurs en sciences humaines et sociales, entre responsables de la santé publique HAS, ARS, CNAM–CPAM 84 et représentants des différents modes d’hospitalisation publique/privée et ESPIC. La session grand public a été l’occasion d’échanges fructueux et instructifs sur la perception des difficultés comme des satisfactions rencontrées que nous ont fait partager les malades, leurs proches et les représentantes des associations. Au total, un congrès de réflexion partagé par de nombreux acteurs qui cherchent tous à améliorer le parcours de soins des malades atteintes de cancer du sein. La publication le 21 janvier par l’INCa de dix indicateurs de qualité du parcours de soins pour les malades atteints de cancer du sein est une étape importante qu’attendaient tous les participants d’Avignon — SFSPM 2018.

Few data are available to describe the changes in incidence of pediatric-onset inflammatory bowel disease (IBD). The aim of this study was to describe changes in incidence and phenotypic presentation of pediatric-onset IBD in northern France during a 24-year period.Pediatric-onset IBD (17 years) was issued from a population-based IBD study in France between 1988 and 2011. Age groups and digestive location were defined according to the Paris classification.1,350 incident cases were recorded (8.3% of all IBD) including 990 Crohn's disease (CD), 326 ulcerative colitis (UC) and 34 IBD unclassified (IBDU). Median age at diagnosis was similar in CD (14.4 years (Q1=11.8-Q3=16.0)) and UC (14.0 years (11.0-16.0)) and did not change over time. There were significantly more males with CD (females/males=0.82) than UC (females/males=1.25) (P=0.0042). Median time between onset of symptoms and IBD diagnosis was consistently 3 months (1-6). Mean incidence was 4.4/10In this population-based study, CD and UC incidences increased dramatically in adolescents across a 24-year span, suggesting that one or more strong environmental factors may predispose this population to IBD.

Despite satisfactory efficacy of WHO-recommended second-line antiretroviral treatment for patients with HIV in low-income countries, the need for simplified, low-cost, and less-toxic maintenance strategies remains high. We compared boosted protease inhibitor monotherapy with dual therapy with boosted protease inhibitor plus lamivudine in patients on second-line antiretrovial therapy (ART).We did a multicentre, randomised, parallel, open-label, superiority, trial in the HIV services of five hospitals in sub-Saharan Africa (Yaoundé, Cameroon; Dakar, Senegal; and Bobo Dioulasso, Burkina Faso). We recruited patients from the long-term, post-trial cohort of the ANRS 12169/2LADY study that compared the efficacy of three second-line combinations based on boosted protease inhibitors. Participants for our study were HIV-1 infected with multiple mutations including M184V, at first-line failure, aged 18 years and older, on boosted protease inhibitor plus two nucleoside reverse transcriptase inhibitors (NRTI) for at least 48 weeks with at least 48 weeks follow-up in the 2LADY trial, with two viral load measurements of less than 200 copies per mL in the previous 6 months, CD4 counts of more than 100 cells per μL, adherence of at least 90%, and no change to ART in the past 3 months. We randomly assigned participants (1:1) to receive either monotherapy with their boosted protease inhibitor (once-daily darunavir 800 mg [two 400 mg tablets] boosted with ritonavir 100 mg [one tablet] or coformulation of lopinavir 200 mg with ritonavir 50 mg [two tablets taken twice per day]) or to boosted protease inhibitor plus once-daily lamivudine 300 mg (one 300 mg tablet or two 150 mg tablets). Computer-generated randomisation was stratified by study site and viral load at screening (50 copies per mL, and 50-200 copies per mL), and concealed from study personnel throughout the inclusion period. After randomisation, treatment allocation was not masked from clinicians or patients]. Patients had follow-up visits at weeks 4 and 12, and every 3 months until 96 weeks; if viral load exceeded 500 copies per mL at any visit, NRTI (tenofovir and lamivudine) were reintroduced into treatment. The primary outcome was the proportion of participants who had treatment failure at 96 weeks in the intention-to-treat analysis, where treatment failure was defined as one of the following: a confirmed viral load of more than 500 copies per mL, reintroduction of NRTI, or interruption of boosted protease inhibitor. We designed the study to detect a difference of 12% between groups in the primary outcome, with an expected 20% of patients having treatment failure in the monotherapy group. This study is registered with ClinicalTrials.gov, number NCT01905059.Between March 5, 2014, and Jan 26, 2015, 265 participants were assigned to receive monotherapy (133) or boosted protease inhibitor plus lamivudine (132). At week 48, an independent data safety monitoring board reviewed data, and advised discontinuation of the monotherapy group because the number of failures had exceeded the expected 20%; therefore results here are for week 48. At this point, treatment failure occurred in four (3·0%; 95% CI 0·8-7·6) of 132 participants on dual therapy and 33 (24·8%; 17·7-33·0) of 133 participants on monotherapy (relative risk 8·2, 95% CI 3·0-22·5; odds ratio 10·6, 95% CI 3·6-42·1). The difference between groups (21·8%, 95% CI 13·9-29·7; p0·0001) showed superiority of dual therapy compared with monotherapy. We recorded 46 severe adverse events of grade 3 or 4 (29 in the monotherapy group, 17 in the boosted protease inhibitor plus lamivudine group); one event in the montherapy group (intoxication resulting from co-administration of ritonavir-boosted lopinavir with an ergotamine derivate) was deemed related to study drug. Two participants in the monotherapy group and one in the dual therapy group died, all from causes not related to study drugs or procedures (one from complications from gastric cancer surgery, one in a work accident, and one from a lung disease of unknown cause).After viral suppression with boosted protease inhibitor plus NRTI in second-line ART, maintenance therapy with boosted protease inhibitor plus lamivudine was associated with a high rate of success, despite the presence of M184V mutations at first-line treatment failure. Results indicated that boosted protease inhibitor monotherapy cannot be recommended for these patients.Agence National de Recherche sur le Sida et les hépatites and Janssen Pharmaceutica.

