Yes / Objectives The Cohen-Mansfield Agitation Inventory (CMAI; (Cohen-Mansfield and Kerin, 1986)) is a well-known tool for assessing agitated behaviours in people with dementia who reside in long-term care. No studies have evaluated the psychometric qualities and factor structure of the CMAI in acute general hospitals, a setting where people with demand may become agitated. Method Longitudinal study investigating pain, agitation and behavioural problems in 230 people with dementia admitted to acute general hospitals in 2011–2012. Cohen-Mansfield Agitation Inventory was completed as part of a battery of assessments including PAINAD to measure pain. Results A nine-item two-factor model of aggressive and nonaggressive behaviours proved to be the best-fitting measurement model in this sample, (χ2 = 96.3, df = 26, p<0.001; BIC [Bayesian Information Criterion] = 4593.06, CFI [Comparative Fit Index] = 0.884, TLI [Tucker Lewis Index] = 0.839, RMSEA [Root Mean Square Error of the Approximation] = 0.108). Although similar to the original factor structure, the new model resulted in the elimination of item 13 (screaming). Validity was confirmed with the shortened CMAI showing similar associations with pain as the original version of the CMAI, in particular the link between aggressive behaviours and pain. Conclusion The factor structure of the CMAI was broadly consistent with the original solution although a large number of items were removed. Scales reflecting physical and verbal aggression were combined to form an Aggressive factor, and physical and verbal nonaggressive behaviours were combined to form the Nonaggressive factor. A shorter, more concise version of the CMAI was developed for use in acute general hospital settings. Copyright © 2017 John Wiley & Sons, Ltd. / Alzheimer's Society and the BUPA Foundation. Grant Number: 131

Endodontics is a branch of dentistry focused on preventing and treating dental conditions affecting the pulp, root canal system, and periapical tissues Exposure to bacteria can cause infection of the root canal system and surrounding tissues. Endodontic treatment can be highly challenging due to the bacterial biofilm and anatomical complexities. Therefore, the development of new technologies that effectively disinfect root canals is imperative for the improved success of endodontic treatment. EndoLogic device is a new irrigation technology works by creating an electrical discharge in a conductive liquid that can kill pathogens. The electric discharge causes cavitation, shock waves, ultraviolet radiation, multiple anti-microbial radicals. The findings for the EndoLogic device were inconsistent. Preliminary LIVE/DEAD staining indicated promising results, but later CFU experiments showed a negative correlation between EndoLogic activation and root canal disinfection. Additional experiments are planned to further investigate the effectiveness of this innovative device. / 2026-08-02T00:00:00Z

Une lecture comparative de la « Poudre d’intelligence » de Kateb Yacine, de Pélagie-La-Charrette d’Antonine Maillet, de Midnight’s Children de Salman Rushdie et de Texaco de Patrick Chamoiseau, révèle le rôle fondamental des contingences qui produisent l’humour à travers un contexte déclencheur commun. En tant que processus, l’humour voile et dévoile, tout comme le procédé optique de l’anamorphose. Or un même bouleversement épistémologique affecte l’humour et l’anamorphose, chacun partageant le même principe de recréation des formes, du monde distendu ; un observateur ou un lecteur est alors indispensable à leur réalisation. Ces deux phénomènes convergent ainsi vers un humour anamorphique rendu sensible par les oeuvres du corpus. Rêve poétique et lucidité politique, l’humour marque une quête de communion porteuse de toutes les espérances. Son pouvoir évocateur émerveille et invite à entrer en contact avec la totalité du monde. La phénoménologie de l’humour anamorphique est sonapparition/disparition. Nous nous intéressons à son déploiement en suivant le mode de lecture du processus anamorphique. Suivre des yeux l’humour anamorphique revient à s’attacher à l’expression d’un bouleversement dans la vision du monde et dans le rapport aux signes. C’est en ce sens que l’humour se placerait sous le signe d’Hermès, originellement évoqué par des petits tas de pierres déposés au seuil des maisons et des temples.Symbole de seuil, de transition, de circulation, de mouvement, Hermès transparaît en agitateur del’humour anamorphique. / A comparative reading of '' La Poudre d'intelligence'' by Kateb Yacine, Pélagie-La-Charette by Antonine Maillet, Midnight's Children by Salman Rushdie and Texaco by Patrick Chamoiseau brings to light the crucial role of the contingencies that make humour trigger from a common context. As a process, humour veils and unveils reality, just as the optical process of anamorphosis does. Now, identical epistemological disruption affects humour and anamorphosis, both sharing principle of re-Creating forms and a distorted world. An observer or reader proves therefore necessary to their realization. These two phenomena converge towards an anamorphic humour that stands out from the corpus' works. A poetical dream and a political clear-Headedness, humour initiates a quest for a communion filled with every possible hope. One marvels at its suggestive power and is invited to get into close acquaintance with the whole world. The phenomenology of anamorphic humour lies into its appearance/disappearance.Through the lens of the process of anamorphosis the focus will be set on how humour unfolds. Observing anamorphic humour amounts to studying the expression of a disruption in how the world is viewed as well as in the relationship to signs. It is in this sense that anamorphic humour could be associated with Hermes, who was originally evoked through small piles of stones on houses' and temples' thresholds. A symbol of threshold, transition, flow and movement, Hermes appears as an agitator of anamorphic humour, which is the hallmark of a passage, a change in direction, of a place where different meanings intertwine.

