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Intraoperative hypotension should be differentiated with respect to the different underlying causal mechanisms. Post-induction hypotension is defined as arterial hypotension occurring during the first 20 minutes after induction of anaesthesia and early intraoperative hypotension is arterial hypotension during the first 30 minutes of surgery. The aim of our study is to evaluate the incidence of intraoperative hypotension during surgery under general anaesthesia in a patient population and the factors influencing its occurrence. Materials and Methods: This is a prospective study, carried out over a period of 4 months on 154 patients scheduled for surgery under general anaesthesia at the Military Hospital of Instruction Mohammed V in Rabat. We collected the following information : age, sex, ASA score, body mass index, comorbidities, drug intake and type of surgery. The occurrence or not of post induction hypotension and early intraoperative hypotension. Results: The mean age of the patients in our case series was 58.5 ± 12 years. The sex ratio was 1.4 with a predominance of males. ASA I and II status were predominant. In univariate analysis: advanced age, the existence of chronic arterial hypertension and the decrease in systolic blood pressure before induction were factors favouring the occurrence of intraoperative hypotension. In multivariate analysis: We found that these 3 factors were independently related to the occurrence of intraoperative hypotension. Conclusion: We found that lower pre-induction systolic blood pressure, older age and comorbidity such as hypertension are factors independently associated with post-induction and early intraoperative hypotension. We believe that this will allow preventive optimisation of the risk through early implementation of continuous haemodynamic monitoring and adequate therapeutic intervention.

Introduction:in otolaryngologic surgery, ankle is frequently used for monitoring anesthesia in place of brachial when the patient doesn´t need invasive arterial cannulation. If there is a clinically useful and Predictable link between the two readings in hemodynamic normal patient, this difference during otolaryngologic surgery, was not evaluated. We aimed to investigate the reliability and the acceptability of non invasive blood pressure measurements at the ankle compared to those obtained concurrently at the arm during otolaryngologic surgery. Methods:eighty ASA grade I and II patients who had to be operated under general anesthesia were taken as subjects for our study. Blood pressures were measured simultaneously in the 2 limbs before induction and then every 10 minutes until the end of the surgical procedure. Readings were initiated concurrently. Statistical analysis was performed with PASW Statistics 13. Results:there were 41 males (51.2 %) and 39 females (48.8 %). Bland-Altman analysis of mean difference between the ankle and arm (95 % limits of agreement) was -11.47 (- 23.77 to 0.82)mmHg for systolic blood pressure (SBP), -7.89 (-19.16 to 3.36)mmHg for diastolic blood pressure (DBP) and - 9.09 (18.19 to 0.00)mmHg for mean arterial pressure (MAP). Non-parametric analysis showed that 67.5 % of SBP, 46.2 % of DBP and 56.2 % of MAP measurements differed by > 10mmHg. Conclusion:ankle BP cannot be used routinely in otolaryngological surgery. Although, the ankle can be used as an alternative where the arm cannot be used taking into account a difference.

Vertical axis wind turbines (VAWT) as energy saving devices can be used in many engineering fields. There are two types of rotors in VAWT. Savonius rotors require a low torque for starting, but their efficiency is very low and Darrieus rotors have high efficiency, but they are difficult to start up. The hybrid wind turbine obtained by combining these two technologies, has the self-starting ability and high efficiency. A Darrieus-Savonius combined rotor aiming at a high aerodynamic performance with a low start-up requirement has drawn the attention of many researchers. In this paper, the effect of Darrieus-Savonius combined wind turbine performance is investigated in order to improve VAWT efficiency by a CFD (Computational Fluid Dynamics) approach. Unsteady simulations solving the Reynolds Averaged Navier-Stokes equations with standard k-ω SST turbulence model were conducted to obtain the static torque and the power coefficient. This numerical study focused on Darrieus-Savonius wind turbine with Savonius rotor placed in the middle of the Darrieus rotor at different tip speed ratio of 0.4, 0.6, 0.8, 1.0 and 1.2. The commercial CFD software Fluent 15.0 is used for the numerical study. The torque and power coefficient results of single Savonius turbine are compared and validated against experimental and numerical data based on the literature.