International audience; This paper deals with the vibroacoustic behavior of an electric window-lift gear motor for automotive vehicle which consists of a direct current (DC) motor and a worm gear. After describing the overall vibroacoustic behavior of this system and identifying the various excitation sources involved, this study focuses on the excitation sources associated to the contacts between brushes and commutator. To that end, a specific test bench is designed. It makes use of a modified gear motor for which various specific rotors are driven with an external brushless motor. It allows the discrimination of some excitation sources associated to the contact between brushes and commutator by removing them one after the other. The respective weight of friction, mechanical shocks, electrical current flow, and commutation arcs occurring jointly at the brush/commutator interface are dissociated and evaluated. The friction and the mechanical shocks between brushes and commutator blades increase the vibroacoustic response of the window-lift gear motor. The flowing of electrical current in brushes/commutator contacts tends to moderate the frictional component of excitation sources, while commutation arcs induce their rising, leading to a global additive contribution to the dynamic response.

International audience; The synthesis of diamond films with extreme insulating properties is of great interest for most diamond film applications in nanoelectronics. SOD (Silicon-On-Diamond) is a promising alternative to standard SOI (Silicon-On-Insulator) because of the high heat-spreading capability of diamond material. Current Fully Depleted MOS processing technologies require a thickness of the dielectric buried layer of 150 nm. Synthesis of polycrystalline diamond films is already well documented. Nonetheless, the difficulties here are to keep their high thermal conductivity and their high electrical resistivity in spite of the reduction of the diamond layer thickness. This study aims at the fine control of both the nucleation density and the growth process to enable the fabrication of optimized fully covered diamond films as thin as possible.A mathematical model describing the coalescence was used to determine the surface coverage of the diamond film according to the linear growth of the diamond nanocrystals for different nucleation densities. The model gives information on the nucleation density needed to obtain a covering diamond film within ultrathin diamond layer thickness. To corroborate the coalescence model, diamond layers with different surface coverages were characterized. Our work led to ultrathin diamond layers (thickness below 140 nm) exhibiting electrical resistivities above 2 × 10^13 Ω cm.

In this study, we compare NCD films on 10 x 10 mm2 silicon substrates synthesised with high methane concentration and NCD films synthesised with prolongated bias during the growth step. Further, we performed in-situ sequential XPS analysis (carbon binding state) using an UHV surface analysis system connected to the MPCVD reactor. AFM and HRSEM were used to characterize films morphology. Using the same substrate holder, NCD films have been deposited on silicon 2 in wafers, To improve the homogeneity, a rotating substrate-holder set-up enabling biasing and heating of the stage has been developed and coupled with computer control of the process for a better reproducibility. UV-interferometry was performed to map the film thickness on 2 inches and quantify its thickness uniformity. Considering the symmetry of the system, AFM measurements were performed along the radius of the wafer to evaluate the surface homogeneity and its smoothness. The thickness uniformity of a NCD film of 1.6 pm deposited on 2 inch wafer is under 10% and the RMS roughness comprised between 13 and 14 nm.

