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Background: The overdetermination of the subject in digital cultures, particularly as it relates to processes of dividuation, introduces various tensions and complications. The reduction of subjectivity to data sets for use in predictive algorithms has been linked to the manipulation, marginalization, and harmful production of subjectivity. This situation raises questions about how to challenge or redirect the axiomatic logics of computing. Analysis: This article explores the potential of the aesthetics of computational ambiguity as a resource for expanding agency within the processes of dividuation. Conclusions and implications: This potential is demonstrated by artists exploring the ambiguities of glitch aesthetics, machine learning indeterminacies, and the randomization of computational outputs. [ABSTRACT FROM AUTHOR]

Les infirmières de pratique avancée sont actuellement formées et intégrées progressivement dans les équipes cliniques françaises. Dans certains pays comme le Royaume-Uni, elles sont déjà incluses depuis plusieurs années avec la délégation de gestes techniques comme l'ablation de sonde JJ en ambulatoire. L'expérience britannique montre qu'il existe une liberté quant aux gestes techniques autorisés avec une gestion locale par le coordinateur d'équipe, en accord avec les textes officiels. Il existe cependant des différences d'accès au titre d'infirmière de pratique avancée selon les pays, avec une difficulté plus importante dans le curriculum français. L'urologie doit intégrer ces nouveaux acteurs du soin pour améliorer la prise en charge des patients. Clinical Nurse Specialists (CNS) are currently being trained and progressively integrated into French clinical teams. In some countries, such as the UK, they have already been included for several years, with the delegation of technical procedures such as the removal of ureteral stents on an outpatient basis. The UK experience shows that a "grey zone" exists around the authorized technical procedures for CNS with local management by the team coordinator, in accordance with official texts. However, access to the title of CNS varies among countries, with greater difficulty in the French curriculum. French Urology needs to involve these new actors into the patient's care, as they are being integrated in other medical fields. [ABSTRACT FROM AUTHOR]

In this article, we resume discussions about the application of Differential and Integral Calculus in the Teaching of Chemical Kinetics in Teacher Training. Aspects aimed at demonstrating statements through the resolution of tasks in a course of studies and research as a strategy aimed at appropriating concepts in the domain of reaction kinetics, in the context of activities based specifically on the Anthropological Theory of the Didactic (ATD), based on epistemological models of reference and the dominant one around the object speed laws of chemical reaction. Along the way, the importance and reason for being of Integral and Differential Calculus techniques for teacher training and the formulation of didactic organizations that can serve as support for tasks in the exercise of the profession in high school were highlighted, highlighting the use of instruments of ICT, such as Excel, in the construction of these tasks. It was observed that throughout the course the students understood the steps proposed in the reference epistemological model by completing a crucial task, associated with the question that generated the course, which necessarily applies integration and differentiation techniques to obtain ordinary differential equations, associated with the technique analysis of the least squares method, for the kinetic characterization of a chemical system, a medicine in the simulation of the experimental determination of its expiration date. [ABSTRACT FROM AUTHOR]

This article aims to present a method of intervention in the classroom, specifically in the Differential and Integral Calculus course of a Mathematics Teaching degree, when working with students on the Intermediate Value Theorem. We base our approach on the studies by Bicudo (1991), Garnica (1992), and Garnica and Bicudo (1994) regarding a teaching methodology based on hermeneutic work with mathematical texts in the classroom. We describe the experience conducted and our understanding of the activity carried out. We present the questions posed by the students and the indications of their understanding of the ideas introduced in the studied theorem. [ABSTRACT FROM AUTHOR]

This article proposes a theoretical reflection on models and Calculus, pointing out preliminary notions and basic principles for building a reference epistemological model to teach this subject. To this end, we examine some models present in our daily lives to suggest a generalization of the term. Next, we present the representative model proposed by the anthropological theory of the didactic to subsequently define the dominant and the reference epistemological models as well as the didactic model of reference. Having overcome these definitions, we develop a brief history of the term to clarify what we understand today by Calculus and how it has been used over time. The results of the theoretical-bibliographical research will be valuable for didactic researchers in constructing a reference epistemological model for teaching Calculus. [ABSTRACT FROM AUTHOR]