This work is an extensive numerical study of the heat dissipation and cooling of a heat- generating vertical base using corrugated fins. The overall objective is to improve the heat transfer performance for passive heat sink applications. Three-dimensional numerical simulations were performed using FLUENT; the mass conservation equation, Navier–Stokes equations and the energy equation were solved using a finite volume approach. Various geometrical configurations were considered, where the aspect ratio of the thickness ( A R ) for corrugated fins was adopted as the key variable for improving heat transfer performance. The applied heat flux is in the range 811.55 to 4674.56 W / m 2 . The results for the corrugated fins were compared to those for the conventional plate fins in terms of fluid flow, temperatures, heat transfer coefficients and weights. The results show that the proposed finned heat sinks can improve the heat transfer coefficient by up to 12.52 % compared to the reference-finned plate. Additionally, the curved fin design can reduce the unit weight and thus the material use by up to 59 % compared with the conventional fin design. Finally, the overall thermal efficiency of the proposed fins is around 98 % . The proposed design presents a suitable solution for industrial applications where the mass of the heat sink substrate is significant.

In this work, the thermohydraulic performance of a proposed design of an air-to-water double pipe heat exchanger with helical fins on the annulus gas side, is numerically studied. Three-dimensional computational fluid dynamics (CFD) simulations are performed, using the FLUENT software in order to investigate the gas side fluid flow, turbulence, heat transfer, and power consumption for different configurations of the heat exchanger. CFD performance analysis is conducted under turbulent flow conditions for configurations with helical fin spacings in the range of 0.05–0.2 m. The numerical model is first verified against experimental data available in the literature, for a double-pipe heat exchanger with longitudinal fins. Then, longitudinal fins are considered as a reference configuration and a comparative analysis of the thermohydraulic performances of the different helical fin configurations and the reference configuration is conducted. The flow field characteristics of the helical fin configurations are clearly demonstrated and discussed. Key design parameters such as the heat transfer coefficient, pressure drop, and thermal performance enhancement factor are evaluated to predict the overall performance of the heat exchangers. Results show that the use of helical fins significantly enhances the heat transfer rate for the same unit weight, but it also increases the pressure drop. The overall compactness and performance of the heat exchanger improve through the use of helical fins, and within the scope of the present investigation, the helical fin configuration with a fin spacing of 0.1 m provides the optimal thermohydraulic performance. Therefore, the present study helps to reveal and expand the potential of helical fins in providing an enhanced overall performance of this type of heat exchanger as well as in limiting its material cost for design engineers and manufacturers.

Intraoperative pneumothorax is a rare complication with a high risk of cardiorespiratory arrest by gas tamponade especially on a single lung. We report the case of a female patient aged 53 years who benefited from a left pneumonectomy on pulmonary tuberculosis sequelae. The patient presented early postoperative anemia with a left hemothorax requiring an emergency thoracotomy. In perioperative, the patient had a gas tamponade following a pneumothorax of the remaining lung, and the fate has been avoided by an exsufflation. Intraoperative pneumothorax can occur due to lesions of the tracheobronchial airway, of the brachial plexus, the placement of a central venous catheter or barotrauma. The diagnosis of pneumothorax during unipulmonary ventilation is posed by the sudden onset of hypoxia associated with increased airway pressures and hypercapnia. The immediate life-saving procedure involves fine needle exsufflation before the placement of a chest tube. Prevention involves reducing the risk of barotrauma by infusing patients with low flow volumes and the proper use of positive airway pressure, knowing that despite protective ventilation, barotraumas risk still exists.

In this paper, the design and thermo-hydraulic performance of a double pipe heat exchanger with helical baffles in the annulus side, are investigated numerically. Three-dimensional computational fluid dynamics (CFD) model, using the software FLUENT, have been performed to investigate the annulus side fluid flow, heat transfer coefficient and pressure drop for different configurations. A numerical analysis is conducted for different values of Reynolds number and baffle spacing (0.025–0.1 m). The numerical model was first validated for a simple double pipe heat exchanger by comparison with empirical correlations. The model was then used to investigate the helical baffles effects. The results obtained for a helically baffled annulus side provide enhanced heat transfer performance and high-pressure drop compared to the simple double-pipe exchangers. Thermal performance and high-pressure drop is an increasing function of baffle spacing and Re . In addition, empirical correlations expressing the results were developed based on curve fitting.