We report here on the characterisation of neutron detectors fabricated using a range of synthetic diamonds including polycrystalline as well as single crystal samples. After material characterisations including response to alpha particles (stability, detection efficiency etc), measurements were made using thermalised neutrons in a nuclear reactor at fluencies of 10 6 –10 10 neutrons/cm 2 s. The readout electronic was based on current preamplification: it enables to locate the electronic preamplifier remotely from the hostile environment, typically at distances that can exceed 20 up to 200 m. It requires high signal to noise ratios for the detection device. To enable the neutron conversion (diamond itself remains transparent to such low energy neutrons) a thin film converting material made of 235 Uranium element is used to emit charged particles that are detected by the diamond film. The device responses were studied in terms of sensitivity, response time, reliability, and conformity with respect to the fluency as measured using calibration fission chambers. The results exhibit remarkable linearity and stability. The fabricated devices display are capable of faithfully following the power cycles of a nuclear reactor. With respect to gas ionisation chambers, these devices of much smaller dimension can find a use for neutron fluency profiling with high position resolution.

CVD diamond is a remarkable material for the fabrication of radiation detectors. Radiation hardness, chemical resistance and high-temperature operation capabilities of diamond motivate its use for fabrication of devices operating in hostile environments such as that encountered in nuclear industry and high energy physics. Its potentialities for such applications have been well documented and recent studies have led to the developments of a few applications that are addressing specific industrial needs. One particular interest of diamond stands in the fact that its atomic number is close to that of human tissues. This implies that the response of a diamond device to radiation is close to that received by the human body. Its thus enables the straightforward measurement of the dose for radiotherapy applications. However, this requires high reproducibility and linearity. It is widely observed that radiation exposure is modifying the initial performances of diamond detectors and priming devices is therefore required to obtain the required linearity. However, the nature of defects in the material strongly influences the type of priming required. This paper will address this problem from the study of trapping levels and their influence on the device response. We present here the current status of the development of polycrystalline diamond for this type of application, and propose new techniques of improving the material characteristics toward the optimisation of ionisation chamber performances as well as that of thermoluminescent dosimeters for the particular field of radiotherapy applications.

We report a retrospective analysis of MRI in 206 patients with intractable seizures and describe the findings in bilateral mesial temporal sclerosis (MTS) on fast spin-echo (FSE) and fast fluid-attenuated inversion-recovery (fFLAIR) sequences. Criteria for MTS were atrophy, signal change and loss of the digitations of the head of the hippocampus. In patients with bilateral MRI signs of MTS, correlation with clinical electro, volumetric MRI data and neuropsychological tests, when available, was performed. Bilateral MTS was observed in seven patients. Bilateral loss of the digitations and signal change on fFLAIR was seen in all seven. In three, bilateral atrophy was obvious. In two patients, mild bilateral atrophy was observed and in two others, the hippocampi were: asymmetrical, with obvious atrophy on only one side. Volumetric data confirmed bilateral symmetrical atrophy in five patients, and volumes were at the lowest of the normal range in the other two. The EEG showed temporal abnormalities in all patients, unilateral in five and bilateral in two. All patients had memory impairment and neuropsychological data confirmed visual and verbal memory deficits; two patients failed the Wada test on both sides. High-resolution T2-weighted FSE and fFLAIR sequences allow diagnosis of bilateral MTS, which has important therapeutic and prognostic implications.

We investigated the prognostic value of the type of epilepsies and epileptic syndromes for seizure recurrence. In patients with partial epilepsy, we focused on the prognostic value of any structural brain abnormality and of the location of the epileptogenic region.A total of 2,200 adult outpatients were included in a hospital-based observational survey, with a follow-up of 1 to 7 years. Twenty-two percent of the patients exhibited generalized epilepsy, 62% partial epilepsy, and 16% undetermined epilepsy.Seizure control (1 year without seizure) was achieved in 82% of patients who had idiopathic generalized epilepsy, 35% of those with symptomatic partial epilepsy, 45% of those with cryptogenic partial epilepsy, and 11% of those with partial epilepsy associated with hippocampal sclerosis (HS). Temporal lobe epilepsy (TLE) was the most refractory partial epilepsy, with only 20% of such patients remaining seizure free, compared with 36% of extra-TLE patients. In partial epilepsy, HS, cerebral dysgenesis, and dual pathology (HS and another lesion) were associated with a low rate of seizure-free patients (11%, 24%, and 3%, respectively). No significant difference in seizure control was found between patients with extra-TLE and those with TLE and no HS.In adults, partial epilepsy is more difficult to treat than idiopathic generalized epilepsy. In patients who have partial epilepsy, the location of the epileptogenic zone does not seem to be a determining factor. Brain abnormalities--especially HS, either alone or associated with another lesion--are a major prognostic factor.

