A isquemia e reperfusão intestinal (I/R-i) é relevante fator para o desenvolvimento da síndrome do desconforto respiratório agudo (SDRA). A lesão tecidual decorrente da I/R-i pode ser local e em órgãos distante do sitio isquêmico, notadamente o pulmão. Indivíduos submetidos à isquemia intestinal ao tornarem-se vulneráveis, desenvolvem resposta exacerbada a estímulos inflamatórios secundários constituindo assim a percepção de lesão decorrente de uma dupla agressão. Neste estudo desenvolvemos modelo murino de dupla agressão pulmonar ocasionada pela I/R-i seguida de estímulo da instilação nasal de LPS ou de suco gástrico (SG). A fase de caracterização do modelo de I/R-i revelou aumento de IL-6, G-CSF, KC, IP-10 e MCP-1, mas não de TNF-a no soro e em homogeneizados de pulmão e intestino. Anticorpos anti TNF-a e o etanercepte falharam em inibir o aumento de MPO pulmonar e intestinal após a I/R-i. A instilação nasal de LPS após a I/R-i aumentou a atividade pulmonar de MPO e exacerbou a permeabilidade vascular pulmonar. Neste caso, aminoguanidina ou a vimblastina reverterem o aumento da permeabilidade vascular, sugerindo a participação conjunta de neutrófilos e óxido nítrico no processo lesivo causado pela dupla agressão. A instilação nasal de SG induziu aumento inicial (2h) de MPO pulmonar seguido de influxo de neutrófilos (24h) para o espaço alveolar. Tal processo foi acompanhado por expressão inicial e transiente de TNF-a no LBA e contrabalanceada por IL-10. A resposta inflamatória aumentada de camundongos IL-10 KO à instilação de suco gástrico mostra o papel fundamental desta citocina do controle da inflamação. O rolipram ou o composto PKF 241-466 (inibidores de TNF-a) reduziram a inflamação pulmonar induzida pelo SG. A instilação de SG após a I/R-i (I/R-i +SG) exacerbou o aumento da permeabilidade vascular pulmonar. Os dados apresentados sugerem que a exposição do organismo ao trauma intestinal torna o pulmão suscetível a um estímulo secundário como o LPS e o suco gástrico. Visto a gama de estímulos inflamatórios a que indivíduos internados em unidades de terapia intensiva podem ser submetidos, os resultados deste estudo podem contribuir para a compreensão dos mecanismos reguladores do recrutamento de neutrófilos e geração de mediadores inflamatórios na síndrome do desconforto respiratório agudo. / Intestinal ischemia and reperfusion (I/R) is implicated as a prime initiating event in the development of systemic inflammatory syndrome and Acute Respiratory Distress Syndrome (ARDS). Several studies pointed the possibility of massive systemic inflammatory events rendering the lungs more susceptible to an exacerbated inflammatory response, the so called two-hit hypothesis. In this way, minor local inflammatory stimuli could be a trigger for ARDS. In this study we investigated the effects of low-dose LPS or gastric juice (GJ) administered by nasal instillation to mice previously submitted to intestinal I/R. Our data showed that i-I/R alone induced histological signs of edema in lung as well as an increase of lung MPO activity and IL-6, G-CSF, KC, IP-10 and MCP-1 levels. Nasal instillation of LPS following i-I/R increased lung MPO activity and exacerbated lung vascular permeability. In this case, aminoguanidine or vinblastine blocked the increase of vascular permeability, suggesting the role of neutrophils and nitric oxide in injury induced by the two-hit stimuli. Instillation of GJ induced an initial (2h) increase of lung MPO followed by the influx of neutrophils (24h) to the alveolar space. Such process was followed by the transient expression of TNF-a in BAL and balanced by IL-10. The exacerbated inflammatory response of IL-10 KO mice to GJ instillation shows the importance of this cytokine in the control of the inflammation in such model. Treatment with rolipram or PKF 241-466 compound (TNF-a inhibitors) reduced lung inflammation induced by GJ. Nasal instillation of GJ after i-I/R exacerbated the increase in lung vascular permeability. The data shown suggest that the exposition of the organism to mesenteric trauma primes the host organism to a secondary inflammatory stimulus such as LPS or gastric juice. Considering the possible multiple insults to lung to which patients in intensive care units are submitted, the results of this study might contribute to the understanding of the regulatory mechanisms of neutrophils and generation of inflammatory mediators in the context of ARDS.