In this work, the thermo-hydraulic performance of shell and tube heat exchangers with segmental baffles (STHX) were investigated numerically for different baffle cuts. The heat transfer coefficient and the pressure drop have been considered as key parameters. These two parameters depend on the fluid flow path, which affected by the baffles characteristics (type, spacing, and the baffle cut). Baffles are used to improve heat transfer on the shell-side, but they increase the pressure drop, thus requiring a higher pumping power. This Phenomenon reduces the exchanger efficiency. For this purpose, the influence of different baffle cuts in a STHX on the heat transfer coefficient and the pressure drop were studied. The ratio $\displaystyle \frac {h_{s}}{\Delta _{p}}$ has been taken as a criterion of performance evaluation and the commercial software Ansys-Fluent has been adopted to conduct the simulations. The results show that the heat transfer coefficient and the pressure drop are sensitive to the baffle cut selection. The maximum performance could be obtained with a baffle cut of 25%.

Shell-and-tube heat exchanger, is one of the most widely used heat exchange apparatus in various industrial process and research fronts. Baffle selection is critical to control and improve the thermo-hydraulic performance of this type of heat exchanger. In this paper, three-dimensional computational fluid dynamics (CFD) simulations, using the commercial software ANSYS FLUENT, have been performed to study and compare the shell-side flow distribution, heat transfer coefficient and the pressure drop between the recently developed trefoil-hole, helical baffles and the conventional segmental baffles, at low shell side flow rates. In this numerical comparison, the whole heat exchangers consisting of the shell, tubes, baffles and nozzles are modeled, the numerical model predicts the thermo-hydraulic performance with a considerably good accuracy, by comparing with experimental data for single segmental baffles. The model is then used to compute and compare the thermo-hydraulic performance for the same heat exchanger with trefoil-hole and helical baffles. The results show that the use of helical baffles results in higher thermo-hydraulic performance while trefoil-hole baffles has a higher heat transfer performance with large pressure drop compared to segmental baffles.

Pneumothorax occult is defined by the presence of a non-visible to standard asymptomatic pneumothorax and pulmonary diagnosed only by X-ray computed tomography. The presence of this type of pneumothorax before planned surgery is a rare situation. What to do remains non-consensual. Through two clinic cases and a literature review, the authors discuss the modalities of management of this entity.

In the present work, a new fin shape is proposed to improve the convective heat transfer in heat sinks and to reduce their weight. The problem under consideration is a natural convection with air as the working fluid. Three-dimensional numerical simulations are carried out using FLUENT 19.0, to solve the continuity, momentum, turbulence, and energy equations to predict the flow and temperature field for different fins on a vertical base. Five configurations of rippling fins are considered with two aspect ratios and different heat flux inputs. The numerical results are compared to previous data available in the literature for a vertical rectangular finned plate (reference case) to validate the model. For each configuration, the heat sink temperature field and the natural convection driven air flow are discussed. The heat flux is varied from 519.396 W m 2 to 4674.565 W m 2 . The overall thermal performance is characterized by the heat dissipation rate per unit mass. By comparison to conventional rectangular fin, the proposed fin geometry can reduce the temperature at the heat sink base by up to 18.35 K, increase the mass specific heat transfer coefficient by up to 101.41%, and decreases the thermal resistance by 9.81%. Within the scope of this study. The case with one ripple provides the best thermal performance. The results also showed that, the flow and heat transfer enhancements are a decreasing function of Rayleigh number. Overall, the heat transfer enhancement is better with rippling fins than with the rectangular fins, with a maximal mass reduction of 47 % . The proposed models provide a practical alternative to the widely adopted plate fin heat sinks, which very promising for future thermal developments.