Les avancées technologiques en endo-urologie font désormais de l'urétéroscopie souple (URSS) une technique de choix pour traiter les calculs urinaires mais aussi un casse-tête lorsqu'il s'agit de choisir son équipement. La mise en place d'un guide de sécurité au sein des cavités rénales (nitinol, 0,035″, « stiff ») par cystoscopie rigide est non obligatoire mais constitue un critère de sécurité. Il en est de même concernant les gaines d'accès urétéral, celles avec aspiration étant en cours d'évaluation. Si leur utilisation réduit la pression et la température au sein des cavités rénales facilitant la vision, leur insertion peut occasionner des lésions urétérales. Les systèmes d'irrigation utilisant la gravité avec pompe manuelle sont à privilégier pour minimiser le risque de barotraumatisme. Le choix de l'urétéroscope est complexe : diamètre, capacité de déflexion, position du canal opérateur et qualité de vision sont à considérer. Aussi, il est difficilement envisageable de n'utiliser qu'un modèle endoscope pour l'intégralité des URSS. Les lasers Holmium:Yttrium-Aluminium-Grenat (Ho:YAG) et Thulium Fibré (TFL) sont aujourd'hui recommandés pour le traitement des calculs urinaires en URSS, avec un avantage potentiel du TFL pour la pulvérisation fine. Les paniers sont nombreux et divers, leur taille et forme devant également être considérées avant acquisition. En fin d'intervention, un drainage urétéral n'est pas systématique, mais les sondes JJ en silicone ont montré des risques d'incrustation et de gêne fonctionnelle plus faibles que les sondes faites de polyuréthane. Flexible ureteroscopy is now widely used as the preferred option to surgically treat a urinary stone, due to several technological advancements. Thus, choosing the adequate equipment is challenging, but respects safety concepts. Indeed, placing the safety wire (nitinol, 0,035″, "stiff") under rigid cystoscopy is not mandatory but improve safety. Regarding ureteral access sheath (UAS), considerations are similar: UAS facilitates vision, pressure and temperature control but can also be responsible of ureteral injuries at insertion. Suction devices are now under evaluation and could not be discussed. To limit the barotrauma risk, irrigation devices with manual pumps should be used (40 cmH 2 0). Choosing a flexible ureteroscope (fURS) is challenging; a special attention has to be given to size, deflexion, working channel position and vision. Thus, using a single fURS is hardly imaginable. Both Holmium:Yttrium-Aluminium-Garnet (Ho:YAG) and Thulium Fiber (TFL) lasers are recommended to treat urinary stones during fURS, with a potential advantage of TFL on thin pulverization. A wide variety of baskets exists and size and shape have to be considered before acquisition. Finally, if ureteral stenting is not mandatory in uncomplicated cases, silicone stents present a lower risk of encrustation and stent-related symptoms compared to polyurethane ones. [ABSTRACT FROM AUTHOR]

