Une approche pour la comparaison, du point de vue fonctionnement hydraulique, de propositions d'extension d'un réseau d'assainissement

Les outils informatiques développés dans le cadre de la conception des réseaux d'assainissement permettent de concevoir plusieurs solutions de réseaux pour un même problème. Il revient ensuite au décideur de choisir quelle solution retenir. Le problème qui se pose alors est la comparaison des propositions selon des critères économiques, écologiques, de fonctionnement, de maintenance, .... La difficulté vient du fait que certains de ces critères sont difficiles à évaluer. Nous présentons dans cet article une méthode permettant d'évaluer l'un de ces critères : le fonctionnement global d'un réseau d'assainissement suite à l'extension de ce dernier. Cette méthode est basée sur des simulations hydrauliques. Or ces simulations donnent des informations en chaque noeud du réseau (histogrammes de vitesses, débits ou hauteurs de charge) et non une indication sur la qualité de fonctionnement du réseau dans son ensemble. Il nous a donc fallu élaborer une technique d'agrégation permettant de passer de l'élément isolé (le tronçon) à l'ensemble organisé (le réseau). Cette technique d'agrégation utilise les notions de "période d'insuffisance" d'un tronçon qui est la période de retour d'une pluie pour laquelle ce tronçon dépasse un certain seuil de dysfonctionnement (dans notre cas, le débordement) et de sensibilité du tissu urbain à un dysfonctionnement hydraulique du réseau. Cette dernière notion est nécessaire car certains tronçons peuvent très bien déborder sans induire de désordres apparents s'ils ont, par exemple, une capacité d'écoulement faible et/ou s'ils se trouvent dans une zone non bâtie. Les informations nécessaires à l'utilisation de cette méthode étant souvent de qualité inégale en termes de précision, nous avons pris le parti de raisonner non sur des valeurs déterminées ais sur des classes d'appartenance modélisées sous forme de sous-ensembles flous.Software packages developed for the design of urban storm drainage networks allow several solutions to be proposed for the same problem. It then falls to the designer to choose which solution to use, the main problem being the evaluation of the efficiency (quality) of each solution. A multi-criteria approach represents one theoretical solution to the problem. This necessitates the determination of which criteria to use and how to evaluate them. In this paper, we present a method of evaluation of the criteria related directly to the functioning of an urban storm drainage network after its extension. This method is developed on the basis of hydraulic simulations of the network. These simulations produce results (histograms of discharge, water levels, rates of filling, hydraulic head, ...) for each pipe. Given these results, the designer must be able to assess whether the proposed solution is satisfactory, and then compare it with other solutions. The problem is therefore to be able to evaluate a complete network, whereas the results of conventional simulations present a fragmented and partial view of its functioning (pipe by pipe). A solution to this problem is proposed in the form of a tool, able to calculate a single combined value from the simulation results. The following calculation steps are proposed:1. First we model the effectiveness of each pipe. To do that, we determine the "return period of failure" of a pipe which is the return period of a rainfall for which the pipe passes a certain level of failure (in this paper, we take the level of failure as the state of overflow). The rainfall model used is the same one used for the design of the network. Then we attribute a numerical value (S) for the operation of a pipe according to its return period of failure by way of a satisfaction function. 2. Secondly we model the weighting given to each pipe. This weighting is constructed from the discharge capacity of the pipe and the sensitivity of the urban fabric (in proximity to the pipe) to system failure. The discharge capacity is calculated using Manning's formula on the basis of diameter, slope and internal roughness. The value of the coefficient (R), which indicates the sensitivity, necessitates a good knowledge of the urban fabric. Among the important variables related to this factor, we can identify the population density, the traffic density and the density of land use -DLU- (this variable is identified by the density of residential land use, the density of commercial land use, ...). We can then write R=f(density of population, density of traffic, DLU,...). Considering the difficulty of the identification of (f), we preferred to explore an expert approach. The rules have been identified from a bibliographical analysis and limited expertise. An example of theses rules is presented here : IF density of population is high and density of commercial land use is average THEN the degree of sensibility is average. The examination of the identified rules shows the use of words like low, average and high. To model this linguistic qualifying information, we have chosen fuzzy sets. Also the inferences of fuzzy information are treated by using operations of fuzzy logic. 3. Finally, we aggregate the results with the following equation:     nC=∑QaixRix∆Si  i=1where DSi=Si - Si' represents a measure of the effect of network modification upon the operation of the pipe i (Si and Si' are the effectiveness of the pipe respectively before and after the proposed modification), Qai is the discharge capacity of the pipe i, Ri is the coefficient of sensitivity of the area to failure associated with pipe i and C is a factor which quantifies the effect on the general operation of the network. With the coefficient C, the designer is now able to classify the different solutions of extension of an existing urban drainage network according to their impacts on its functioning and to introduce this classification order in a multi-criteria method