When a reactive fluid circulates inside a porous medium it can dissolve some minerals if equilibrium is not reached and modiy the porosity and permeability. The positive feedback between fluid transport and mineral dissolution lead to complex reaction front morphologies such as fingers. Our study is carried out with two objectives: 1) to evaluate experimentally these processes at a decimeter scale, 2) to compare the experiment to a numerical model of water-rock interaction. The experiment consists of a two-dimensional porous medium that allows for the dissolution of halite under an imposed fluid flow. The numerical code used solves the equations of reaction and transport in a porous medium. Both experiment and numerical simulation indicate the development of an instability whose propagation rate depends on the rate of water injection raised to a 2/3 power.

Surfactant flooding is one of the effective technologies to enhance oil recovery of water flooded petroleum reservoirs. Several previous studies have demonstrated that the release of oil from a rock submitted to waterflood depends on the competition between displacing forces (viscous and buoyancy) and capillary forces. This competition is expressed by two dimensionless numbers, the Capillary number, defined as the ratio of viscous to capillary forces and the Bond number, defined as the ratio of gravity to capillary forces. At the core scale the evolution of the oil residual saturation as function of the capillary number is better known as the Capillary Desaturation Curve (CDC), which constitutes an important input parameter in EOR processes reservoir simulation. In this work we present a new experimental workflow to investigate the effect of rock structure on the CDC. This workflow combines core flood experiments and CT-scan imaging to accurately measure the mean residual oil saturation at different capillary number values as well as the local saturation distribution along the core plug. The CDC was measured on a set of water-wet sandstone with different permeability and degree of heterogeneity. The capillary number was varied by injecting a surfactant solution at different flow rates. Using this methodology, we first study the effect of core flood orientation (Horizontal injection and vertical downflow injection). The resulting local saturation curves show that in a horizontal configuration the oil migrates upwards in the sample inducing an oriented front strongly deviating from the piston like displacement, and very different from the one observed in the vertically placed sample. This behaviour is manly attributed to buoyancy forces that are no more negligible compared to capillary forces when surfactant is injected. This experiment shows that when measuring a CDC the capillary number needs to be corrected to take into account the buoyancy forces. In a second step we have investigated the effect of local heterogeneity of core plugs on the CDC with Clashach and Fontainebleau sandstones. Two samples of Clashash sandstone with equivalent mean properties were studied (mean permeability of 380 and 426 md and mean porosity of 13.4 % and 14.1% respectively). The resulting CDC curve exhibits almost two decades difference in the critical capillary number. This discrepancy is explained in terms of the local variation of the porosity that induces important differences in the local saturation profile.

La toxicite recto-colique des AINS est moins connue des prescripteurs que leurs effets secondaires gastro-duodenaux. On peut distinguer l’effet nocif des AINS sur des pathologies basses preexistantes et les lesions induites « de novo » aigues et chroniques. La prise d’AINS favorise la survenue des complications de la maladie diverticulaire et il est probable qu’elle puisse declencher d’authentiques poussees de maladie inflammatoire chronique de l’intestin. Les AINS peuvent etre responsables d’ulceres du colon, de perforations et de colites ischemiques segmentaires. Ils sont une cause indiscutable de colite aigue mais leur imputabilite dans la colite collagene est douteuse. Les effets secondaires rectaux des AINS sont frequents. La gravite de certaines complications (perforation, fistule…) justifie que leur prescription soit prudente et bien motivee.

Chemical flooding, SP or ASP, is of increasing interest due to the need to increase oil production. Design of chemical processes is very project specific and requires case by case studies including various steps among which reservoir data analysis, chemic