Décrire la technologie du laser Thulium:Yttrium-Aluminium-Garnet pulsé (p-Tm:YAG) et ses résultats actuels pour lithotritie laser endocorporelle. Une revue de la littérature, interrogeant les bases Pubmed, Scopus, et Cochrane a été conduite en janvier 2024 utilisant les mots clés « laser », « pulsed Thulium:YAG », « stones » et « lithotripsy ». De par les faibles niveaux de preuve et nombre de publications, une revue narrative de la littérature a été réalisée. Le laser p-Tm:YAG est un laser à cavité avec un cristal YAG dopé aux ions thulium, pompé par des diodes laser. Avec une longueur d'onde du faisceau laser de 2013 nm, il présente un coefficient d'absorption dans l'eau intermédiaire entre le laser Ho:YAG et TFL. Le diamètre minimal utilisable des fibres laser est de 200 μm. Différentes modulations impulsionnelles sont proposées visant à minimiser la rétropulsion des calculs avec notamment une puissance crête (Peak Power) réglable (≥ 800 W). De multiples études comparatives in vitro suggèrent que la capacité du p-Tm:YAG à fragmenter les calculs serait similaire à celle de l'Ho:YAG ; au contraire, sa capacité à pulvériser (dusting) tous types de calculs serait similaire à celle du TFL, avec une faible rétropulsion. Une seule étude in vivo a confirmé la faisabilité de la lithotritie du p-Tm:YAG au cours d'une urétéroscopie souple avec des taux de sans fragment résiduel (< 3 mm) et zéro fragment résiduel de 95 % et 55 %, respectivement. Aucune étude comparative n'est disponible à ce jour. Le nouveau laser p-Tm:YAG pulsé pourrait représenter un compromis sûr et efficace entre le laser Ho:YAG et le TFL pour la lithotritie laser endocoporelle mais des études comparatives, notamment avec le TFL sont nécessaires pour définir sa place dans l'arsenal thérapeutique. To describe the pulsed-Thulium:Yttrium-Aluminum Garnet (p-Tm:YAG) laser technology and its current evidence for endoscopic laser lithotripsy. A literature review, querying PubMed, Scopus, and Cochrane databases, was conducted in January 2023 using keywords "laser", "pulsed Thulium:YAG", "stones" and "lithotripsy". Due to the limited level of evidence and the number of publications, a narrative literature review was undertaken. The p-Tm:YAG laser is a cavity laser with a thulium-doped YAG crystal, pumped by laser diodes. With a laser beam wavelength of 2013 nm, p-Tm:YAG presents an intermediate absorption coefficient in water between Ho:YAG and TFL lasers. The minimal usable diameter of laser fibers for this technology is 200 μm. Various pulse modulations are proposed to minimize stone retropulsion, including adjustable peak power (≥ 800 W). Multiple in vitro comparative studies suggest that p-Tm:YAG's ability to fragment stones is similar to that of Ho:YAG, while its ability to dust various types of stones is similar to TFL, with low retropulsion. A single in vivo study confirmed the feasibility of p-Tm:YAG lithotripsy during flexible ureteroscopy, with stone-free (< 3 mm) and zero-fragment rates of 95% and 55%, respectively. No comparative studies are available to date. The new pulsed p-Tm:YAG laser could represent a safe and effective compromise between Ho:YAG and TFL for endoscopic laser lithotripsy, but comparative studies, especially with TFL, are necessary to define its role in the therapeutic arsenal. [ABSTRACT FROM AUTHOR]

Les lasers sont aujourd'hui des outils incontournables en endourologie, aussi bien pour le traitement des calculs urinaires, que des tumeurs urothéliales (vésicales ou du haut appareil) ou de l'hypertrophie bénigne de prostate. Si pendant une trentaine d'années, le laser Holmium : Yttrium-Aluminium-Grenat (Ho:YAG) a été l'acteur prépondérant pour ces applications, les lasers thulium fibré (TFL) et Thulium : YAG (Tm:YAG) sont aujourd'hui des alternatives grandissantes. Les TFL et Ho:YAG sont désormais recommandés pour le traitement des calculs urinaires, un manque de données cliniques limite les recommandations concernant le Tm:YAG. Pour le traitement des lésions urothéliales (énucléation « en-bloc » vésicales ou vaporisation des lésions du haut appareil urinaire), Ho:YAG, TFL et Tm:YAG sont utilisables mais il n'est pas possible à ce jour de recommander une source laser en particulier. De la même manière, ces trois sources lasers semblent utilisables pour réaliser une énucléation endoscopique de prostate, bien que le recul soit plus important pour l'Ho:YAG. Les techniques chirurgicales et les courbes d'apprentissage vont dépendre de la source laser, responsables d'effets bien différents, qu'il faut donc prendre en considération avant d'acquérir un générateur laser. Nowadays, laser technology has become the gold standard for many endourological applications, encompassing the treatment of urinary calculi, urothelial tumors (bladder or upper tract), and benign prostatic hyperplasia. While the Holmium: Yttrium-Aluminum-Garnet (Ho:YAG) laser dominated these applications for about thirty years, thulium fiber laser (TFL) and Thulium: YAG (Tm:YAG) lasers are emerging as growing alternatives. TFL and Ho:YAG are now recommended for urinary calculi treatment, but a lack of clinical data limits recommendations for Tm:YAG. For urothelial lesion treatment ("en-bloc" enucleation of a bladder tumor or vaporization of upper urinary tract lesions), Ho:YAG, TFL, and Tm:YAG are usable, but it is not currently possible to recommend a specific laser source. Similarly, these three laser sources appear usable for endoscopic prostate enucleation, although there is more extensive experience with Ho:YAG. Surgical techniques and learning curves will depend on the laser source, which can produce different effects, requiring careful consideration before acquiring a laser generator. [ABSTRACT FROM AUTHOR]