Prevention of Ventricular Arrhythmias With Sarcoplasmic Reticulum Ca2+ ATPase Pump Overexpression in a Porcine Model of Ischemia Reperfusion

Background— Ventricular arrhythmias are life-threatening complications of heart failure and myocardial ischemia. Increased diastolic Ca2+ overload occurring in ischemia leads to afterdepolarizations and aftercontractions that are responsible for cellular electric instability. We inquired whether sarcoplasmic reticulum Ca2+ ATPase pump (SERCA2a) overexpression could reduce ischemic ventricular arrhythmias by modulating Ca2+ overload.Methods and Results— SERCA2a overexpression in pig hearts was achieved by intracoronary gene delivery of adenovirus in the 3 main coronary arteries. Homogeneous distribution of the gene was obtained through the left ventricle. After gene delivery, the left anterior descending coronary artery was occluded for 30 minutes to induce myocardial ischemia followed by reperfusion. We compared this model with a model of permanent coronary artery occlusion. Twenty-four–hour ECG Holter recordings showed that SERCA2a overexpression significantly reduced the number of episodes of ventricular tachycardia after reperfusion, whereas no significant difference was found in the occurrence of sustained or nonsustained ventricular tachycardia and ventricular fibrillation in pigs undergoing permanent occlusion. Conclusions— We show that Ca2+ cycling modulation using SERCA2a overexpression reduces ventricular arrhythmias after ischemia-reperfusion. Strategies that modulate postischemic Ca2+ overload may have clinical promise for the treatment of ventricular arrhythmias

High-resolution polarimetry of Parsamian 21: revealing the structure of an edge-on FU Ori disc

We present the first high spatial resolution near-infrared direct and polarimetric observations of Parsamian 21, obtained with the VLT/NACO instrument. We complemented these measurements with archival infrared observations, such as HST/WFPC2 imaging, HST/NICMOS polarimetry, Spitzer IRAC and MIPS photometry, Spitzer IRS spectroscopy as well as ISO photometry. Our main conclusions are the following: (1) we argue that Parsamian 21 is probably an FU Orionis-type object; (2) Parsamian 21 is not associated with any rich cluster of young stars; (3) our measurements reveal a circumstellar envelope, a polar cavity and an edge-on disc; the disc seems to be geometrically flat and extends from approximately 48 to 360 AU from the star; (4) the SED can be reproduced with a simple model of a circumstellar disc and an envelope; (5) within the framework of an evolutionary sequence of FUors proposed by Green et al. (2006) and Quanz et al. (2007), Parsamian 21 can be classified as an intermediate-aged object.Comment: Accepted for publication in the MNRAS. 16 pages, 18 figures and 5 table

Correction of human phospholamban R14del mutation associated with cardiomyopathy using targeted nucleases and combination therapy

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Seismic damage estimation of in-plane regular steel/concrete composite moment resisting frames