After primary and secondary production of oil from a petroleum reservoir, more than half of the oil is often left in place. In order to improve the process displacement efficiency – so that one can recover some of this remaining capillary-trapped or water-by-passed oil –, it is necessary to apply enhanced oil recovery (EOR) techniques such as surfactant flooding, either Surfactant (S), Surfactant-Polymer (SP) or Alkaline-Surfactant-Polymer (ASP). This paper describes a complete workflow for optimizing S, SP or ASP processes for chemical EOR. The workflow consists in successive steps: reservoir fluid and rock characterizations, formulation screening, core flood validation and simulation including sensitivity studies. Formulation design is performed through a validated High Throughput Screening (HTS) methodology using a robotic platform combined with microfluidic tools. Objective of the formulation platform is to provide a robust formulation adapted to the variability of the reservoir conditions (temperature and salinity windows, oil composition). Data on brine compatibility, oil solubilization ratio and water-oil interfacial tension (IFT) are systematically provided. Adsorption measurements are conducted for the selection of the best formulations. Core flood experiments are performed to validate performances of selected chemical formulation(s) and define simulation input data. IFT measurements, adsorption data, capillary desaturation curves, and diphasic water-oil relative permeabilities are further used as input for simulations. A chemical EOR simulator (SaripCH software), specifically designed for ASP processes design, has been developed. After the lab study, pilot design is the next step towards the application of the S, SP or ASP process in the field. SaripCH simulator is used to evaluate the performances of the process at the reservoir scale.

The efficacy of low-dose aspirin in preventing fetal growth retardation was tested in a randomised, placebo-controlled, double-blind trial. A secondary aim was to find out whether dipyridamole improves the efficacy of aspirin. 323 women at 15-18 weeks' amenorrhoea were selected at twenty-five participating centres on the basis of fetal growth retardation and/or fetal death or abruptio placentae in at least one previous pregnancy. They were randomly allocated to groups receiving placebo, 150 mg/day aspirin, or 150 mg/day aspirin plus 225 mg/day dipyridamole, for the remainder of the pregnancy. In the first phase of the trial all actively treated patients (n = 156) were compared with the placebo group (n = 73). Mean birthweight was significantly higher in the treated than in the placebo group (2751 [SD 670] vs 2526 [848] g; difference 225 g [95% CI 129-321 g], p = 0.029) and the frequency of fetal growth retardation in the placebo group was twice that in the treated group (19 [26%] vs 20 [13%]; p less than 0.02). The frequencies of stillbirth (4 [5%] vs 2 [1%]) and abruptio placentae (6 [8%] vs 7 [5%]) were also higher in the placebo than in the treated group. The benefits of aspirin treatment were greater in patients with two or more previous poor outcomes than in those with only one. In the second analysis, of aspirin only (n = 127) vs aspirin plus dipyridamole (n = 119), no significant differences were found. There was no excess of maternal or neonatal side-effects in the aspirin-treated patients.

Summary Ion exchange and dissolution/precipitation processes are of considerable concern when aqueous fluids are injected into reservoir sandstones, as in waterflooding or alkaline flooding or in well treatments. This paper describes a flow model that takes into account several ion exchange equilibria and the precipitation/dissolution of carbonates and hydroxides. Its validity is tested through simulations of laboratory experiments dealing with brine and alkali injection. Some insights into the effects of ion exchange and precipitation on flow properties are given.

A16 Injectivity Impairment Due to Dissolution/ Precipitation Processes During a CO2 Injection J.-M. Lombard* (Institut Francais du Petrole) P. Egermann (Institut Francais du Petrole) O. Vizika (Institut Francais du Petrole) S. Bekri (Institut Francais du Petrole) & B. Bazin (Institut Francais du Petrole) SUMMARY Keeping the well injectivity over the lifetime of CO2 geological storage operations is crucial for the environmental technical and economical success of such projects. The specificity of a CO2 injection compared to a conventional hydrocarbon gas injection is the possibility for geochemical reactions to occur between the mobile reactive brine and the host formation. This leads

International audience

In the Trilège trial, following induction with a zidovudine, lamivudine, and indinavir regimen, human immunodeficiency virus (HIV) replication was less suppressed by 2-drug maintenance therapy than by triple-drug therapy.To identify mechanisms of virologic failure in the 3 arms of the Trilège trial.Case-control study conducted from February to October 1998.Three urban hospitals in Paris, France.Fifty-eight case patients with virologic failure (HIV RNA rebound to500 copies/mL in 2 consecutive samples) randomized to 3 therapy groups: triple drug (zidovudine, lamivudine, and indinavir), 8; zidovudine-lamivudine, 29; and zidovudine-indinavir, 21; the case patients were randomly matched with 58 control patients with sustained viral suppression.At virologic failure (S1 sample) and 6 weeks later (S2 sample), assessment of protease and reverse transcriptase gene mutations, plasma indinavir level, and degree of viral load rebound; pill count during induction and maintenance periods.Only 1 primary resistance mutation, M184V, was detected in S1 plasma samples from 4 of 6 patients in the triple-drug and in all 22 in the zidovudine-lamivudine therapy groups and in S2 plasma samples from 3 of 6 in the triple-drug and 20 of 21 in the zidovudine-lamivudine groups. Of controls, M184V was detected in 11 of 13 S1 plasma samples and in 10 of 11 S2 plasma samples. Indinavir levels were undetectable in all S1 samples but 2 in 7 triple-drug cases tested and in the expected range in 11 of 18 S1 and 5 of 12 S2 zidovudine-indinavir case plasma samples tested. Maintenance adherence rates were lower for cases vs controls for zidovudine (P = .05) and indinavir (P = .05). Low indinavir levels, lower adherence rates for zidovudine (P = .04) and lamivudine (P = .03), and rebound to near-baseline values suggested adherence as cause of early failure for 4 of 8 triple-drug cases. In the zidovudine-lamivudine arm, for which case and control adherence rates did not differ significantly (P = .96), most failures occurred late with low rebound, suggesting suboptimal drug potency. In the zidovudine-indinavir arm, virologic failures may be related to both mechanisms.During the maintenance phase early and late virologic failures appeared to be related more to problems of adherence and antiretroviral treatment potency, respectively, than to selection of resistant mutant viruses.