Thromboembolic disease (TED) is a major cause of maternal mortality and severe morbidity. The pregnant woman presents with some anatomical and physiological modifications that expose her to risk of blood clot and thisrisk issignificantly higher when she gives birth by caesarean section. In this light, the health team has a responsibility to ensure that adequate preventive measures are employed to prevent the occurrence of this disease. This was a descriptive and prospective study which was carried out on patients who had undergone a caesarean section in the YGOPH from September to October 2023 and who had given their concern. Patients were recruited from the anaesthetic consultation room, followed up in the theatre, to the recovery room and to the intensive care and obstetric units. Data was collected on Sociodemographic and clinical characteristics as well as the patient’s risk factors, the non-pharmacological and pharmacological measures of prevention and the evolution of the patient. The data was analysed using the software; Epi info and excel and presented in the form of tables, graphs and charts. We recruited a total of 54 women who had a caesarean section between the age ranges of 18 to 42 years with the mean age of 27.8 years. After the assessment of our patients’ risk factors, 5(9%) patients were classified at the low risk level, 49 (91%)patients at the intermediate and no patient at the high risk level. As regards the nonpharmacological methods, we found out that only 3 (5.3%) patients were putting on the compression stockings, 3 (5.6%) patients were deambulated on the 6-8hours post op. Only 14 (25.9%) patients took the normal amount of fluids in 24hours. The only pharmacological measure of prevention was enoxaparin which was systematically prescribed and 46 (85.2%) patientstook the drug but 8 (14.8%) patients could not afford and did not receive the drug. For those that received the drug, there was a disparity as regards the dosage and the duration of prophylaxis as only 3 (5.5%) took the drug for at least 10days as required. Finally, out of the 54 patients, 15 (27.8%) presented with complications. In this study, it was revealed that, the preventive measures of thromboembolic disease in caesarean section at the YGOPH were not optimal and needed to be improved [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the results of open pyelolithotomy in the Urology Department of the Ignace Deen National Hospital, CHU of Conakry. This was a prospective and descriptive study of 28 cases of pyelitis operated on from January 1, 2015 to December 31, 2017. The variables studied were sociodemographic, clinical, paraclinical and therapeutic. In our study, pyelic lithiasis ranked first among upper urinary tract lithiasis n=50 (56%) and second among all urinary stones n=28 (29.9%).The most affected age group was 31 to 40 years old with 32.1%. The sex ratio was 18 males to 10 females. Lumbar pain was the main reason for consultation. The cytobacteriological examination of urine revealed an infection in 24 patients or 85.7%. The IVU made the diagnosis in 85.7% of cases. The mean size of the stones was 24.1 ± 6.7 mm in diameter. The mean duration of the operation was 103±38mn. Intraoperatively we recorded two cases of peritoneal perforation, one case of avulsion of the ureter which side and one case of damage to the renal pelvis. The main post-operative complication was infection of the operating site with 28.6%.Open pyelolithotomy still retains its indications in some third world countries like ours. Nowadays it is more and more rare in favour of mini-invasive techniques (LEC; Endo- Urology). [ABSTRACT FROM AUTHOR]

In the research reported in this article, we seek to explore aspects of differential thinking and thinking-with-GeoGebra that emerge when high school students investigate activities on the calculation of areas and volumes. Initially, we discuss issues about mathematical thinking and differential thinking, proposing a perspective on differential thinking formed by four aspects: Notion of limit and continuity; Notion of infinitesimal; Defined integral concept; Visualgeometric design. From the methodological point of view, based on qualitative research, we developed teaching experiments with 6 pairs of students from the 10, 11 and 12 grades of High School, considering the elaboration of a task composed of 5 activities. In the article, based on the notion of sampling in qualitative research, we discuss the investigation developed by one pair of 12th grades about the activity entitled "The Problem of Volume". In the data analysis, we highlighted the role of visualization and experimentation-with-technologies in the development of students' thinking. In particular, we emphasize how the resources or potentialities of the software offered ways for students to articulate the four aspects that make up differential thinking in the proposed perspective. This study contributes to the production of knowledge about the use of digital technologies in Mathematics Education, in particular to the relation to the teaching of Calculus in High School. [ABSTRACT FROM AUTHOR]