Le climat local, le transport avec l’agitation entre l’endroit de bétonnage et le site de fabrication du béton influencent fortement les propriétés du béton frais et durci. Selon les particularités du béton autoplaçant (BAP), le maintien de l’homogénéité et l’ouvrabilité du BAP avant la mise en place est très important. Les propriétés des BAP sont généralement plus sensibles à la température et au transport par rapport à celles des bétons conventionnels. Une meilleure compréhension de l’effet de la température et de l’agitation sur la performance des BAP est nécessaire pour prévoir les conséquences du changement du climat (température) et de l’effet du transport (temps et vitesse d’agitation), puis pour donner des précautions à suivre afin de répondre à la demande des BAP pour un bon rapport performance-coût.De manière pragmatique, il s’avère nécessaire d’utiliser la méthode du mortier de béton équivalent (MBE) afin d’analyser rapidement les influences de la température et de l’agitation sur les propriétés rhéologiques, calorimétriques et mécaniques des BAP. Cinq températures (8, 15, 22, 29 et 36°C) et deux vitesses d’agitation (6 et 18 tr/min) ont été étudiées sur les MBE. Ensuite, quelques compositions spécifiques (type d’adjuvant et ajout cimentaire) ont choisies afin de vérifier avec des températures compasse entre 8 à 36°C et les agitations différentes (2 et 6 tr/min) sur les BAP destinés aux travaux de bâtiment (BAP-B) sans agent entraîneur d’air et sur des bétons semi-autoplaçant destinés aux travaux d’infrastructures (BSAP-I) avec agent entraîneur d’air. La fluidité initiale des MBE et BAP a été fixée en faisant varier la demande en SP, la température et l’agitation.Les résultats montrent qu’il y a un effet important de la température et de l’agitation sur l’efficacité des adjuvants, la fluidité, la teneur en air, les propriétés rhéologiques, calorimétriques et mécaniques des MBE et des BAP. Pour prévoir la performance de MBE à différentes températures, une équation mathématique est proposée pour déduire la demande en SP, la demande en AEA, le flux maximal et la résistance en compression à 1 jour en fonction des mêmes propriétés sur MBE à 22°C et de la température. Enfin, une corrélation linéaire a été trouvée entre les MBE et les BAP sur ces mêmes propriétés. / The local climate, the transport of agitated concrete after manufacturing but before being cast strongly influence the properties of the fresh and hard concrete. It’s important to keep the stability and workability of the self-consolidating concrete (SCC) because of its special characteristics. Compare to the normal concrete, the properties of SCC are generally more sensitive to the temperature and the transport. Therefore it’s necessary to understand the effects of the temperature and the agitation on the performance of the SCC in order to predict the consequences of climate change (temperature) and transport (time and speed of agitation), and then to give the better precautions with a good performance-cost report. In this study, the concrete mortar equivalent (CEM) method is used to quickly analyze the influences of the temperature and the agitation on the rheological, calorimetric and mechanical properties of the SCCs. Five temperatures (8, 15, 22, 29 and 36 °C) and two agitation speed (6 and 18 tr/min) are varied in CEMs. And then, some compositions (type of adjuvant and supplementary cementing material) are chosen to be valued with the temperature (8-36 °C) and the agitation (2 and 6 tr/min) in SCCs for the building without air-entraining admixture (AEA) and semi-flowable SCC for infrastructure with AEA. The initial slump flow of CEM and SCC is fixed, but the demand superplasticizer, the temperature and the agitation were varied. The results show that there are the effects of temperature and agitation on the effectiveness of admixture, the slump flow, the air content, the rheological, calorimetric and mechanical properties of CEM and SCC. A mathematical equation is proposed to predict the performance of SCC at different temperatures for the SP and AEA requirement, the maximum of heat flow and the compressive strength at one day by these same properties of SCC at 22 °C and by the temperature. Finally, a good linear correlation is found between CEM and SCC for these properties.