A multicentric randomized double-blind trial was realized in order to determine whether a treatment with a low-dose aspirin (150 mg/day) with or without dipyridamole (225 mg/day) was able to prevent the perinatal consequences of pre-eclampsia. This study demonstrated a significant difference in birthweight and incidence of fetal growth retardation between treatment and placebo groups. No difference was demonstrated between aspirin and aspirin + dipyridamole patients.

Matrix treatments of horizontal drains in carbonate reservoirs require large amounts of acid, leading to economic-cost and pumping-time considerations. Therefore it is essential to improve candidate selection and to optimize treatment design, especially acid volume, placement and diverting technique. This paper discusses first, on a theoretical basis, the formation damage effects on horizontal well productivity. Hence, a stimulation strategy is being defined. The effectiveness of a Self-Gelling Acid Diverter (SGAD) is evaluated by screening the crosslinking conditions with single core flow tests. In particular, the effects of the acid strength in both the diverter stage and the neat acid stage are scrutinized. The diverting effect is also analyzed with a dual core flow apparatus specially designed to reproduce down-hole injection conditions in horizontal wells. The efficiency of the self-gelling agent is evaluated from fractional flow measurements and X-Ray CT visualization of the wormhole penetration. Finally, the study is completed with radial core flow experiments, previously damaged with a drilling fluid. Design and operational guidelines are deduced from the experimental results and a case history is presented.

Acidizing treatments in carbonate formations is of paramount importance to restore or to stimulate the near-wellbore area by creating wormholes. Emulsified acid was found to be especially effective when the injection rate is low. This paper discusses the properties of some emulsified acid formulations. The systems used in the study are mixtures of acid, diesel oil, surfactant and possibly a cosurfactant. Model systems made of anionic and nonionic surfactants are compared to the properties of a commercial emulsified acid. Experimental results are focused on the effect of the acid to oil volume ratio, the acid concentration and the surfactant nature. Rheological properties and temperature stability of the emulsion systems are analysed. Results of coreflood tests in limestone samples are presented which compare the behaviour of emulsified acids to the behaviour of plain HCl acid. It is shown that emulsified acids are effective stimulation fluids at low flow rates: their main advantage is a deep penetration in conditions where plain acid gives compact dissolution patterns. On the opposite, at high flowrates, plain HCl gives better results. These results are confirmed by CT scanner tomography analysis showing highly branched wormhole structures even at low flow rates. Guidelines are deduced to improve acidizing treatments in low permeability carbonate reservoirs.

Breast cancer is the most common cancer in women worldwide. Many studies have been performed worldwide to assess the effectiveness of screening in terms of reduced mortality due to breast cancer. Since the end of 1989, 10 breast cancer mass screening programs using mammography have been carried out in France under the sponsorship of the National Fund for Health Prevention, Education, and Information (FNPEIS) from the National Health Insurance of Salaried Workers (CNAMTS). These 10 campaigns, which are on a district scale, are organized according to variable methods and are assessed using a common procedure. Four groups of criteria are measured in this procedure, which investigates the impact, quality, effectiveness, and costs of screening programs. The average and extreme values of each criterion as calculated from the campaigns are presented in this paper. In order to enlighten the judgment on the French results, a comparison with the international standards in force and with the results of foreign screening programs is proposed.