This article contributes to the knowledge about the learning of systems of differential equations from the point of view of dynamical systems. It analyzes the evolution of the Schema of dynamic systems of two variables in university students, after finishing a course of dynamic systems designed with the Action Process Object Object Schema (APOE) theory as a support for the design of activities used throughout the course. In particular, this study focuses on how students give meaning to the strategies used to represent and interpret systems of differential equations and the relationships they establish between the structures that make up the Systems of Equations Schema and in particular the relationships between the function and its derivative through the different representations used to study them. This work also contributes to enrich the notion of Schema and interaction between Schemas of the APOE theory, as well as to the analysis of the relationships between the different concepts involved in and between the different representations of the solutions that play a role in the context of systems of differential equations and, importantly, in the understanding of parametric functions. [ABSTRACT FROM AUTHOR]

Les textes offrent la possibilité de manipulations calcultoires via leur matérialité sémiotique : les symboles informatiques codant les caractères permettent la mobilisation d’algorithmes et outils informatiques. Cependant, ces traitements butent sur ce que nous appelons la duplicité du sémiotique, selon laquelle les symboles informatiques ne sont pas des signes dans la mesure où les premiers ne signifient rien contrairement aux seconds : les calculs sont effectués indépendamment de l’interprétation des signes textuels. Manipulation computationnelle et interprétation herméneutique sont donc hétérogènes et distincts, la première ne peut qu’approximer et simuler la seconde. Cet écart procède de la nature du sens et de ce qui manque aux machines pour y accéder. Cet article considère les différents types de complexité, analytique, synthétique et herméneutique pour voir dans la dernière ce qui résiste à réduction calculatoire. Ce constat est approfondi en revenant à la constitution phénoménologique du sens et ce qui fait que le sens d’un texte n’est accessible qu’à une entité ayant la notion d’un environnement qui l’excède et d’un ailleurs qui lui manque. Cet écart irréductible ne disqualifie pas l’intérêt des traitements algorithmiques : ils permettent bien au contraire de s’émanciper des contraintes du sens. Mais les résultats doivent être finalement repris et réassumés dans une entreprise herméneutique, pour transformer les données résultats en textes à comprendre.

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La cystinurie est une maladie monogénique induisant une perte de fonction d'un transporteur d'acides aminés dibasiques impliqué dans la réabsorption de cystine au niveau des tubules rénaux proximaux. L'excrétion urinaire de cystine chez ces patients est augmentée d'un rapport 10 à 60 par rapport au sujet sain, responsable d'une sursaturation avec précipitation de cristaux de cystine dans les reins et de calculs dans les cavités excrétrices. La physiopathologie de la cystinurie est particulière : la concentration plasmatique de cystine est souvent normale alors que l'absorption intestinale est diminuée. Ce paradoxe est expliqué par une absorption intestinale préservée de cystéine et de méthionine qui sont deux acides aminés soufrés métabolisés notamment en cystine. Le principe du traitement consiste à empêcher la formation de cristaux de cystine dans les reins afin de prévenir la survenue d'une maladie lithiasique, mais aussi d'une authentique néphropathie cristalline responsable d'une insuffisance rénale chez plus de la moitié des patients. Le traitement médical des patients cystinuriques repose (1) sur une diminution de l'excrétion urinaire quotidienne de cystine qui est le reflet de l'absorption intestinale et donc des apports en méthionine ; (2) sur une augmentation du seuil de solubilité urinaire de la cystine afin de prévenir une précipitation cristalline intratubulaire et intracavitaire par une dilution et une alcalinisation des urines avec des valeurs cibles de 3 L et un pH urinaire aux alentour de 7,5. Le traitement par sulfhydryle dont le but est de dissocier les ponts disulfures des molécules de cystine avec un effet modeste sur la dissolution des calculs de cystine constitués ne devrait en toute logique être utilisé en dernier recours une fois les mesures diététiques et la cible de pH urinaire obtenue. Cystinuria is a dibasic amino acid transporter molecular defect preventing cystine reabsorption within renal proximal tubules. A 10 to 60 fold increase of urine cystine concentration compared to healthy subjects is responsible for pure cystine crystal onset within tubules and stones in the urinary tract leading to chronic renal failure in half cases. Plasma cystine concentration is usually reported in the normal range despite a decreased cystine intestinal absorption. This discrepancy is explained by a preserved intestinal absorption of cysteine and methionine, two sulphur amino acids which are partly metabolized into cystine. Monitoring and treatment is based on a pathophysiological approach aiming at decreasing both urine cystine excretion and concentration but also increasing urine cystine solubility (i.e. raising urine pH). Guidelines are thus based upon a methionine restricted diet, a water intake target of 3 liters/day and a urine pH target of 7.5. Sulfhydryl treatment (mainly tiopronin), frequently used in France in order to dissociate cystine disulfur bonds has a moderate effect on cystine stones solubilization and thus should be consider, to our view, only after diet and urine goal targets are reached. [ABSTRACT FROM AUTHOR]