Les patients hospitalisés en réanimation présentent fréquemment des troubles neurologiques (troubles de la vigilance, troubles du sommeil, dysfonctions cognitives multiples, confusion mentale), psychologiques (anxiété, dépression, syndromes délirants), des syndromes douloureux et de l'inconfort. Ces troubles ont en commun : la problématique de leur définition et de leur reconnaissance par l'équipe de réanimation, leur expression fréquente par un comportement d'agitation, une association avec la réponse de stress post-agressive rencontrée au cours des pathologies traitées en réanimation. La physiopathologie de ces troubles est complexe, impliquant à la fois la pathologie qui a déterminé l'hospitalisation du patient en réanimation, ses antécédents médicaux, mais aussi la réanimation elle-même par les thérapeutiques invasives qui y sont utilisées, ainsi que la sédation médicamenteuse ou le coma artificiel. En outre, ces troubles peuvent être associés dans leur expression comme dans leur détermination, certain pouvant être cause ou conséquence d'un autre. L'objectif de cette thèse était de montrer qu'une prise en charge diagnostique et thérapeutique rationalisée de la douleur, des troubles neurologiques et psychologiques était associée à un meilleur pronostic du patient en réanimation. / Patients who are hospitalized in Intensive Care Units (ICU) develop frequent neurological disorders (vigilance disorders, sleep disorders, multiple cognitive disorders, delirium), psychological disorders (anxiety, depression, delusion), pain syndrom and discomfort. These disorders have jointly the problem of their definition and recognition by the ICU team, their frequent expression by an agitated behaviour, an association with the post-aggressive stress response affecting pathologies treated in the ICU setting. The physiopathology of these disorders is complex, implying both the pathology which had determined the admission of the patient to the ICU and his/her medical history, but also either the invasive therapeutics used by the intensive medicine and the administration of sedatives or therapeutic coma. Moreover, theses disorders can be associated either in their expression and their cause, some of them able to be a cause or a consequence of another. The objective of this thesis was to show that a rationalized diagnostic and therapeutic management of pain, neurological and psychological disorders was associated with a better outcome of the patient in the ICU.

Les étapes de mélange sont souvent délicates à appréhender, car il subsiste encore des lacunes sur les lois dynamiques qui régissent ces opérations. De ce fait, la prédiction de l’homogénéité d’un mélange de poudres nécessite encore de nombreux essais. Dans ce travail de thèse, nous nous attachons à développer une méthodologie qui permet de contribuer au développement de modèles prédictifs dans les mélangeurs de poudres tout en mettant en évidence des invariants possibles pour les changements d’échelle sur ces procédés. Ainsi nous avons étudié l’agitation de poudres, avec différentes résistances à l’écoulement, dans un mélangeur convectif planétaire de type Triaxe® d’une contenance de 48 L. Des mesures de propriétés rhéologiques à l’échelle du laboratoire (rhéomètre FT4, voluménomètre) sont effectuées afin de mieux comprendre le comportement des poudres à l’échelle du mélangeur. Un mélangeur convectif prototype a été conçu dans le cadre de cette thèse. Cet appareil polyvalent constitué d’une cuve cylindrique transparente et agité par un mobile constitué de quatre pales, permet de visualiser les régimes et les mécanismes d’écoulement tout en effectuant des mesures rhéologiques. Deux régimes d’écoulement ont été identifiés (roulement, cataracte), ainsi que trois mécanismes (convection, diffusion et avalanche). Ces mécanismes ont permis d’établir un modèle stochastique, dont les paramètres ont été évalués expérimentalement pour une poudre à écoulement libre et pour une poudre cohésive. / Mixing systems are usually difficult to understand, because there is a lack of knowledge concerning dynamic laws ruling these operations. Thus, nowadays, several tests are needed to predict properly the homogeneity of a powder mix. Throughout this PhD work, a method is developed to build predictive models for powder mixers and to bring out possible invariants for scale switching on these processes. Thus the stirring of powders is studied using different flow resistances within a 48L capacity Triaxe®, a convective planetary mixer. Rheological properties measurements are done at labscale (FT4 rheometer, volumenometer) for a better understanding of powder behavior at a wider mixer scale. A prototype blender has been built for this work. This polyvalent device, made of four blades and of a transparent vessel, allows to observe flow regimes and mechanisms, and to do rheological measurements. Two flow regimes have been identified (rolling, cataracting) and three flow mechanisms (convection, diffusion and avalanching). These mechanisms allowed to do stochastic modelling, for which parameters have been evaluated with experiments for free-flowing and cohesive powders.