The purpose of this work was to comparatively assess the results of mass screening programs for breast cancer implemented in six French departments in 1986, within the scope of the National Fund for Health Prevention, Education and Information of the National Health Insurance Office of Salaried Workers.The data collected by the screening centres were analyzed by ten assessment teams that were independent from the program promotion staff, all using the same evaluation form. A complementary population study performed in eight French districts then, allowed assessing the frequency of self-referred screening (mammography performed out of program).The rate of participation in screening programs, in relation to the invited population, ranged from 21 to 48%, according to the district (36% in average). This low participation was probably related to the extent of self-referred screening. In fact, 19 to 40% of women, according to the district, had previously had a screening mammographic coverage: rate was around 68% in women aged 50 to 69 years. Positive findings with mammography ranged from 4.5 to 15.8% (10.1% in average), while intervention rates ranged from 0.7 to 1.6% and detection rates from 3.8 to 6.2%. The ratio between benign tumors and cancers ranged from 0.7 to 2.1 according to the district. In order to enlighten the judgement on French results, we propose a comparison with the international standards in force.The various experiences with breast cancer screening in France show that this screening is technically feasible on the basis of existing medical structures. However, some criteria are still below the expected values, especially if compared with international standards. This result is probably accounted for by the high rate self-referred screening before age 40 in France. In these conditions, the question is whether extending breast cancer screening programs in France is an appropriate course of action.

A 32-year old man treated for several years with phenothiazine for chronic psychosis developed acute necrotizing colitis. The causal relationship with neuroleptics was reinforced by the absence of any other treatment and by histological findings including extensive mucosal necrosis without stenotic lesion and without mesenteric vessels alteration. The patient required emergency total colectomy and was discharged after 7 weeks of hospitalisation in the intensive care unit.

In the framework of the National Fund for Prevention, Health Education and Information, the setting-up in France, on an experimental basis, of mass breast cancer screening programs by mammography in ten departments leads to suggest a common protocol for the evaluation of these programs, before an eventual generalization to the whole country. These programs are based on common principles: local screening based on existing medical facilities, single view mammography with double reading. However, the screening organisation is different in each department according to the target population, the screening interval, the mode of invitation, the methods for arranging double reading, etc. The purpose of this article is to report on the work of the evaluation group of the ten programs, and to propose a methodology for comparing the screening experiences in order to measure the role of the organisation methods. It gives definitions and modes of calculations for the evaluation criteria in four fields: impact, quality, efficacy and cost (with details about the feasibility of data collection) and proposes a reflection on analysis techniques in order to develop an optimum mass screening strategy.

ContextIn the Trilege trial, following induction with a zidovudine, lamivudine, and indinavir regimen, human immunodeficiency virus (HIV) replication was less suppressed by 2-drug maintenance therapy than by triple-drug therapy.ObjectiveTo identify mechanisms of virologic failure in the 3 arms of the Trilege trial.DesignCase-control study conducted from February to October 1998.SettingThree urban hospitals in Paris, France.PatientsFifty-eight case patients with virologic failure (HIV RNA rebound to >500 copies/mL in 2 consecutive samples) randomized to 3 therapy groups: triple drug (zidovudine, lamivudine, and indinavir), 8; zidovudine-lamivudine, 29; and zidovudine-indinavir, 21; the case patients were randomly matched with 58 control patients with sustained viral suppression.Main Outcome MeasuresAt virologic failure (S1 sample) and 6 weeks later (S2 sample), assessment of protease and reverse transcriptase gene mutations, plasma indinavir level, and degree of viral load rebound; pill count during induction and maintenance periods.ResultsOnly 1 primary resistance mutation, M184V, was detected in S1 plasma samples from 4 of 6 patients in the triple-drug and in all 22 in the zidovudine-lamivudine therapy groups and in S2 plasma samples from 3 of 6 in the triple-drug and 20 of 21 in the zidovudine-lamivudine groups. Of controls, M184V was detected in 11 of 13 S1 plasma samples and in 10 of 11 S2 plasma samples. Indinavir levels were undetectable in all S1 samples but 2 in 7 triple-drug cases tested and in the expected range in 11 of 18 S1 and 5 of 12 S2 zidovudine-indinavir case plasma samples tested. Maintenance adherence rates were lower for cases vs controls for zidovudine (P = .05) and indinavir (P = .05). Low indinavir levels, lower adherence rates for zidovudine (P = .04) and lamivudine (P = .03), and rebound to near-baseline values suggested adherence as cause of early failure for 4 of 8 triple-drug cases. In the zidovudine-lamivudine arm, for which case and control adherence rates did not differ significantly (P = .96), most failures occurred late with low rebound, suggesting suboptimal drug potency. In the zidovudine-indinavir arm, virologic failures may be related to both mechanisms.ConclusionsDuring the maintenance phase early and late virologic failures appeared to be related more to problems of adherence and antiretroviral treatment potency, respectively, than to selection of resistant mutant viruses.

