Realizamos estudo prospectivo randomizado para comparar cinco métodos específicos de avaliação funcional do ombro e uma avaliação genérica da saúde em pacientes operados de capsuloplastia e descompressão subacromial associado à reparação do manguito rotador. Foram estudados 30 pacientes de cada grupo, avaliados no período entre cinco a seis meses após o tratamento cirúrgico com os questionários dos Cirurgiões Americanos de Ombro e Cotovelo(ASES), Sistema de Pontuação do Ombro de Constant & Murley (CONSTANT), Folha de Classificação da Reparação de Bankart (ROWE), Teste Simples de Ombro (SST), Escala de Avaliação do Ombro da Universidade de Califórnia - Los Angeles (UCLA) e o Questionário Genérico de Avaliação de Qualidade de Vida (SF-36). A idade no grupo de \"Descompressão\" variou de 44 a 77 anos (média 59,2) e no grupo de \"Capsuloplastia\" foi de 17 a 65 anos (média de 31,4). Em relação ao sexo, o grupo da \"Descompressão\" foi predominantemente feminino e no grupo da \"Capsuloplastia\" foi predominante o sexo masculino. As médias da pontuação no grupo de \"Capsuloplastia\" são maiores que no \"Descompressão\" (93,6 e 71,7 respectivamente). A variabilidade dos escores observado no grupo \"Capsuloplastia\" (89,1 a 100) é inferior ao do grupo \"Descompressão\" (65,1 a 95,9). Não existe uma forte concordância entre os resultados obtidos pelos diferentes questionários (variação de zero a 0,51). A média nos oito domínios do SF-36 no grupo \"Descompressão\" foi de 70,8 variando de 60,4 (Vitalidade) a 89,2 (Aspectos Sociais). Para o grupo \"Capsuloplastia\" a média foi de 91,2 variando de 83,4 (Saúde Mental) a 96,6 (Aspectos Emocionais). Nos coeficientes de correlação linear de Pearson, não foi detectada associação linear entre a escala de CONSTANT e SF-36 no grupo \"Descompressão\" e entre ROWE e SF-36 no grupo \"Capsuloplastia\". Em ambos os grupos a maior correlação encontrada foi entre os questionários UCLA e ASES (0,900 na \"Descompressão\" e 0,893 na \"Capsuloplastia\"). Concluiu-se que nas cirurgias de descompressão subacromial o questionário UCLA foi o mais completo mostrando maior confiabilidade e reprodutibilidade e para as capsuloplastias o método ROWE apresentou maior confiabilidade, reprodutibilidade e praticidade. / A prospective randomized study was realized to compare methods of both disease specific and generic health status of shoulder\'s functional assessment in patients after operative treatment of subacromial decompression associated a repair of a tear of the rotator cuff and capsuloplasty. The thirty patients in each group were studied and at follow-up five to six months later, with the following questionnaires: American Shoulder and Elbow Surgeons Shoulder Evaluation Form (ASES), Constant-Murley Shoulder Scoring System (CONSTANT), Rating Sheet for Bankart Repair (ROWE), Simple Shoulder Test (SST), University of California at Los Angeles Shoulder Rating Scale (UCLA) and the Short Form-36 (SF-36). The age in Decompression group was greater than Capsuloplasty group and the gender of first group was predominantly consisted of women and in the second group was men. The scores averages of Capsuloplasty group were higher than Decompression group (93,6 and 71,7 respectively). The variability of the scores observed in the Capsuloplasty group, 89,1 to 100,0 was less than in the Decompression group, 65,1 to 95,9. A strong interrater reliability between the questionnaires does not exist - variation 0 to 0,51. The average in the eight domains of SF-36 in Decompression group was 70,8 [range 60,4 (Vitality) to 89,2 (Social Aspect)]. In Capsuloplasty group the average was 91,2 [range 83,4 (Mental Health) to 96,6 (Emotional Aspect) ]. Pearson\'s coefficient analysis, shows that the correlation between CONSTANT and SF-36 was not detect, and in Capsuloplasty was not detect in ROWE and SF-36. In both groups Capsuloplasty (0,893) and Decompression (0,900), a strong correlation between UCLA and ASES were observed. It follows that to subacromial decompression surgery, UCLA shows more reliability and in Capsuloplasty, the Rowe method shows more applicability.