L’IA est souvent présentée comme un modèle devenu un concurrent de l’intelligence humaine. Mais si on la caractérise qu’elle est une manière artificielle de résoudre des problèmes qui requièrent de la part des humains de l’intelligence, rien n’implique qu’il lui soit nécessaire de faire preuve d’intelligence. Dans cet article, nous abordons cette question à deux niveaux : à un niveau ontologique, la machine est-elle aussi intelligente que l’humain, ou l’humain aussi stupide qu’une machine ? à un niveau sociologique, la machine n’est-elle pas appelée à remplacer l’humain du fait de nos sociétés modernes dont la rationalité calculante confine les personnes à des tâches machinales et répétitives ? Nous argumentons que la machine reste ontologiquement stupide à la différence des êtres humains, les trois énigmes du brin d’herbe, de la caresse et du regard marquant un écart irréductible, mais que la véritable question est de savoir penser une société moderne misant sur l’intelligence humaine où la machine est son complément et non son concurrent.

Le méga-urètre congénital est une malformation rare à l'origine d'un désordre mictionnel avec parfois un retentissement sur le haut appareil urinaire. Malgré l'association fréquence avec d'autres malformations urinaires et extra urinaires, chez l'enfant, la complication par des calculs n'a été rapportée qu'une seule fois dans la littérature. Nous rapportons un cas de méga-urètre congénital compliqué de calculs de stase chez un enfant de 3 ans pris en charge avec succès au Service de Chirurgie Pédiatrique du Centre Hospitalier Mère et Enfant de Nouakchott. A travers cette observation, nous revenons sur les aspects épidémiologiques, cliniques et thérapeutiques de cette association entre méga-urètre congénital et calculs urinaires.

Researchers have recently proposed that educated adults solve the simplest addition problems (e.g., 3 + 2) by an automatic counting procedure, challenging the long-held view that educated adults solve small additions by associative memory retrieval. We tested predications of a sum-counting model that assumes a procedure in which the 2 quantities represented by the operands are encoded and counted sequentially. Here, we presented the 2 operands sequentially (e.g., "3 +" first and then "2") and manipulated the preview time for the first operand (O1) and operator across 2 experiments (both n = 36); the O1 preview times were 1000 ms and 500 ms in Experiments 1 and 2, respectively. We measured response time (RT) from the presentation of the second operand (O2) and compared it with RT when both operands appeared simultaneously. Contrary to the sum-counting model, with sequential presentation, problems with the same O2 sizes (e.g., 3 + 2, 4 + 2) demonstrated significant RT differences across levels of O1, and the sum of the operands was a better RT predictor than O2 with both sequential and simultaneous displays. These results challenge a sum-counting model of the present data but are consistent with a memory retrieval theory. [ABSTRACT FROM AUTHOR]

This article analyses pay determination as a process of commensuration as well as a process in which commensuration can fail. The analysis is based on an empirical study of two collective firms in Germany and the United Kingdom and their attempts to self-determine fair pay. Due to the formal equality of members and their democratic decision-making processes, these cases are a specifically interesting context for studying the determination of pay. Through the analysis of a failed attempt at finding a formula for fair pay, as well as a fragile compromise formula, a contribution is made to the literature on commensuration and the construction of compromises. The article also extends this literature by explaining the obstacles to the creation of a compromise that would go beyond the need for a common interest. Callon and Muniesa's work on calculation is used to clarify the steps that are necessary to move from questions of worth to the assessment of worth and its expression in measures. To introduce the question of legitimacy in evaluation processes, Callon and Muniesa's framework is supplemented with Boltanski and Thévenot's work on critical capacities. [ABSTRACT FROM AUTHOR]