The thesis deals with the issue of singletons. Its main question is directed to the childhood of singletons and its importance for the whole life of a human. It wonders whether the childhood of singletons affects humans in adulthood, or in which areas and which way. The thesis is divided into two parts, theoretical and part of the research. In the first part basic terms are defined which constitute the basis for the second part of the work. The research part of the work is more extensive and forms the core of the thesis. It is a qualitative research. Biographical design, specifically the realistic biography, has been used as the most appropriate research plan. First, three interviews were made and processed - depth probes of the respondents who grew up as the singletons. The analysis of the probes divided the interview into three stages: childhood upbringing, the upbringing of their own children and self-education. After processing the individual parts of the research, the final synthesis revealed that the childhood of the respondents and the fact of being an only child had a significant impact on their overall life. It affected their childhood and also the following life stages. The biggest deficit of the singletons was in socialization, predominantly in the area of interpersonal relations and...

Bien que les femmes aient toujours fait partie des composantes de la main-d’oeuvre d’une entreprise et y jouent toujours un rôle prépondérant, il faut dire que, dans les postes décisionnels, elles ont été considérablement sous-représentées. La barrière entre cadres intermédiaires et cadres supérieurs, baptisée le « plafond de verre », est aujourd’hui, presque aussi infranchissable qu’il y a 20 ans, quand une multitude de femmes diplômées sont entrées dans le monde des affaires. L’objet de cette recherche vise à identifier pourquoi le taux des femmes présentes dans les instances de haute direction des banques libanaises reste-t-il si minime. La présente étude va consister à analyser la corrélation entre les aspirations professionnelles des femmes, leur ambition d’accéder aux plus hauts échelons de l’entreprise et le phénomène du plafond de verre. Par ailleurs, cette étude va approfondir l’examen des styles de leadership adoptés par les femmes et mesurer l’impact du style adopté sur la progression réalisée dans la carrière choisie. Nous prendrons l’exemple du Moyen-Orient et particulièrement du Liban où le secteur bancaire est soucieux de réduire les inégalités professionnelles. Cependant les différenciations entre hommes et femmes persistent. De multiples facteurs, certains explicites, telle la formation ou la mobilité, d’autres plus implicites, comme les horaires de travail ou la maternité, semblent se combiner et se renforcer mutuellement pour expliquer des évolutions de carrière moins favorables chez les femmes. Un questionnaire à choix fermé a été diffusé sur un site Web sécurisé à des femmes cadres dans 6 banques opérant au Liban afin de déterminer la relation entre les variables dépendantes et indépendantes relevées. Les hypothèses ont été validées déterminants ainsi divers facteurs qui affectent l’existence du plafond de verre. / Women have always been an inherent part of the workforce. They have been playing a fundamental role throughout history; however, they have been considerably underrepresented in top management positions. The existent barrier between middle and top management positions entitled “Glass Ceiling” remains almost as impassable as it has been 20 years ago, even though the number of educated women who have entered the labor market has substantially increased. The purpose of this research is to identify why the number of women in the top management positions of the Lebanese banks remains minim. As such, the primary object lies in analyzing the correlation between the aspiration and ambition of women to access the highest levels in the organization’s hierarchy and the glass ceiling phenomena. Moreover, this study focuses on the leadership styles adopted by these women; it aims at measuring the impact of the adopted style on the hierarchical advancement in the chosen career. In Lebanon, the banking sector is eager to reduce professional discrepancies; however, these gaps remain existent between men and women. Several factors, some of which are explicit – such as training & development and mobility, others implicit such as the working schedules and the maternity leaves, interact and interrelate to explain the less favorable career paths that women face. A close-ended questionnaire has been communicated throughout a secured website to middle management women in 6 banks operating in Lebanon in order to determine the relationship between the identified dependant and independent variables. The hypothesis statements were accepted as true; stipulating that several factors affect the perpetuity of the glass ceiling.