Wire ropes play important roles in industry development, maritime industrial services and civil engineering applications. They are composed of multi-wire strands twisted together to form a structure with enormous mechanical properties, combining high axial strength, rigidity and torsional flexibility. In most applications, wire ropes are exposed to different damage mechanisms. One of these mechanisms is corrosion, which can accelerate the damage to cable components and lead to brutal and unforeseen failure. In this regard, experimental tensile tests were carried out on several strand samples; one sample was virgin and the others were corroded by immersion of a well-defined number of strands in sulfuric acid solutions. The studied strands were extracted from a 19 * 7 non-rotating steel wire rope. The static damage enables to monitor the evolution of residual stresses of damaged samples with different corrosion levels. Based on the ultimate residual stress and the endurance limit of the virgin strand, the influence of corrosion on the strand‘s endurance limit was studied by plotting the S-N curves according to the unified theory. The obtained results enabled to assess the mechanical behavior of the strand in a corrosive environment under static stress and to predict the number of cycles at which the strand will break. This procedure makes it possible to anticipate the service life of this structure under corrosive conditions. It also helps to establish a solid maintenance system that ensures a safe and reliable working environment.

L'arrêt cardiaque au bloc opératoire est un événement redoutable, ces étiologies sont multiples. Nous rapportons le cas d'une patiente de 53 ans sans antécédents pathologiques particuliers, programmée pour cure chirurgicale d'une tumeur de l'intestin grêle. 20 minutes après l'induction anesthésique la patiente a présenté une asystolie rapidement réversible après les mesures de réanimation, l'association d'un rush cutané du visage et du thorax a fait suspecter une réaction anaphylactoïde tardive. L'amélioration rapide de la patiente a permis l'autorisation d'une reprise de l'intervention. Le début de la manipulation tumorale a occasionné une deuxième bradycardie extrême rapidement résolutive après 0,5 mg d'atropine, une réapparition du rush cutané au niveau du visage et du thorax a été observée, cette deuxième complication a rapidement fait suspecter une crise carcinoïde conduisant à l'administration du sandostatine. Aucun incident n'a été signalé ultérieurement, la patiente a passée 24 heures en réanimation sous une perfusion de sandostatine. Les valeurs du 5-HIAA urinaire étaient très élevées et l'examen histologique de la pièce opératoire a confirmé la nature carcinoïde de la tumeur. Nous soulignons la rareté de cette entité et l'intérêt de penser à une crise carcinoïde devons la survenue de complications peropératoires au cours d'une anesthésie pour tumeur de l'intestin grêle.

L'arrêt cardiaque au bloc opératoire est un événement redoutable, ces étiologies sont multiples. Nous rapportons le cas d'une patiente de 53 ans sans antécédents pathologiques particuliers, programmée pour cure chirurgicale d'une tumeur de l'intestin grêle. 20 minutes après l'induction anesthésique la patiente a présenté une asystolie rapidement réversible après les mesures de réanimation, l'association d'un rush cutané du visage et du thorax a fait suspecter une réaction anaphylactoïde tardive. L'amélioration rapide de la patiente a permis l'autorisation d'une reprise de l'intervention. Le début de la manipulation tumorale a occasionné une deuxième bradycardie extrême rapidement résolutive après 0,5 mg d'atropine, une réapparition du rush cutané au niveau du visage et du thorax a été observée, cette deuxième complication a rapidement fait suspecter une crise carcinoïde conduisant à l'administration du sandostatine. Aucun incident n'a été signalé ultérieurement, la patiente a passée 24 heures en réanimation sous une perfusion de sandostatine. Les valeurs du 5-HIAA urinaire étaient très élevées et l'examen histologique de la pièce opératoire a confirmé la nature carcinoïde de la tumeur. Nous soulignons la rareté de cette entité et l'intérêt de penser à une crise carcinoïde devons la survenue de complications peropératoires au cours d'une anesthésie pour tumeur de l'intestin grêle.

La laryngoscopie directe en suspension est un geste chirurgical diagnostique et/ou therapeutique des lesions endo-laryngees. Sa gestion anesthesique est compliquee. Differentes techniques anesthesiques peuvent etre proposees. Malgre les contraintes, les curares gardent tout leur interet. L’association rocuronium et sugammadex est envisageable, elle permet une inversion rapide du bloc neuromusculaire profond et par consequent une reduction de la morbidite postoperatoire. Nous rapportons un cas d’une laryngoscopie directe en suspension realisee sous anesthesie generale dont l’utilisation de l’association rocuronium-sugammadex a permis une facilite du geste chirurgicale, une securite pour le patient et un confort pour l’anesthesiste.