Congenital mega-urethra is a rare malformation causing micturition disturbance sometimes associated with upper urinary tract impairment. Despite the frequent association with other urinary and non-urinary abnormalities in children, stone-related complication has been reported only once in the literature. We report a case of congenital mega urethra complicated by stasis and stone formation in a 3 year old child successfully treated in the Department of Paediatric Surgery at the Mother-Child Hospital in Nouakchott. This study highlights the epidemiological clinical and therapeutic features of this association between congenital mega-urethra and urinary stones. [ABSTRACT FROM AUTHOR]

The spontaneous elimination rate of ureteral stones decreases with their size, but also in function of their location. The objectives of stone surveillance are to detect the occurrence of a complication (e.g., fever, clinical tolerance) and to verify the potential stone migration/elimination. The use of urological procedures and the choice of technique are based on many different factors. Kidney stone surveillance is proposed mainly to people with low risk of progression or complications (size<4mm and/or lower calyx location and non-infection stone). Surveillance may be extended to patients with larger stones, in function of the clinical context and comorbidities. Conversely, a urological procedure may also be proposed to patients with stones<4mm for professional (e.g., soldier, pilot, expatriate) or social reasons or if travelling is planned. The choice of technique is based on the stone composition (if already known) and density, the advantages and limitations of each technique, and also the clinical context, while trying to choose the least invasive procedure for a stone-free objective. METHODOLOGY: These recommendations were developed using two methods: the Clinical Practice Recommendations method (CPR) and the ADAPTE method, depending on whether the question was considered in the European Association of Urology (EAU) recommendations (https://uroweb.org/guidelines/urolithiasis) [EAU 2022] and their adaptability to the French context. This chapter is based on the references used in the chapters on the different techniques (extracorporeal shock wave therapy, ureteroscopy, percutaneous nephrolithotomy, medical expulsive therapy, postural therapy, chemolysis by alkalinization) as well as the American Urological Association (AUA) and EAU recommendations., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)

Endocorporeal lithotripsy has progressed thanks to the development of lasers. Two laser sources are currently available: Holmium:YAG (Ho:YAG) and more recently Thulium Fiber Laser (TFL). The settings generally used are dusting, fragmentation, and "pop-corning". These are the first recommendations on laser use for stone management and their settings. Settings must be modulated and can be changed during the treatment according to the expected and obtained effects, the location and stone type that is treated. METHODOLOGY: These recommendations have been developed using two methods: the Clinical Practice Recommendation (CPR) method and the ADAPTE method, depending on whether or not the question was considered in the European Association of Urology (EAU) recommendations (https://uroweb.org/guidelines/urolithiasis [EAU Guidelines on urolithiasis. 2022]) and their adaptability to the French context., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)

Extracorporeal shock wave lithotripsy (ESWL) is a minimally invasive technique for the fragmentation of urinary tract stones using shock waves under fluoroscopic and/or ultrasound guidance. ESWL results depend on the indication (stone size/composition, clinical context) and also on how it is performed. The stone structure, nature and density (Hounsfield units; evaluated by CT without contrast agent) influence the fragmentation achieved by ESWL. The upper size limit of kidney stones has been lowered to 15mm (1.68cm 3 ) due to the increased risk of steinstrasse with larger sizes and the potential need of anesthesia and ureteral stenting. Conversely, the development of endourological technologies allows a finer stone fragmentation and/or better elimination, thus reducing the risk of steinstrasse and decreasing the potential number of sessions or additional interventions. METHODOLOGY: These recommendations were developed using two methods: the Clinical Practice Recommendations method (CPR) and the ADAPTE method, depending on whether the question was considered in the European Association of Urology (EAU) recommendations (https://uroweb.org/guidelines/urolithiasis [EAU 2022]) and their adaptability to the French context., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)