© 2016 Elsevier Ltd. Simple empirical expressions to estimate maximum seismic damage on the basis of four well known damage indices for planar regular steel/concrete composite moment resisting frames having steel I beams and concrete filled steel tube (CFT) columns are presented. These expressions are based on the results of an extensive parametric study concerning the inelastic response of a large number of frames to a large number of ordinary far-field type ground motions. Thousands of nonlinear dynamic analyses are performed by scaling the seismic records to different intensities in order to drive the structures to different levels of inelastic deformation. The statistical analysis of the created response databank indicates that the number of stories, beam strength ratio, material strength and ground motion characteristics strongly influence structural damage. Nonlinear regression analysis is employed in order to derive simple formulae, which reflect the influence of the aforementioned parameters and offer a direct estimation of the damage indices used in this study. More specifically, given the characteristics of the structure and the ground motion, one can calculate the maximum damage observed in column bases and beams. Finally, three examples serve to illustrate the use of the proposed expressions and demonstrate their accuracy and efficiency

Geriatric pharmacotherapy : optimisation through integrated approach in the hospital setting

Since older patients are more vulnerable to adverse drug-related events, there is a need to ensure appropriate prescribing in these patients in order to prevent misuse, overuse and underuse of drugs. Different tools and strategies have been developed to reduce inappropriate prescribing; the available measures can be divided into medication assessment tools, and specific interventions to reduce inappropriate prescribing. Implicit criteria of inappropriate prescribing focus on appropriate dosing, search for drug-drug interactions, and increase adherence. Explicit criteria are consensus-based standards focusing on drugs and diseases and include lists of drugs to avoid in general or lists combining drugs with clinical data. These criteria take into consideration differences between patients, and stand for a medication review, by using a systematic approach. Different types of interventions exist in order to reduce inappropriate prescribing in older patients, such as: educational interventions, computerized decision support systems, pharmacist-based interventions, and geriatric assessment. The effects of these interventions have been studied, sometimes in a multifaceted approach combining different techniques, and all types seem to have positive effects on appropriateness of prescribing. Interdisciplinary teamwork within the integrative pharmaceutical care is important for improving of outcomes and safety of drug therapy. The pharmaceutical care process consists offour steps, which are cyclic for an individual patient. These steps are pharmaceutical anamnesis, medication review, design and follow-up of a pharmaceutical care plan. A standardized approach is necessary for the adequate detection and evaluation of drug-related problems. Furthermore, it is clear that drug therapy should be reviewed in-depth, by having full access to medical records, laboratory values and nursing notes. Although clinical pharmacists perform the pharmaceutical care process to manage the patient’s drug therapy in every day clinical practice, the physician takes the ultimate responsibility for the care of the patient in close collaboration with nurses

Massive young disks around Herbig Ae stars

Herbig Ae stars (HAe) are the precursors of Vega-type systems and, therefore, crucial objects in planet formation studies. Thus far, only a few disks associated with HAe stars have been studied using millimetre interferometers. Our aim is to determine the dust evolution and the lifetime of the disks associated with Herbig Ae stars. We imaged the continuum emission at 3 mm and 1.3 mm of the Herbig Ae/Be stars BD+61154, RR Tau, VY Mon and LkHa 198 using the Plateau de Bure Interferometer (PdBI). These stars are in the upper end of the stellar mass range of the Herbig Ae stars (stellar mass greater than 3 solar masses). Our measurements were used to complete the Spectral Energy Distribution (SED). The modelling of the SED, in particular the FIR-mm part, allow us to determine the masses and dust properties of these disks. We detected the disks associated with BD+61154, RR Tau and VY Mon with disk masses of 0.35 Msun, 0.05 Msun and 0.40 Msun respectively. The disk around LkHa 198 was not detected with an upper limit to the disk mass of 0.004 Msun. We detected, however, the disks associated with the younger stellar objects LkHa 198--IR and LkHa 198-mm that are located in the vicinity of LkHa 198. The fitting of the mm part of the SED reveal that the grains in the mid-plane of the disks around BD+61154, RR Tau and VY Mon have sizes of 1--1000 microns. Therefore, grains have not grown to centimetre sizes in these disks yet. These massive (M>3 Msun) and young (about 1 Myr) HAe stars are surrounded by massive (>0.04 Msun) disks with grains of micron-millimetre sizes. Although grain growth is proceeding in these disks, their evolutionary stage is prior to the formation of planetesimals. These disks are less evolved than those detected around T Tauri and Herbig Be stars

Further investigation of confirmed urinary tract infection (UTI) in children under five years: a systematic review.