This paper is devoted to the simulation of the thermal shock and the induced pressure-waves expansion, generated by a dc pin-to-plan corona discharge in the air at ambient temperatures and under atmospheric pressure. The positive dc voltage applied to the tip generates a monofilamentary streamer that crosses the gap from the tip toward the plan. The simulation models are based on the coupling of a 2-D dynamics streamer model with the hydrodynamics conservation equations of a compressible gas. The source term for the gas dynamics equations takes into account the fast-energy relaxation from excited molecules to the random thermal energy. The simulation shows that the streamers generate a thermal shock near the anodic tip, which induces high pressure gradients and finally the gas expansion. The thermal shock is located just in front of the anodic tip, where the injected energy density is the highest. After 0.3 μs, the mean gas temperature increases up to around 800 K in a small volume just in front of the anodic tip while the maximum temperature reaches 1200 K. In addition, two pressure waves, a spherical and a cylindrical one, are induced with a propagation velocity of 370 m s-1 i.e., close to the speed of sound in air.

La laryngoscopie directe en suspension est un geste chirurgical diagnostique et/ou thérapeutique des lésions endo-laryngées. Sa gestion anesthésique est compliquée. Différentes techniques anesthésiques peuvent être proposées. Malgré les contraintes, les curares gardent tout leur intérêt. L’association rocuronium et sugammadex est envisageable, elle permet une inversion rapide du bloc neuromusculaire profond et par conséquent une réduction de la morbidité postopératoire. Nous rapportons un cas d’une laryngoscopie directe en suspension réalisée sous anesthésie générale dont l’utilisation de l’association rocuronium-sugammadex a permis une facilité du geste chirurgicale, une sécurité pour le patient et un confort pour l’anesthésiste.

A numerical simulation of the heat transfer and temperature distribution through the layers of a photovoltaic (PV) solar panel is performed in this study to explore its electrical performance and efficiency while being subjected to forced convection due to the surrounding wind. A commercial PV panel was taken as a basis to model this work. A mechanical meshing system and the finite volume method computational fluid dynamics (CFD) system were used to simulate the air flow on top and below the panel. By varying wind velocity, tilt angle and ambient temperature, different working conditions are considered. The surface convection coefficients resulting from the CFD calculations were introduced into the transient thermal analysis system which provided the heat transfer results within the solar panel. Under the conditions simulated, the thermal benefit of forced convection, as compared to natural convection, is found to be of significance depending on the air flow properties and above certain wind speed values. The wind vector direction (or conversely the solar panel's orientation) is found to be of importance as separated flow situations may rise and negate the effect of forced convection in panel's leeward regions due to the air speed dropping to 0 and recirculation. Further investigation is in order, to determine the possibilities of harnessing the effects of wind vector orientation.

Purpose This study was designed to compare videolaryngoscopy with direct laryngoscopy with respect to ease of intubation when inserting a double lumen tube (DLT).

In the one-dimensional periodic potential case, we formulate the condition of Bloch periodicity for the reduced action by using the relation between the wave function and the reduced action established in the context of the equivalence postulate of quantum mechanics. Then, without appealing to the wave function properties, we reproduce the well-known dispersion relations which predict the band structure for the energy spectrum in the Kronig-Penney model.

In a stationary case and for any potential, we solve the three-dimensional quantum Hamilton-Jacobi equation in terms of the solutions of the corresponding Schrodinger equation. Then, in the case of separated variables, by requiring that the conjugate momentum be invariant under any linear transformation of the solutions of the Schrodinger equation used in the reduced action, we clearly identify the integration constants successively in one, two and three dimensions. In each of these cases, we analytically establish that the quantum Hamilton-Jacobi equation describes microstates not detected by the Schroodinger equation in the real wave function case.

The present chapter draws on the Social Indicators and quality of life approaches in analysing the general situation of the Islamic populations. These latter are represented here in the 57 country members of the Organization of Islamic Conference (OIC). Since the issue of quality of life has an important cultural component, we attempt in the fist part of the Chapter to summarise the essence of the Islamic view on life and its quality. The second part examines the quality of life of the selected populations relying on a number of well established objective and subjective indicators. These include: Population growth, economic growth and poverty, Education and knowledge, health provisions, political life and freedoms, and subjective measures. The last part strengthens the analysis through the specific case of the country of Algeria. It has been shown that despite their diversity in terms of geography, economy and political backgrounds, Muslim countries generally share the same cultural heritage and are faced to a great extent with similar life and human development challenges. Building policies allowing for more freedom and democracy, and the strengthening of in-between countries cooperation would help alleviate a lot of suffering among these populations.