Människans påverkan på växthuseffekten har under de senaste åren varit en mycket aktuell fråga. Det är många olika faktorer som bidrar till ett negativt avtryck på miljön, där ett stort bidrag kommer från sektorn bilindustri. Majoriteten av dagens bilar drivs på fossila bränslen som genererar skadande utsläpp på miljön. Att hitta nya alternativa bränslen som är förnyelsebara och energivänliga som kan ersätta de fossila skulle kunna leda till ett signifikant minskat avtryck på klimat och miljö. Att använda väte som bränsle och i synnerhet att driva fordonet på vätgas är ett av de alternativen då avgivna utsläpp endast består av vatten och varm luft, förutsatt att man använder sig av förnybar energi vid framställning av vätgasen. I bränsletanken återfinns ett högt tryck hos vätgasdrivna bilar, detta för att mer bränsle ska kunna förvaras och därmed öka antal mil möjliga att köra på en tank. Ett tryckfall är nödvändigt för att förse bränslecellen med vätgas vid rätt tryck, och för att uppnå högst möjliga verkningsgrad. Teslaventilen har inga rörliga delar vilket medför ett brett spektrum av applikationer i industriella situationer på grund av dess uthållighetsegenskaper. För att kunna kategorisera prestandan och uppnå optimal effekt krävs förståelse om ventilens geometriska uppbyggnad. Med rätt geometri på Tesla-ventilens olika strukturparametrar kan man uppnå ett högt tryckfall, med andra ord en hög prestanda. I denna studie har tre olika geometriska parametrar hos Tesla-ventilen undersökts för att kunna dra slutsatser och etablera deras optimala värden för bästa prestanda. Parametrarna som varit av intresse är innerradien på kurvan av Tesla-ventilen, avståndet mellan flera sammankopplade ventiler och tvärsnittets utformning. Resultaten erhölls genom numeriska metoder av Computational Fluid Dynamics simuleringar i programmet ANSYS Fluent. Resultat visade att en liten innerradie och ett längre avstånd mellan flera sammankopplade ventiler gav upphov till högre tryckfall. Tvärsnitten som undersöktes var rektangulärt och cirkulärt, där det cirkulära visade en bättre förmåga av att effektivt sänka trycket hos fluiden. Slutsatser som drogs var att cirkulärt tvärsnitt var att föredra och att en liten innerradie och ett stort avstånd mellan ventiler optimerar prestandan hos Tesla-ventiler. / 在过去的几年里，人类对温室效应的影响一直是社会舆论中一个突出和争论的主 题。对环境造成负面影响的因素有很多，汽车便是其中之一。如今，大多数汽车依靠 化石燃料驱动，在这个过程中会造成有毒物质的排放。因此，对可再生与环境友好的 替代燃料的研究重要性愈发突出。氢，（更具体地说，氢气），由于燃烧产物只有 水，成为了一种可选的替代燃料。 在氢燃料汽车的储氢罐中，往往设置高压以提高氢气储量并增加里程数。而为了 保证燃料电池高效运行，在储氢罐和燃料电池之间必须采取减压手段，这也使高效降 压成为了氢燃料汽车研究领域中的一个长期需求。特斯拉阀在没有活动部件的情况 下，允许流体沿一个方向流动，并限制其往相反方向流动。该概念在工业环境中具备 广泛的应用潜力，而理解特斯拉阀（的工作机理）对于表征设备性能非常重要。采用 最优几何形状的特斯拉阀，可以实现高压降，换言之高性能。 本研究对特斯拉阀的三种结构参数进行了调查，得出了使特斯拉阀降压性能达到 最优时的参数值。所研究的三种参数分别是内部曲线半径，多级特斯拉阀中的阀间距 以及阀门的横截面。为了获得结果，使用计算流体动力学软件 ANSYS Fluent 进行了数 值模拟。结果表明，与较大的半径相比，较小的内部曲线半径产生更高的压降。随着 多级特斯拉阀的阀间距增大，阀门降压性能提高。对横截面的研究中，比较了矩形截 面和圆形截面的特斯拉阀的降压性能，发现圆形截面的特斯拉阀降压性能更优。本研 究的最终结论是（在特斯拉阀设计中采用）圆形横截面，小的内部曲线半径和大的阀 间距可以提高装置性能。 / The last couple of years, the footprint of humankind on the greenhouse effect has been a highlighted and debated topic. There are many contributing factors to the negative impacts on the environment, one of them being the sector of automobile. Today, most cars are driven on fossil fuel energy which produces toxic emissions. The search for replaceable alternative fuels is hence of importance and keys of demands are renewable energy and energy-friendly resources. Hydrogen as a fuel, in particular the hydrogen gas, is one of the options considering the only residues to be water and hot air, provided that the energy used in the hydrogen production comes from renewable sources. In the storage tank of cars fueled by hydrogen gas, a high pressure is set due to its advantages of opportunities of more storage and thus increased mileage of the tank. A decompression process is necessary to supply the fuel cell with hydrogen gas at the right pressure, and thus achieve highest possible degree of efficiency. The concept offers a wide set of application opportunities in industrial situations and understanding the valve is important for characterizing the performance on the device. Given correct and optimal geometry on the Tesla valve, a high pressure-drop could be achieved, in other words a high performance. In this study three geometric parameters were investigated in order to conclude their ideal value for optimizing the performance. The parameters of interest were the inner curve radius, the valveto-valve distance in a multi-stage Tesla valve and the cross-section of the valve. In order to obtain the results, a numerical study was conducted using simulations in a Computational Fluid Dynamics program, ANSYS Fluent. The results denoted that a small inner curve radius yielded the highest pressure-drop when comparing to larger radius’. The performance was enhanced with a large valveto-valve distance of the multi-stage Tesla valves and the findings of the cross-sections, which were chosen to be rectangular and circular of interest, displayed a superior performance for the circular cross-sections. Conclusions were drawn that circular cross-section is to prefer and that a small inner curve radius and large valve-to-valve distance yield an enhanced performance of the device.

This thesis describes the lifelong work of significant Russian interpretation theorist, pedagogue and active conference interpreter Anatoly Fedorovich Shiryaev. The thesis is theoretical and is divided into three main sections. In the first section, the theoretical background that helps A. F. Shiryaev develop his Complex Model of Simultaneous Interpretation is described. It focuses on the unit of orientation, redundancy and speech compression in detail. This section explains why these are important in the simultaneous interpretation context and the role they have in its process. In the second section, A. F. Shiryaev's Complex Model of Simultaneous Interpretation is analysed in detail along with its specific features. Next, the model is compared with other selected simultaneous interpretation models which were being developed approximately at the same time. The third section describes A. F. Shiryaev's approach to simultaneous interpretation teaching. It deals with methodology and teaching didactics, and the objectives which are to be achieved during the simultaneous interpretation course, and describes the system of interpretation exercises. The thesis also includes a brief biography of A. F. Shiryaev which presents information about his professional life.