Syfte: Att undersöka om frånvaro av sederingsmål påverkar sederingsnivå samt att kartlägga sederingsdjupet, bedömt enligt Richmond Agitation-Sedation Scale (RASS-skalan) hos intuberade patienter på IVA, Norrlands Universitetssjukhus (NUS). Bakgrund: Vikten av en adekvat sedering är något som medvetandegjorts de senaste åren och trenden inom intensivvård har gått från användandet av djup sedering med muskelblockad till en mer ytlig sederingsstrategi. Översedering leder till olika former av komplikationer i form av förlängd ventilatortid och vårdtid samt ökad mortalitet. Undersedering ökar riskerna för stress och smärta. En adekvat sederingsnivå innebär att patienten är lugn och komfortabel men lättväckt. För att erhålla den optimala sederingsnivån och därigenom undvika de negativa effekterna av både över- och undersedering, är sederingsskalor ett viktigt hjälpmedel. Design: En journalgranskning med kvantitativ ansats och med retrospektiv design utfördes. Metod: Under perioden 1 januari till 30 juni vårdades totalt 422 patienter på IVA, NUS. Efter granskning enligt inklusions- och exklusionskriterier återstod 46 patienter som ingick i studien. Journalerna granskades med avseende på ordinerade mål och bedömda nivåer enligt RASS. Populationsbeskrivning samt insamlade RASS mål och nivåer fördes in i Statistical Package for the Social Sciences (SPSS 23,0). Resultat: Hos studiens 46 patienter registrerades totalt 216 dygn där patienterna varit sederade och intuberade. Av dessa saknades ordinerat sederingsmål 47% av dygnen. Frånvaro av ordinerat sederingsmål påverkade inte sederingsdjupet så att statistisk signifikant skillnad förelåg mellan patienter med och utan mål. Totalt registrerades 1048 uppmätta RASS nivåer med syfte att kartlägga sederingsdjup. Medelvärdet för varje enskild patient per dygn räknades ut och alla medelvärden sammanställdes. Sederingsdjupen låg på en lägre nivå än -3 de första fyra dygnen för att därefter gå mot en ytligare nivå. Konklusion: Genom att identifierar bakomliggande faktorer till smärta och oro kan sjuksköterskan bidra med att minska många negativa konsekvenser av inadekvat sedering. Det var ett positivt fynd att sederingsdjupen förändrades över tid till en mer, enligt litteraturen adekvat, sederingsnivå. Utifrån resultatet ses ett behov av fler studier för att kunna utröna vad som påverkar RASS-nivåerna och för att utvärdera hur adekvat sederade patienter är. Det skulle vara av intresse att undersöka detta på en större population och under en längre tidsperiod. / Aim: To investigate if absence of goals for sedation affect the level of sedation and to map out the depth of sedation, assessed according to the Richmond Agitation-Sedation Scale (RASS-scale) on intubated patients at the Intensive Care Unit (ICU), Norrlands Universitetssjukhus (NUS). Background: The importance of adequate sedation is something that has been raised to awareness the last years and the trend within intensive care has gone from extensive use of sedatives with neuromuscular blocking agents to a more lightly sedative strategy. Over-sedation leads to different kinds of complications such as prolonged mechanical ventilation and hospital stay and also increases mortality rates. Under-sedation increases the risk for stress and pain. An adequate level of sedation is defined as when the patient is calm and comfortable yet easy to arouse from sleep. To obtain the appropriate level of sedation, and thereby avoiding the negative effects of both over- and under-sedation, sedation scales are an important tool. Design: Data was collected using