Le tremblement de terre survenu le 12 janvier 2010 à Port-au-Prince, Haïti a provoqué le déplacement de milliers d’individus. Aujourd’hui, plus de 250000 habitants, dont la plupart ont été affectés par le séisme, se sont établis à Canaan, un nouvel établissement informel en périphérie de Port-au-Prince. Simultanément au cadre bâti, les habitants ont pris l’initiative de concevoir des espaces publics et de les aménager. Typiquement, la construction d’espaces publics en milieu précaire est reléguée au second plan face aux conditions de vie précaires qui y sévissent. Pourtant, des reportages démontrent que les Cananéens aspirent à faire de ce territoire une « vraie » ville et un milieu de vie sain. Ce projet de recherche exploratoire avance que les aspirations et les références ont un rôle dans le processus de conception des espaces publics à Canaan. Parallèlement, il examine la considération des aspirations et des références dans le projet de réaménagement de certaines places publiques dans le cadre du programme Canaan Upgrading and Community Development, collaboration entre plusieurs ONG. Trois cas de places ont été étudié : Horeb, Astrel et Zanmitay. Cette étude a démontré qu’il n’y a pas de lien direct entre les références en matière d’espace public et le processus de conception. De plus, les aspirations des habitants ne portent pas particulièrement sur les espaces publics, mais bien sur leur milieu de vie. Finalement, la prise en compte des aspirations et références des Cananéens a été limitée lors du projet de réaménagement d’espaces publics par des ONG. / The earthquake that occurred on January 12, 2010, in Port-au-Prince, Haiti caused the displacement of thousands of people. Today, more than 250,000 people, most of whom were affected by the earthquake, have settled in Canaan, a new informal settlement on the outskirts of Port-au-Prince. Simultaneously with the built environment, the inhabitants took the initiative to design and build public spaces. Typically, the construction of public spaces in informal settlements is relegated to the background in the face of precarious living conditions. However, reports show that the Canaanites aspire to make this territory a “real” city and a healthy community. This exploratory research project argues that aspirations and references have a role in the design process of public spaces in Canaan. At the same time, it examines the consideration of aspirations and references in the proposed redevelopment of some public spaces as part of the Canaan Upgrading and Community Development (CUCD) program, a collaboration between several NGOs. Three publics spaces studied are place Horeb, place Astrel and place Zanmitay. This study shows there is no direct link between public space references and the design process. Moreover, the inhabitants’ aspirations are not particularly about public spaces, rather than their environment. Finally, the consideration for Canaanites’ aspirations and references was limited during the CUCD project.

Objective: In this study, the efficiency of telemedical consulting with regard to fine needle aspirates from space-occupying lesions (SOLs) of the liver is investigated for the first time. Study Design: The study includes fine needle aspirations from 62 patients, 33 with hepatocellular carcinoma (HCC) and 29 with non-hepatic tumors. Using the Internetbased iPath system, the initial pathologist submitted 1–8 images from smears and cell block sections. One consultant assessed the cytological and another one the histological images. Both made their diagnoses independent of each other. A final diagnosis was made by immunochemistry of cell block sections. The cytological images were analyzed retrospectively for the occurrence of the most typical HCC indicators. The number of these indicators was related to the initial diagnoses of the three pathologists, and possible reasons for diagnostic errors were analyzed based on this analysis. Results: The accuracy of the preliminary telemedical diagnoses regarding HCC was 82.0% for the cytological images and 87.7% for the histological images. Most of the false diagnoses occurred in tumors with unusual cytological and histological patterns. Conclusions: Telemedical consulting is a valuable tool to obtain a second opinion. However, for improvement of the diagnosis of HCC, supplementary immunochemical tests are necessary.

The aim of this semester project is the introduction to the problematic of ion fields, where and under what circumstances they originate and extinct and the techniques of measurement. The project will deal with the atmosphere and the electrical field of the Earth. I will consider the composition of the atmosphere and the principles of origin and extinction of ions. I am going to mention the division of ions and their influence on the living organisms. Another topic to be dealt with is the methods for measuring the air ions and the small currents. Gradually we are going to learn the known methods of the measuring of air ions. We are going to get a closer look at the method of measuring with the cylindrical aspiration capacitor. We are also going to deal with the problem of measuring very low currents, where they originate and how it is possible to compensate them. The outcome of the project should be the concept and later the creation of the sonde for the measuring of the ion fields itself.

Introduction: Simultaneous detection of disseminated tumor cells (DTCs) and circulating tumor cells (CTCs) was shown to be associated with an especially poor prognosis and increased incidence of disease-related deaths in non-metastatic breast cancer patients. We analyzed the occurance of DTCs in bone marrow and CTCs in peripheral blood in patients with primary breast cancer, we evaluated the correlation of their presence with other prognostic markers and we investigated the changes in DTCs/CTCs number at different time points during treatment. Materials and methods: Blood of 50 patients with primary breast cancer were used for immunomagnetic separation and detection of circulating tumor cells using the commercial available system the AdnaTest Breast Cancer™ (AdnaGen GmbH, Langenhagen, Germany). Bone marrow aspirates from 50 patients were analyzed for DTCs by immunocytochemistry using the pancytokeratin antibody conjugated with FITC (Monoclonal Anti-Cytokeratin antibody F3418, Sigma Aldrich, USA). Results: DTCs were identified in 30% (15/50) and CTCs in 22% (11/50) of patients. We found that DTC positivity could point to a significantly high risk of larger primary tumor size (p- value 0.011) and significantly higher risk of lymph node involvement (p- value 0.002). For CTC positivity, no such...