Com o objetivo de avaliar os efeitos do tempo da descompressão medular em 50 ratos, machos, da raça Wistar, criou-se um modelo experimental de compressão medular através da passagem de uma fita de tecido (cetim), que reduz em 30% o diâmetro do canal vertebral na região da coluna torácica após laminectomia (TIX E TX). Os animais foram distribuídos em cinco grupos com 10 ratos cada, sendo: grupo A, controle da técnica de exposição medular atraumática, sem lesão; grupo B, submetidos à compressão medular, seguida de descompressão cinco minutos após a lesão; nos grupos C e D, realizou-se o mesmo procedimento do grupo B, porém a descompressão ocorreu 24 e 72 horas após a compressão, respectivamente; os ratos do grupo E sofreram compressão, sem descompressão até o fim do experimento na quarta semana, quando os 50 ratos foram submetidos à eutanásia. Todos os animais com compressão (B, C, D e E) apresentaram paraplegia no pós-operatório imediato. A recuperação neurológica foi avaliada através do potencial evocado motor, da escala BBB de capacidade locomotora e do exame anatomopatológico do sítio da lesão. Observou-se relação direta entre o potencial de recuperação neurológica e o tempo da descompressão medular nos três métodos de avaliação / With the objective of evaluating the effects of medullary decompression time in 50 male Wistar rats, an experimental model of medullary compression was created, through the insertion of a satin tape, which reduces in 30% the diameter of the vertebral canal at the region of the thoracic column after laminectomy (TIX and TX). The animals were distributed in five groups with 10 rats each, as follows: group A: control of the technique of atraumatic medullary exposure, with no lesion; group B, submitted to medullary compression, followed by decompression five minutes after the lesion; groups C and D underwent the same procedure, but decompression was performed 24 and 72 hours after compression, respectively; and finally, rats from group E underwent compression without decompression up to the end of the experiment on the 4th week, when all 50 rats were euthanized. All animals submitted to compression (groups B, C, D and E) presented paraplegia in the immediate post-operative period. The neurological recovery was evaluated through the motor-evoked potential of the BBB scale of locomotor capacity and anatomopathological examination of the lesion site. A direct correlation between the neurological recovery potential and time of medullary decompression was observed at the three evaluation methods

La mousse flexible de polyuréthane est couramment utilisée dans nombreuses applications telles que acoustiques, thermiques et de bâtiment grâce à sa faible densité et à son pouvoir d’isolation thermique et acoustique. Elle est également utilisée dans les applications de confort pour les sièges tels que véhicule, train, avion etc. grâce sa faible raideur et à son pouvoir à absorber l’énergie de déformation. Pour optimiser le confort des systèmes d’assise, il est nécessaire de modéliser le siège et en particulier la partie flexible, c’est-à-dire la mousse de polyuréthane. Les objectifs principaux de cette thèse consistent à identifier puis à modéliser le comportement quasi-statique de la mousse de polyuréthane sous différentes conditions d’essais sous grandes déformations. Des essais de compression/décompressions unidirectionnels monocycle et multicycle à différentes vitesses de déformations ont été réalisés sur trois types de mousse de polyuréthane, afin de comprendre le comportement du matériau. Ces essais ont permis de déduire que les mousses de polyuréthanes sous grandes déformations présentent à la fois un comportement hyperélastique et un comportement viscoélastique. Ils ont également montrés que les mousses de polyuréthanes présentent un phénomène d’assouplissement appelé ‘effet de Mullins’ lors que les essais de compression/décompressions multicycle, c’est-à-dire que les contraintes dans 1er cycle sont moins faibles que les contraintes dans les cycles suivants pour une même déformation. Sur la base des résultats d’expérimentaux et afin de modéliser le comportement quasi-statique de la mousse de polyuréthanne, nous avons développé trois modèles visco-hyperélastiques qui se composent de deux éléments à savoir la partie modèles énergétiques