Micro-discharges are specific cold filamentary plasma that are generated at atmospheric pressure between electrodes stressed by high voltage. As cold plasma or non-thermal plasma, we suggest that the energy of electrons inside the conductive plasma is much higher than the energy of the heaviest particles (molecules and ions). In such kind of plasma, the temperature of the gas remains cold (i.e. more or less equal to the ambient temperature) unlike in the field of thermal plasmas where the gas temperature can reach some thousands of Kelvin. This high level of temperature can be measured for example in plasma torch or in lightning. The conductive channels of micro-discharges are very thin. Their diameters are estimated around some tens of micrometers. This specificity explains their name: micro-discharge. Another of their characteristic is their very fast development. In fact, micro-discharges propagate at velocity that can attain some tens of millimetres per nanosecond i.e. some 107 cm.s-1. This very fast velocity is due to the propagation of space charge dominated streamer heads. The space charge inside the streamer head creates a very high electric field in which the electrons are accelerated like in an electron gun. These electrons interact with the gas and create mainly ions and radicals. In fact, the energy distribution of electrons inside streamer heads favours the chemical electron-molecule reactions rather than the elastic electron-molecule collisions. Therefore, micro-discharges are mainly used in order to activate chemical reactions either in the gas volume or on a surface (Penetrante & Schultheis, 1993, Urashima &Chang, 2010, Foest et al. 2005, Clement, 2001). Several designs of plasma reactors are able to generate micro-discharges. The most convenient and the well known is probably the corona discharge reactor (Loeb, 1961&1965, Winands, 2006, Ono & Oda a, 2004, van Veldhuizen & Rutgers, 2002, Briels et al., 2006 ). Corona micro-discharges reactor has at least two asymmetric electrodes i.e. with one of them presenting a low curvature that introduces a pin effect where the geometric electric field is enhanced. The corona micro-discharges are initiated from this high geometric field area. Some samples of corona reactor geometries are shown in Fig. 1. The transient character and the small dimensions make some micro-discharges parameters, like charged and radical densities, electron energy or electric field strength, difficult to be accessible to measurements. Therefore, the complete simulation of the discharge reactor, in complement to experimental study can lead to a better understanding of the physico

International audience; The present paper shows for the first time in the literature a complete 2D simulation of the ozone production in a DC positive multi-tip to plane corona discharge reactor crossed by a dry air flow at atmospheric pressure. The simulation is undertaken until 1 ms and involves tens of successive discharge and post-discharge phases. The air flow is stressed by several monofilament corona discharges generated by a maximum of four anodic tips distributed along the reactor. The nonstationary hydrodynamics model for reactive gas mixture is solved using the commercial FLUENT software. During each discharge phase, thermal and vibrational energies as well as densities of radical and metastable excited species are locally injected as source terms in the gas medium surrounding each tip. The chosen chemical model involves 10 neutral species reacting following 24 reactions. The obtained results allow us to follow the cartography of the temperature and the ozone production inside the corona reactor as a function of the number of high voltage anodic tips.

This study was designed to compare videolaryngoscopy with direct laryngoscopy with respect to ease of intubation when inserting a double lumen tube (DLT).In this prospective randomized study 68 patients American Society of Anesthesiologists (ASA) physical status I and II were included. Patients with criteria indicating possible difficult intubation were excluded. The patients were randomized into two groups, depending on the tool used to facilitate intubation: videolaryngoscope (VL group) or direct laryngoscopy (DL group). The time required for intubation was the primary endpoint. Cormack and Lehane glottic visualization (CL) scores, the need for external laryngeal maneuvers and the number of attempts were measured.Glottic visualization was better in the VL group than in the DL group. The CL scores were I, II and III in 24, eight and two patients, respectively, in the VL group compared with 13, 11 and eight in the DL group (P = 0.025). Patients in the VL group required fewer attempts than the DL group (P = 0.019). Intubation time was 39.9 ± 4.4 sec in the VL group and 47.9 ± 5.4 sec in the DL group (P 0.001). No intubation failure was noted in group VL compared with two in the DL group (not significant).The use of a videolaryngoscope reduces the time required for intubation with a DLT compared with the direct laryngoscopy in elective thoracic surgery.