Background: Further investigation of confirmed UTI in children aims to prevent renal scarring and future complications. Methods: We conducted a systematic review to determine the most effective approach to the further investigation of confirmed urinary tract infection (UTI) in children under five years of age. Results: 73 studies were included. Many studies had methodological limitations or were poorly reported. Effectiveness of further investigations: One study found that routine imaging did not lead to a reduction in recurrent UTIs or renal scarring. Diagnostic accuracy: The studies do not support the use of less invasive tests such as ultrasound as an alternative to renal scintigraphy, either to rule out infection of the upper urinary tract (LR- = 0.57, 95%CI: 0.47, 0.68) and thus to exclude patients from further investigation or to detect renal scarring (LR+ = 3.5, 95% CI: 2.5, 4.8). None of the tests investigated can accurately predict the development of renal scarring. The available evidence supports the consideration of contrast-enhanced ultrasound techniques for detecting vesico-ureteric reflux (VUR), as an alternative to micturating cystourethrography (MCUG) (LR+ = 14.1, 95% CI: 9.5, 20.8; LR- = 0.20, 95%CI: 0.13, 0.29); these techniques have the advantage of not requiring exposure to ionising radiation. Conclusion: There is no evidence to support the clinical effectiveness of routine investigation of children with confirmed UTI. Primary research on the effectiveness, in terms of improved patient outcome, of testing at all stages in the investigation of confirmed urinary tract infection is urgently required

An international comparative study of blood pressure in populations of European vs. African descent

Background: The consistent finding of higher prevalence of hypertension in US blacks compared to whites has led to speculation that African-origin populations are particularly susceptible to this condition. Large surveys now provide new information on this issue. Methods: Using a standardized analysis strategy we examined prevalence estimates for 8 white and 3 black populations (N = 85,000 participants). Results: The range in hypertension prevalence was from 27 to 55% for whites and 14 to 44% for blacks. Conclusions: These data demonstrate that not only is there a wide variation in hypertension prevalence among both racial groups, the rates among blacks are not unusually high when viewed internationally. These data suggest that the impact of environmental factors among both populations may have been under-appreciated

Treatment of hypertension in rural Cambodia: results of a 6-year programme

This study was aimed to describe the outcomes of a hypertension treatment programme in two outpatient clinics in Cambodia. We determined proportions of patients who met the optimal targets for blood pressure (BP) control and assessed the evolution of mean systolic and diastolic BP (SBP/DBP) over time. Multivariate analyses were used to identify predictors of BP decrease and risk factors for LTFU. A total of 2858 patients were enrolled between March 2002 and June 2008 of whom 69.2% were female, 30.5% were aged >/=64years and 32.6% were diabetic. The median follow-up time was 600 days. By the end of 2008, 1642 (57.4%) were alive-in-care, 8 (0.3%) had died and 1208 (42.3%) were lost to follow-up. On admission, mean SBP and DBP were 162 and 94 mm Hg, respectively. Among the patients treated, a significant SBP reduction of 26.8 mm Hg (95% CI: 28.4-25.3) was observed at 6 months. Overall, 36.5% of patients reached the BP targets at 24 months. The number of young adults, non-overweight patients and non-diabetics reaching the BP targets was more. Older age (>64 years), uncontrolled DBP (>/=90 mm Hg) on last consultation and coming late for the last consultation were associated with LTFU, whereas non-diabetic patients were 1.5 times more likely to default than diabetics (95% CI: 1.3-1.7). Although the definite magnitude of the BP decrease due to antihypertension medication over time cannot be assessed definitely without a control group, our results suggest that BP reduction can be obtained with essential hypertension treatment in a large-scale programme in a resource-limited setting