hyperélastiques, utilisés généralement pour des matériaux à comportement caoutchoutique, et la partie modèle à mémoire entier qui tient compte de l’historique et permettant de décrire le comportement viscoélastique. Les paramètres des modèles ont été identifiés en utilisant la méthode d’identification et la méthode d’optimisation appropriée. Les résultats des modélisations du comportement mécanique de la mousse sur les essais monocycles et multicycles ont été comparés aux résultats expérimentaux, monteront à la fois une très bonne capacité à simuler le 1er cycle de charge/décharge, ainsi que les cycles suivant. Nos modèles ont prouvé leur capacité à modéliser l’effet de Mullins sur les mousses de polyuréthane souple. Ces modèles ont été validés sur les trois types de mousse et pour trois vitesses de sollicitation, permettent de conclure leurs efficacités et de leurs représentativités. / Flexible polyurethane foam is widely used in numerous applications such as acoustic, thermal and building due to its low density and its ability to absorb thermal and acoustic energy. It is also used for the comfort of the seats such as the vehicle, train, plane due to its low stiffness and its ability to absorb deformation energy. In order to optimize the comfort of the car seat, it is necessary to model the behavior of seat system, particularly the flexible component - polyurethane foam. The main objective of this study is to identify and model the quasi-static behavior of polyurethane foam under different test conditions in large deformations. Compression / decompression uniaxial unicycle and multicycle tests were carried out on three types of polyurethane foam at different strain rates, which allows us to understand the behavior of the material. The results of the tests indicate that the polyurethane foams exhibit a hyperelastic behavior and a viscoelastic behavior under large deformations. They also showed that the polyurethane foams have a stress softening phenomenon which is called 'Mullins effect' during the compression / decompression multicycle tests. In other words, the stress in first cycle is lower than the stresses in the subsequent cycles in the same deformation. ‘Mullins effect’ for the polyurethane foam is also an important study in this dissertation. Based on the experimental results and the goal of modeling quasi-static behavior of the polyurethane foam, three visco-hyperelastic models were developed. These models consist in two elements: hyperelastic models, which is normally used for description the behavior of rubber materials, and entire memory model which takes into account the history and describing the viscoelastic behavior. Model parameters were identified using appropriate identification and optimization methods. The results of modeling the mechanical behavior of the foam on the unicycle and multicycle tests were compared with experimental results. The models showed a very good competence to simulate the first cycle and the following cycles during the charge / discharge tests. Our models have proven its ability to model Mullins effect on flexible polyurethane foams. These models have been validated on three types of foam in order to present a comparative study of their effectiveness and their representativeness.

Com o objetivo de avaliar os efeitos do tempo da descompressão medular em 50 ratos, machos, da raça Wistar, criou-se um modelo experimental de compressão medular através da passagem de uma fita de tecido (cetim), que reduz em 30% o diâmetro do canal vertebral na região da coluna torácica após laminectomia (TIX E TX). Os animais foram distribuídos em cinco grupos com 10 ratos cada, sendo: grupo A, controle da técnica de exposição medular atraumática, sem lesão; grupo B, submetidos à compressão medular, seguida de descompressão cinco minutos após a lesão; nos grupos C e D, realizou-se o mesmo procedimento do grupo B, porém a descompressão ocorreu 24 e 72 horas após a compressão, respectivamente; os ratos do grupo E sofreram compressão, sem descompressão até o fim do experimento na quarta semana, quando os 50 ratos foram submetidos à eutanásia. Todos os animais com compressão (B, C, D e E) apresentaram paraplegia no pós-operatório imediato. A recuperação neurológica foi avaliada através do potencial evocado motor, da escala BBB de capacidade locomotora e do