The present paper is devoted to the 2D simulation of an Atmospheric Corona Discharge Reactor (ACDR) involving 10 pins powered by a DC high voltage and positioned 7 mm above a grounded metallic plane. The corona reactor is periodically crossed by thin mono filamentary streamers with a natural repetition frequency of some tens of kHz. The simulation involves the electro-dynamic, chemical kinetic, and neutral gas hydrodynamic phenomena that influence the kinetics of the chemical species transformation. Each discharge stage (including the primary and the secondary streamers development and the resulting thermal shock) lasts about one hundred nanoseconds while the post-discharge stages occurring between two successive discharge phases last one hundred microseconds. The ACDR is crossed by a lateral air flow including 400 ppm of NO. During the considered time scale of 10 ms, one hundred discharge/post-discharge cycles are simulated. The simulation involves the radical formation and thermal exchange between the discharges and the background gas. The results show how the successive discharges activate the flow gas and how the induced turbulence phenomena affect the redistribution of the thermal energy and the chemical kinetics inside the ACDR.

This study was designed to compare videolaryngoscopy with direct laryngoscopy with respect to ease of intubation when inserting a double lumen tube (DLT). In this prospective randomized study 68 patients American Society of Anesthesiologists (ASA) physical status I and II were included. Patients with criteria indicating possible difficult intubation were excluded. The patients were randomized into two groups, depending on the tool used to facilitate intubation: videolaryngoscope (VL group) or direct laryngoscopy (DL group). The time required for intubation was the primary endpoint. Cormack and Lehane glottic visualization (CL) scores, the need for external laryngeal maneuvers and the number of attempts were measured. Glottic visualization was better in the VL group than in the DL group. The CL scores were I, II and III in 24, eight and two patients, respectively, in the VL group compared with 13, 11 and eight in the DL group (P = 0.025). Patients in the VL group required fewer attempts than the DL group (P = 0.019). Intubation time was 39.9 ± 4.4 sec in the VL group and 47.9 ± 5.4 sec in the DL group (P

This thesis aims to test theoretical contributions in a psycho-dynamic look from a projective clinical anchorage and to understand the delicate weaving between time registration and work processes in a joint; proposed questioning the perception of the three times (past, present and future), and specific registration in a non-representational situation in the Rorschach test and the account registration process to test the TAT. If the discontinuous nature of the events proves not structured in anxious depressed, amid the non continuity and lack of permanence secured by a object relation, to the other supporting insufficiently whose psyche decomposes in anxious depression , relive the past and expectation often takes the subject into a abyss of anguish in which he loses. No longer able to anchor in this development in a movement and psychic symbolization, and, mirror, engulfing everything possible for the future, the subject says "anxious depressed" would end up, paradoxically, locked in a dead time if contained in a temporal barred spiral without gap which potentiates its instinctual investment, and object-narcissistic.; Cette thèse vise à mettre à l'épreuve les apports théoriques, dans un regard psycho-dynamique à partir d'un ancrage clinique et projectif, afin de comprendre le délicat tissage entre inscription temporelle et processus dans un travail d’articulation ; que propose le questionnement sur la perception des trois temps (passé, présent et futur), et de la spécificité d’inscription dans une situation non-figuratif au test du Rorschach, ainsi que processus d’enregistrement le récit au test du TAT. Si le caractère discontinu des évènements s'avère non structurant chez le déprimé anxieux, sur fond de la non continuité et de défaut de la permanence garanti par une relation objectale, à l'autre insuffisamment étayant, dont le psychisme se décompose dans la dépression anxieuse, revivre le passé et l'attente emporte souvent le sujet dans un abîme d'angoisse dans lequel il se perd. Ne pouvant plus s’ancrer dans le présent dans un mouvement d’élaboration et de symbolisation psychique, et, en miroir, engouffrant tout possible pour l'avenir, le sujet dit « déprimé anxieux » se retrouverait, paradoxalement, enfermé dans une impasse temporelle, se figure dans un spirale temporelle barré, sans écart qui potentialise son investissement pulsionnel, narcissique et objectal.