Ce mémoire porte sur dix-huit femmes ayant choisi de donner naissance en dehors du milieu hospitalier, assistées par une sage-femme. Des entretiens semi-dirigés ont été mené auprès d’elles afin d’en faire ressortir un portrait global de qui elles sont dans leur globalité, en laissant le maximum de place aux émotions et en laissant libre cours à leur récit de vie. C’est ensuite par une analyse rétrospective traversant différentes dimensions impliquées dans les parcours de vie, soit la dimension temporelle, relationnelle et médicale, que nous avons pu en apprendre davantage sur les aspirations qui les ont menées au suivi sagefemme, en plus d’approfondir le vécu de l’accouchement et les nouvelles implications périnatales de ces femmes. Cette enquête fait ressortir des similitudes et différences parmi les interrogés, qui se déclineront selon trois idéaux types, les « expertes », les « alternatives » et les « déçues ». / This thesis focuses on eighteen women who chose to give birth outside the hospital, assisted by a midwife. Semi-structured interviews were conducted with them in order to bring out a global portrait of who they are in their entirety, leaving the maximum space for emotions and giving free rein to their life story. It was then through a retrospective analysis through different dimensions involved in the life course, dimensions temporal, relational and medical, that we were able to learn more about the yearnings that led to midwifery follow-up, in addition to deepening the experience of childbirth and the new perinatal implications of these women. This survey reveals similarities and differences among respondents, which will be broken down into three ideal types, the "experts", the "alternatives" and the "disappointed".

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Bakgrund Sväljning bedöms utifrån två aspekter - hur säker och hur effektiv den är. Tidigare studier har visat att vid stigande ålder blir sväljningen mindre effektiv och att förekomst av penetration ökar. Åldrande sväljning har i tidigare studier inte studerats specifikt utifrån säkerhet och effektivitet. Tidigare forskning med avseende på sväljning har enbart fokuserat på äldre individer respektive snävare åldersgrupper.  Syfte Aktuella studiens syfte är att undersöka om det ses en försämring i normal sväljförmåga vid stigande ålder. Studien syftar  även till att undersöka om det finns könsskillnader i hur sväljförmåga förändras vid ökande ålder, men även oavsett ålder. Bedömning av sväljfunktion, sväljningssäkerhet och sväljningseffektivitet genomfördes med Flexibel videoendoskopisk Undersökning av Sväljning (FUS).  Metod Totalt inkluderades 65 deltagare (33 st kvinnor och 32 st män), i åldrarna 21-91 år (median 44 år). FUS genomfördes för att undersöka sväljningen. Vid FUS sväljer deltagarna föda i olika konsistenser. Fynden från FUS bedömdes utifrån standardiserade skalor: The Dysphagia Outcome and Severity Scale (DOSS), Penetration-Aspiration Scale (PAS) och The Yale Pharyngeal Residue Severity Rating Scale (YPRSRS).  Resultat Majoriteten av alla deltagare bedömdes ha funktionell sväljning. Kvinnor uppvisade en bättre sväljfunktion överlag, men inga könsskillander kunde påvisas gällande säkerhet och effektivitet. Deltagare med en högre uppnådd ålder uppvisade en sämre sväljningssäkerhet och sväljningseffektivitet. Ålder kan således vara en påverkande faktor för sväljningssäkerhet och sväljningseffektivitet.   Slutsatser Denna studie visade att sväljfunktionen hos äldre deltagare var sämre än hos yngre deltagare. Sväljningens säkerhet och effektivitet var inte försämrad hos friska äldre deltagare, jämfört med friska yngre deltagare. Det fanns könsskillnader i sväljförmåga avseende sväljfunktion, kvinnor har en högre förekomst av normal sväljning än männen. Könsskillnader gällande sväljningssäkerhet kunde inte konstateras. Könsskillnad för sväljningseffektivitet kunde ses för sinus piriformis, men inte vallecula. Männen uppvisade genomgående en mindre effektiv sväljning, jämfört med kvinnorna.