exame anatomopatológico do sítio da lesão. Observou-se relação direta entre o potencial de recuperação neurológica e o tempo da descompressão medular nos três métodos de avaliação / With the objective of evaluating the effects of medullary decompression time in 50 male Wistar rats, an experimental model of medullary compression was created, through the insertion of a satin tape, which reduces in 30% the diameter of the vertebral canal at the region of the thoracic column after laminectomy (TIX and TX). The animals were distributed in five groups with 10 rats each, as follows: group A: control of the technique of atraumatic medullary exposure, with no lesion; group B, submitted to medullary compression, followed by decompression five minutes after the lesion; groups C and D underwent the same procedure, but decompression was performed 24 and 72 hours after compression, respectively; and finally, rats from group E underwent compression without decompression up to the end of the experiment on the 4th week, when all 50 rats were euthanized. All animals submitted to compression (groups B, C, D and E) presented paraplegia in the immediate post-operative period. The neurological recovery was evaluated through the motor-evoked potential of the BBB scale of locomotor capacity and anatomopathological examination of the lesion site. A direct correlation between the neurological recovery potential and time of medullary decompression was observed at the three evaluation methods

La drépanocytose est la maladie moléculaire et héréditaire (transmission mendélienne récessive et autosomique) la plus répandue au monde. Elle est un problème de santé publique par sa gravité et ses implications socio-économiques dans de nombreux pays. Seuls les sujets homozygotes (SS) ou hétérozygotes composites (SC) sont malades, les hétérozygotes (AS) ne sont que des transmetteurs du gène S. Elle est la première cause d’OstéoNécrose de la Tête Fémorale (ONTF), douloureuse évoluant vers l’arthrose, en l’absence de traitement chez un patient jeune.<p>La Guadeloupe compte 450.000 habitants, dont 12% sont porteurs de l’hémoglobine S. Le nombre des drépanocytaires est estimé à 1.200 dont les 3/4 sont suivis au Centre Caribéen de la Drépanocytose (CCD), créé en 1990. Le centre assure la prise en charge médicale des enfants dès leur naissance et des adultes malades. Nos activités au CHU de Pointe-à-Pitre, au CCD et à l’Unité INSERM-UMR S458 depuis juillet 1992 nous ont permis d’étudier:<p>- le diagnostic de l’ONTF;<p>- l’évaluation de l’hyperpression osseuse dans l’ONTF et l’évaluation du traitement par forage simple;<p>- l’étude de l’impact de la prise en charge orthopédique précoce sur la survenue et l’évolution de l’ONTF.<p>Notre étude concerne les patients drépanocytaires adultes homozygotes (SS) et double hétérozygotes (SC):<p>- une série rétrospective de 1993-1994 [E-1994] portant sur 115 patients (58 SS, 57 SC) identifiés en 1984,<p>sans suivi médical ni orthopédique;<p>- une série prospective de 1995 à 2008 [E-2008] portant sur 215 patients (94 SS, 121 SC) avec prise en<p>charge médicale et orthopédique.<p>L’IRM est l’examen de référence pour le diagnostic de l’ONTF comme dans la nécrose idiopathique. En absence d’imagerie moderne, la radiographie traditionnelle réalisée de façon complète (profil et, surtout, faux profil), permet le diagnostic avant toute déformation. Seules les lésions cliniquement symptomatiques et évolutives (examen clinique itératif, contrôle radiologique, tomographie, TDM ou IRM) ont une indication opératoire.<p>L’hyperpression intra osseuse, dans l’ONTF drépanocytaire, est significativement liée à la douleur (que les patients soient homozygotes ou hétérozygotes). Sa diminution a un effet antalgique objectif, observée après forage. Elle permet de confirmer le diagnostic d’ostéonécrose au stade précoce, dans les régions où l’IRM est inexistante.<p>Un forage réalisé aux stades précoces de l’ONTF permet un arrêt rapide de l’évolution des lésions vers une arthrose, avec une efficacité certaine pour les stades I et II. Il garde une efficacité limitée pour le stade III. En plus de l’indolence apportée par la décompression, le bénéfice du forage se manifeste par l’allongement du délai avant arthroplastie (de 7,4 ± 2,7 ans). La technique est réalisable dans les régions sous équipées, où la drépanocytose est fréquente.