Only few hundred interventions are performed in France each year to remove upper urinary tract stones using a laparoscopic/robotic transperitoneal or retroperitoneal approach. These interventions are proposed to patients with large (>20mm) and complex stones, sometimes after failure of endoscopic techniques or in the presence of malformations that can be treated at the same time. The major interest of these interventions is the possibility to remove the whole stone without prior fragmentation. Some anatomical situations can increase the technical difficulty, particularly the presence of an intrarenal pelvis and the presence of pelvic and periureteral adhesions. The reported complications are essentially urinary fistula and ureteral stenosis, the risks of which are reduced by the use of double J stenting. As struvite stones are more friable, their whole removal is more difficult and may lead to dispersion of fragments, particularly during laparoscopy. Conventional open surgery has a higher stone-free rate, but comes with a greater kidney function loss. METHODOLOGY: These recommendations were developed using two methods: the Clinical Practice Recommendation (CPR) method and the ADAPTE method, depending on whether the question was considered in the European Association of Urology (EAU) recommendations (https://uroweb.org/guidelines/urolithiasis) (EAU Guidelines on urolithiasis. 2022) and their adaptability to the French context., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)

The primary objective of the combined approach is to limit the number of percutaneous access tracts for the treatment of staghorn, or complex kidney stones by simultaneous percutaneous antegrade and retrograde ureteroscopy. The other indication is the simultaneous presence of several kidney and ureteral stones or of an impacted pelvic stone. The combination of the two techniques may increase the stone-free rate and decrease the retreatment rate of complex stones compared with percutaneous nephrolithotomy alone. The patient is usually in the modified supine position. METHODOLOGY: These recommendations were developed using two methods: the Clinical Practice Recommendation (CPR) method and the ADAPTE method, depending on whether the question was considered in the European Association of Urology (EAU) recommendations (https://uroweb.org/guidelines/urolithiasis) [EAU Guidelines on urolithiasis. 2022] and their adaptability to the French context., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)

Percutaneous nephrolithotomy (Labate et al.) is the standard procedure for the treatment of large (≥2cm) kidney stones. The patient can be in prone or modified supine position. The puncture is performed under fluoroscopy and/or ultrasound guidance. The stone-free rate seems to be comparable between miniaturized and standard PCNL. Procedures performed with smaller diameter instruments tend to be associated with significant lower blood loss, but longer procedure times. The limitation of the number of percutaneous tracts results in better preservation of the kidney function and lowers the risk of complications. The use of tranexamic acid during PCNL may be interesting for reducing the bleeding risk, the transfusion rate, and possibly the intervention duration. METHODOLOGY: These recommendations were developed using two methods: the Clinical Practice Recommendation (CPR) method and the ADAPTE method, depending on whether the question was considered in the European Association of Urology (EAU) recommendations (https://uroweb.org/guidelines/urolithiasis [EAU 2022]) and their adaptability to the French context., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)

Copyright of Réseaux (07517971) is the property of Editions La Decouverte and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A similar prevalence rate has been reported between reading learning difficulties (RLD) and mathematics learning difficulties (MLD). However, the diagnosis of the latter is less frequent than the former. In the literature it is discussed that this phenomenon may be explained by controversies in the conceptualization of MLD in the scientific field, which would impact the educational field: lack of assessment techniques, lack of specific knowledge in teacher training courses. There could be a better ability to recognise RLD in schools. Our aim was to compare the amount of reports present on students' records of the risk in mathematics group with those present in the risk in reading and normally-achieving groups. We studied students from 3rd to 6th grade in Primary School (n=168), with good academic achievement and a favourable socio-economic status. Through the use of standardized tests in reading and arithmetic we grouped the participants in three conditions: risk in reading, risk in arithmetic, and normally-achieving. Furthermore, we codified the observations registered by teachers and school professionals in the student's' records and proceeded to compare this variable in the three groups. The results show that while the risk in reading group shows significantly more reports than the normally-achieving group, this is not the case for the risk in mathematics group, which has a similar amount of reports than the normallyachieving group. Moreover, the risk in mathematics group shows a significantly lower amount of reports in their records than the risk in reading group. Four factors that could be explaining this phenomenon, as well as its consequences on participants' prognosis and associated secondary effects are discussed. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Film Studies is the property of University of Toronto Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Le prix de l'eau est un élément qui influence le comportement du consommateur. Comprendre ses nuances, ses variations et les règles qui le définissent n'est pas évident, mais ce sont des clés que l'usager doit pouvoir maîtriser.