Capacitor pull-up circuitry is another addition to the numerous techniques the MOS engineer has available as a design tool. This `ratioless'-type circuit offers the potential advantage of high-speed two-phase operation. A complete circuit description and analysis is presented. Included in the analysis are topics covering bipolar injection effects, calculation of optimum size devices, stair-step charging wave forms that have been observed, and overlap capacitance effects. Measured speed performance is below the predicted value and the discrepancy appears to be caused by minority carrier injection into the substrate.

According to earlier investigations young bees show a rectal fluid hypo-osmotic to the haemolymph. It had been assumed, however, that in certain situations honey bees have to be economical with water and simultaneously form a rectal fluid hyperosmotic to the haemolymph. The latter has been confirmed by the present investigation.

Abstract Reduction of surfactant retention by using polyphosphates as cheating agent in micellar flooding is discussed in this paper. Laboratory flooding tests have been performed in simulated sandpacks which consisted of kaolinte and quartz, with petroleum, sulfonate TRS 10-80 dissolved in brines with different sodium (or calcium) concentrations. Micellar slug flooding with or without polyphosphate preflush was compared. Other experiments concerning the influences of polyphosphates on surfactant solubility in calcium brines, the exchangeable cations on clay surface, etc. were also performed. The main conclusions are:in a calcium brine environment, the loss of surfactant can be reduced significantly by the addition of polyphosphates to both preflush and micellar slug, but in a sodium brine environment, its effectiveness is somewhat poor: andpolyphosphates improve the surfactant solubility in calcium brine and enhance the exchange of cations between solid and liquid. These behaviors can be explained by the chelation of polyphosphate with calcium and its effect on the surface potential of clay particles.

Inorganic scaling is the process of mineral scale deposition that may occur in the well tubing, and/or in the near well-bore area of both production or injection wells. Scale formation is usually the result of poor compatibility between the brines injected into the reservoir and the minerals in the formation. It may also be the consequence of abrupt pressure and temperature variations to which production fluids may be submitted between the reservoir and the surface. The precipitation of mineral deposits (carbonates, sulfates …) may create significant permeability impairments due to plugging of pore throats and thus induce large well productivity or injectivity losses. In most cases, precipitation cannot be avoided and preventive treatments are recommended. One of the most efficient treatment consists in squeezing a scale specific inhibitor into the formation. This paper presents an original integrated methodology aiming at defining the best chemical inhibitor formulation for a given application and at optimizing its implementation into the corresponding reservoir. Both experimental and numerical approaches are used to select the inhibitors, to evaluate their performance at both core and field levels and to define the best strategy for the squeeze process. Laboratory tests include the classical inhibitor selection methods based on jar tests and tube blocking tests but also on more sophisticated testing procedures recently developed. Numerical simulations of the treatment are performed using a in-house reservoir simulator to upscale the squeeze life time of the treatment from laboratory scale to well geometry.

International audience; OBJECTIVE: To evaluate the reliability of temporal and frontal functional MRI (fMRI) activation for the assessment of language dominance, as compared with the Wada test. PATIENTS AND METHODS: Ten patients with temporal lobe epilepsy were studied using blood oxygen level dependent fMRI and echoplanar imaging (1.5-T). Three tasks were used: semantic verbal fluency, covert sentence repetition, and story listening. Data were analyzed using pixel by pixel autocorrelation and cross-correlation. fMRI laterality indices were defined for several regions of interest as the ratio (L - R)/(L + R), L being the number of activated voxels in the left hemisphere and R in the right hemisphere. Wada laterality indices were defined as the difference in the percentages of errors in language tests between left and right carotid injections. RESULTS: Semantic verbal fluency: The asymmetry of frontal activation was correlated with Wada laterality indices. The strongest correlation was observed in the precentral/middle frontal gyrus/inferior frontal sulcus area. Story listening: The asymmetry of frontal, but not temporal, activation was correlated with Wada laterality indices. Covert sentence repetition: No correlation was observed. CONCLUSIONS: There was a good congruence between hemispheric dominance for language as assessed with the Wada test and fMRI laterality indices in the frontal but not in the temporal lobes. The story listening and the covert sentence repetition tasks increased the sensitivity of detection of posterior language sites that may be useful for brain lesion surgery.