<p>La description histologique aux différents stades radiologiques de l’ONTF montre toujours des lésions de nécrose médullaire et osseuse. A l’inverse des lésions idiopathiques, les lésions drépanocytaires sont caractérisées par la présence d’une inflammation, en dehors de tout processus infectieux.<p>Dans la littérature, la fréquente de l’ONTF drépanocytaire chez l’adulte est voisine de 40%, proche de celle observée dans [E-1994], notre population non suivie (36,5%). En comparant les études [E-1994] et [E-2008], la fréquence de l’ONTF passe de 36,5% à 14,4%. L’officialisation en 1992 d’une prise en charge médicale et d’un suivi orthopédique régulier au CCD et au CHU de Pointe-à-Pitre, a permis la réduction de la fréquence de l’ONTF et d’autres morbidités.<p>Le rappel sur la drépanocytose révèle la complexité de la maladie, la variabilité de son expression clinique et de ses complications. L’amélioration de vie des patients nécessite une prévention primaire, secondaire et tertiaire, en l’absence d’un traitement spécifique de la maladie.<p>La prise en charge médicale, complétée par une prévention et un traitement précoce (orthopédique ou chirurgical) telle que réalisés au CCD en Guadeloupe, a permis une réduction significative de la survenue de la nécrose de hanche et de ses complications. Pour une prévention tertiaire des complications ostéo-articulaires, nous suggérons:<p>- une prise en charge médicale régulière des enfants et des adultes afin de réduire les crises vaso-occlusives;<p>- une éducation des patients à la recherche de signes d’appel de l'ONTF et, aussi, d’autres articulations;<p>- un examen clinique ostéo-articulaire lors des bilans annuels et après toute crise vaso-occlusive;<p>- une attention particulière à l’adolescence (passage enfant-adulte), après une grossesse;<p>- une prise en charge précoce, orthopédique ou chirurgicale conservatrice (forage ou ostéotomie) face à une<p>nécrose, afin de réduire les complications invalidantes de l’ONTF.<p><p>Sickle-cell anemia is the most widespread hereditary (autosomal recessive Mendelian transmission) molecular pathology in the world. It is a public health issue in many countries, due to its severity and socio-economic impact. Only homozygous (SS) and double heterozygous (SC) subjects are affected, heterozygous (AS) subjects merely transmitting the gene S. Sickle-cell anemia is the most frequent cause of osteonecrosis of the femoral head (ONFH), a painful condition which evolves towards osteoarthritis if not treated at an early age.<p>Guadeloupe has a population of 450,000, 12% of whom are carriers of hemoglobin S. There are estimated to be 1,200 sickle-cell anemia sufferers, three-quarters of whom are followed in the Caribbean Sickle-Cell Center (Centre Caribéen de la Drépanocytose: CCD), which was set up in 1990. The Center provides medical care for adult patients and for children as of birth. Work has been ongoing since July 1992, in the Pointe-à-Pitre University Hospital, the CCD and the INSERM-UMR S458 research unit, focusing on:<p>- diagnosis of ONFH;<p>- bone hyperpressure measurement in ONFH and assessment of simple drilling treatment;<p>- the impact of early orthopedic treatment on the onset and evolution of ONFH.<p>The present study involved homozygous (SS) and double heterozygous (SC) adult sickle-cell anemia patients:<p>- a retrospective series, from 1993 to 1994 [S-1994], including 115 patients (58 SS, 57 SC) identified in 1984,<p>who had no medical or orthopedic care;<p>- a prospective series, from 1995 to 2008 [S-2008], including 215 patients (94 SS, 121 SC), with medical and orthopedic care.<p>MRI is the diagnostic gold-standard in ONFH, as in idiopathic necrosis. Where such modern imaging is not available, complete standard X-ray (lateral and especially false lateral) enables diagnosis to be made before deformity sets in. Surgery is indicated only for clinically symptomatic evolutive lesions on iterative clinical check-up, X-ray control, tomography, CT or MRI.<p>Intraosseous hyperpressure in sickle-cell ONFH shows a significant correlation with pain, in both homozygous and heterozygous patients. Pressure reduction is objectively pain-relieving, as seen after drilling, and can confirm diagnosis of ONFH at an early stage, in places where MRI is not available.