medical records. A quantitative approach with retrospective design was performed. Method: From january 1st to june 30th 2015 a totalt of 422 patients were admitted to the ICU, NUS. After auditing the medical reccords according to the inclusion- and exklusionkriterias 46 patients were included in the study. The medical records were audited regarding sedation goals and sedation scores according to the RASS scale. All collected patients’ characteristics, RASS goals and levels were typed in to the Statistical Package for the Social Sciences (SPSS 23,0). Results: The 46 patients in the study were sedated and intubated a totalt of 216 days. Sedation goals were absent 47% of those days. An absence of sedation goals did not affect the depth of sedation, there were no significant difference between patients with and without sedation goals. In totalt 1048 sedation scores as measured by the RASS scale were collected with the purpose of maping out the sedation depth. The mean for each patient per every 24 hours were calculated and compiled. The sedation scores were lower than -3 the first four days, thereafter the scores changed towards a less heavy sedation. Conclusion: By identifying underlying factors for pain and anxiety, the ICU nurse can reduce the many negative consequences of inadequate sedation. It was a positive finding that the depth of sedation changed over time towards a, according to previous studies, more appropriate level of sedation. The results indicate that there is a need for further studies to investigate what affect the levels of sedation and to assess how appropriate patients are sedated. It would be of interest to examine this on a larger group of patients and for a longer period of time.

Background: Delivery room management (DR) of the newly born infant should be performed according to international guidelines, but no recommendations are available for an infant’s position immediately after birth. The present study was performed to answer the following questions: 1. How often is DR-management performed in term infants in side position? 2. Is routine DR-management possible in side position? 3. Is there any benefit of side position with respect to agitation or vital parameters? Methods: Cross-sectional study of video-recorded DR-management in term newborns delivered by C-section in 2012. Videos were analysed for infant’s position, administered interventions, vital parameters and agitation. Results: 187 videos were analysed. The Main Position (defined as position spent more than 70% of the time) was “supine” in 91, “side” in 63 and “not determinable” in 33 infants. “Supine” infants received significantly (p < 0.001) more often stimulation (12.5% of the total time) than “side” infants (3.9% of time). There were no differences between both groups with regard to suctioning; CPAP was exclusively (98%) administered in supine position. Newborns on side were less agitated than those on supine. There was a trend towards a better oxygenation in “side” positioned infants (p = 0.055) and significantly (p = 0.04) higher saturation values in “left-sided” infants than “right-sided” infants at 8th minute. “Side” positioned infants reached oxygen saturation values >90% earlier than “supine” positioned infants (p = 0.16). Conclusions: DR-management is feasible in the side position in term infants. Side position seems to be associated with reduced agitation and improved oxygenation. However, it remains unclear whether this represents a causal relationship or an association. The study supports the need for a randomized controlled trial.