<p>Drilling performed in the early stages of ONFH quickly arrests evolution towards osteoarthritis, with proven efficacy in grades I and II, and a certain degree of effectiveness in grade III. Over and above the pain-relief provided by decompression, drilling also enables hip replacement to be postponed, by 7.4±2.7 years. Moreover, the technique is feasible in those under-equipped regions in which sickle-cell disease is widespread.<p>Histologic description of radiologic ONFH stages consistently finds medullary and bone necrosis. In contrast to idiopathic lesions, sickle-cell related lesions show inflammation without any associated infection.<p>In the literature, the frequency of adult sickle-cell ONFH is reported to be nearly 40%, close to the 36.5% found in the S-1994 study of a non-treated population. In the S-2008 study of a population with medical and orthopedic care, ONFH frequency fell to 14.4%. The official provision of medical care and regular orthopedic follow-up in the CCD and Pointe-à-Pitre Hospital has reduced the frequency of ONFH and other morbidities.<p>A review of sickle-cell disease reveals its complexity: the variability of its clinical expression and associated complications. Improving patients’ quality of life requires primary, secondary and tertiary prevention, in the absence of specific treatment.<p>Medical care, supplemented by early prevention and treatment (orthopedic or surgical), as practiced in the Guadeloupe CCD, has significantly reduced the rates of ONFH and associated complications. We recommend the following CCD protocol for tertiary prevention of osteoarticular complications:<p>- regular medical care for children and adults, to reduce the incidence of vaso-occlusive crises;<p>- patient education in alarm signs of osteonecrosis of the femoral head and of other joints;<p>- systematic osteoarticular assessment at yearly check-up and after all vaso-occlusive crises;<p>- special focus on adolescence (child-to-adult transition) and following pregnancy;<p>- early care, both orthopedic and by conservative surgery (drilling or osteotomy), in case of necrosis, to reduce the rate of disabling complications of ONFH / Doctorat en Sciences médicales / info:eu-repo/semantics/nonPublished

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This thesis consists of two main parts. The first part is a theoretical analysis, or a literary research, it is focused on the physical properties of the fluid, which have direct impact on the decompression. The aim of the second part is to evaluate the measurement of the forging valve and subsequently simulate the issue by means of CFD. The first simulations were performed for the maximal valve stroke and used for the CFD solver setup calibration. The subsequent analyses dealt with possible openings of the valve. In the final chapter the theoretical impact of the liquid compressibility and of the undissolved air is discussed. The results of the thesis can prove useful for the new valve setting in hydraulic circuit or for possible geometry modification.

International Telemetering Conference Proceedings / October 28-31, 1996 / Town and Country Hotel and Convention Center, San Diego, California / This paper describes a 300 Mega Bit Per Second (MBPS) Front End Processor (FEP) prototype completed in early 1993. The FEP implements a patent pending parallel frame synchronizer (frame sync) design in 12 Actel 1240 Field Programmable Gate Arrays (FPGA's). The FEP also provides (255,223) Reed-Solomon (RS) decoding and a High Performance Parallel Interface (HIPPI) output interface. The recent introduction of large RAM based FPGA's allows greater high speed data processing integration and flexibility to be achieved. A proposed FEP implementation based on Altera 10K50 FPGA's is described. This design can be implemented on a single slot 6U VME module, and includes a PCI Mezzanine Card (PMC) for a commercial Fibre Channel or Asynchronous Transfer Mode (ATM) output interface module. Concepts for implementation of (255,223) RS and Landsat 7 Bose-Chaudhuri-Hocquenghem (BCH) decoding in FPGA's are also presented. The paper concludes with a summary of the advantages of high speed data processing in FPGA's over Application Specific Integrated Circuit (ASIC) based approaches. Other potential data processing applications are also discussed.