Microelectronics integration continuously follows the trend of miniaturisation for which the technologies enabling fine pitch interconnection are in high demand. The recent advancement in the assembly of Hybrid Pixel Detectors, a high resolution detecting and imaging device, is an example of where novel materials and processes can be applied for ultra-fine pitch interconnections. For this application, indium is often used for the fine pitch bump bonding process due to its unique properties that make it especially suitable, in particular in a cryogenic environment where some types of detector have to serve. Indium bumps are typically fabricated through vacuum evaporation at the wafer level; however, this thesis investigates an alternative low cost manufacturing process at the wafer scale for the deposition of indium micro-bumps through electroplating. The work has placed its emphasis on the requirements of future technologies which will enable a low temperature (<150oC), high density interconnection (> 40,000 IOs/cm2) with a high throughput and high production yield. This research is a systematic investigation of the wafer-scale indium bumping process through electrodeposition using indium sulphamate solution. An intensive experimental study of micro-bump formation has been carried out to elaborate the effects of two of the main electroplating factors that can significantly influence the quality of bumps in the course of electrodeposition, namely the current distribution and mass transport. To adjust the current density distribution, various waveforms of current input, including direct current (DC), unipolar pulse current and bipolar pulse reverse current, were employed in the experiments. To assist mass transportation prior to or during electroplating, acoustic agitation including ultrasonic agitation at 30 kHz frequency as well as megasonic agitation at 1 MHz, were utilised. The electrochemical properties of the indium sulphamate solution were first investigated using non-patterned plain substrates prior to indium bumping trials. This provided understanding of the microstructural characteristics of indium deposits produced by electroplating and, through cathodic polarisation measurements, the highest current density suitable for electrodeposition was achieved as approximately 30 mA/cm2 when electroplating was carried out at room temperature and with no agitation applied. The typical surface morphology of DC electroplated indium contained a granular structure with a surface feature size as large as 10 µm. Pulse and pulse reverse electroplating significantly altered the surface morphology of the deposits and the surface became much smoother. By introducing acoustic agitation, the current density range suitable for electrodeposition could be significantly expanded due to the greater mass transfer, which led to a higher speed of deposition with high current efficiency. Wafer-scale indium bumping (15 µm to 25 µm diameter) at a minimum pitch size of 25 µm was successfully developed through electroplating trials with 3 inch test wafers and subsequently applied onto the standard 4 inch wafers. The results demonstrate the capability of electroplating to generate high quality indium bumps with ultrafine pitch at a high consistency and yield. To maximise the yield, pre-wetting of the ultrafine pitch photoresist patterns by both ultrasonic or megasonic agitation is essential leading to a bumping yield up to 99.9% on the wafer scale. The bump profiles and their uniformity at both the wafer and pattern scale were measured and the effects of electrodeposition regimes on the bump formation evaluated. The bump uniformity and microstructure at the feature scale were also investigated by cross-sectioning the electroplated bumps from different locations on the wafers. The growth mechanism of indium bumps were proposed on the basis of experimental observation. It was found that the use of a conductive current thief ring can homogenise the directional bump uniformity when the electrical contact is made asymmetrically, and improve the overall uniformity when the electrical contact is made symmetrically around the periphery of the wafer. Both unipolar pulse electroplating and bipolar pulse reverse electroplating improved the uniformity of the bump height at the wafer scale and pattern scale, and the feature scale uniformity could be significantly improved by pulse reverse electroplating. The best uniformity of 13.6% for a 4 inch wafer was achieved by using pulse reverse electroplating. The effect of ultrasonic agitation on the process was examined, but found to cause damage to the photoresist patterns if used for extended periods and therefore not suitable for use throughout indium bumping. Megasonic agitation enabled high speed bumping without sacrifice of current efficiency and with little damage to the photoresist patterns. However, megasonic agitation tended to degrade some aspects of wafer scale uniformity and should therefore be properly coupled with other electroplating parameters to assist the electroplating process.

Dans un procédé de séchage, l'évacuation de l'eau induit des modifications structurelles et physicochimiques qui engendrent des difficultés d'écoulement dans le séchoir. Cette étude a porté sur la modélisation du séchage continu par contact avec agitation. Nous avons développé un modèle markovien pour décrire les transferts de masse, de chaleur et l'écoulement dans un séchoir continu. Les paramètres d'entrée du modèle ont été déterminés expérimentalement sur un produit pâteux, tandis que d'autres paramètres ont été obtenus à partir de la littérature scientifique. L'étude de sensibilité de la teneur en eau et de la masse sèche retenue dans le séchoir a permis d'analyser et de hiérarchiser les effets des différentes variables opératoires. Enfin, nous avons étudié l'influence des variables opératoires sur le profil de teneur en eau, le temps de passage et les courbes de distribution de temps de séjours simulées. L'évolution structurelle du produit a été mise en évidence dans le modèle. / In a drying process, the evacuation of water induced structural and physico-chemical modifications that generate difficulties of flow in the dryer. This study focused on the modeling of agitated indirect continuous dryer. We developed a Markov model to describe the mass transfer, heat transfer and flow in a continuous dryer. The input parameters of the model were determined experimentally on a pasty product, while other parameters were obtained from the scientific literature. The sensitivity study of the moisture content and dry mass retained in the dryer was used to analyze and treat on a hierarchical basis the effects of different operating variables. Finally, we studied the influence of variables operating on the profile of moisture content, the passage time and the simulated curves of residence time distribution. The structural evolution of the product was considered in the model