Dissertations / Theses on the topic 'Facteur de perte'
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Figini, Armelle. "Influence de la température sur le facteur de perte des alliages à fort amortissement." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2001. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp05/MQ65573.pdf.
Full textFlammier, Sacha. "L'autotaxine est un nouveau facteur autocrine contrôlant l'activité ostéoclastique et la perte osseuse en conditions inflammatoires." Thesis, Lyon, 2018. http://www.theses.fr/2018LYSE1056/document.
Full textAutotaxin (ATX) is a secreted protein produced by various tissues including the liver, adipose tissue and bone. ATX exhibits a lysophospholipase D activity responsible for cleavage of lysophosphatidyl-choline (LPC) in lysophosphatidic acid (LPA) that in turn acts as a growth factor, affecting cell proliferation, differentiation, and migration. It has been shown that biological effects of LPA could be the direct consequence of local production of ATX in a given tissue or cell type. We showed that LPA controls osteoclastogenesis and osteoclast bone resorption activity. In addition, we observed that Enpp2 (ATX gene) was upregulated during osteoclastogenesis. The aim of the study was to evaluate if ATX produced by osteoclasts could play a role in osteoclastogenesis and bone mass control, especially in inflammatory conditions.The role of ATX on osteoclastogenesis and osteoclast activity were analysed by murine and human assays. ATX was targeted by conditional inactivation of Ennp2 (ATX gene) in osteoclasts (Enpp2fl/fl Ctsk-Cre) and by treatment with anti-ATX. Arthritic and erosive diseases were studied in arthritis models using human tumor necrosis factor transgenic (hTNF+/-) mice and K/BxN serum-treated mice. Systemic bone loss was analysed in the Lipopolysaccharide (LPS)-induced inflammation model. Joint inflammation and osteoclasts were assessed by histology and bone mass and bone erosion by micro-CT.ATX production by osteoclasts was observed and was revealed as a crucial factor controlling osteoclast activity. Inhibition of ATX led to reduced bone resorption in vitro. Then, we generated Enpp2fl/fl Ctsk-Cre+/- mice allowing ATX depletion specifically in mature osteoclasts. These mice showed no specific bone phenotype under physiological conditions but displayed significant protection against systemic bone loss and almost an absence of bone erosion formation after challenge with LPS and K/BxN serum transfer. Pharmacological inhibition of ATX significantly mitigated focal and systemic TNF-induced bone loss. Pharmacological and genetic inactivation of ATX ameliorates systemic and focal inflammatory bone loss by inhibiting bone resorption. ATX emerges as a new promising therapeutic target for the prevention of inflammatory associated bone loss
Rolland, Michelle. "Etude du facteur de perte d'un panneau d'antenne de satellite en vue de la prevision de son comportement vibratoire a haute frequence." Toulouse 3, 1997. http://www.theses.fr/1997TOU30218.
Full textQuien-Sarrazy, Arabella. "Relation entre la catégorie socio-professionnelle et la perte d'autonomie de la personne âgée : données du projet Paquid." Bordeaux 2, 1997. http://www.theses.fr/1997BOR2M030.
Full textBridoux, Agathe. "Evaluation de la perte de la fonction restauratrice du sommeil comme facteur participant à la fatigue chez les patiens atteints de sclérose en plaques." Thesis, Paris Est, 2015. http://www.theses.fr/2015PESC0011.
Full textThis work consisted first in a crossover study comparing the effect of a nap versus a rest on an electrophysiological measure of post-exercise motor recovery in fatigued patients with multiple sclerosis (MS) (n = 12) and healthy controls (n = 12). This measure corresponded to the amplitude of motor potentials evoked by magnetic stimulation of the cortex, recorded at the hand performing the exercise. This study showed that the restorative function of sleep on the recovery of post-exercise motor evoked potential depression was impaired in fatigued MS patients compared to controls. Second, a comparative study of the spectral power density in the sigma and delta bands at different stages of sleep and of the slope of slow wave during deep sleep was conducted from polysomnographic data in a series of fatigued MS patients (n = 15) compared to healthy subjects (n = 15). The assumption was that the loss of the restorative effect of sleep on motor performance in MS could be due to a dysfunction of synchronization in some neural networks. Our results show no impairment of slow waves slope in patients with MS compared to healthy subjects, which invalidates our hypothesis. However, a decrease in the spectral power density in the sigma and delta bands was found in patients with MS as compared to controls. This result could be explained by differences in micro-arousals, periodic movements of legs or sex-ratio between the two groups. The involvement of an alteration in thalamocortical connections due to myelin damage in the loss of the restorative function of sleep still remains a hypothesis to be explored as part of MS
Duviau, Jean-Pierre. "Influence de la perte d'autonomie et de la dénutrition sur l'escarrification : étude rétrospective puis prospective sur 50 et 29 patients âgés hospitalisés." Bordeaux 2, 1994. http://www.theses.fr/1994BOR2M108.
Full textNjilie, Adamou Franck Éric. "Modélisation et évaluation de l'amortissement de structures sandwichs." Paris 6, 2002. http://www.theses.fr/2002PA066276.
Full textMauchamp, V. "LA SPECTROSCOPIE DE PERTE D'ÉNERGIE DES ÉLECTRONS APPLIQUÉE AUX BATTERIES AU LITHIUM : EXPÉRIENCES ET SIMULATIONS AU SEUIL K DU LITHIUM." Phd thesis, Université de Nantes, 2006. http://tel.archives-ouvertes.fr/tel-00424048.
Full textKouyoumji, Jean-Luc. "Caractérisation des parois courantes et des liaisons structurales pour la prévision de l'isolement acoustique d'une construction en bois." Chambéry, 2000. http://www.theses.fr/2000CHAMS024.
Full textAzoti, Wiyao Leleng. "Conception et amélioration des propriétés amortissantes des composites auxétiques basés sur l'utilisation des outils de la micromécanique." Thesis, Université de Lorraine, 2012. http://www.theses.fr/2012LORR0218/document.
Full textThe design of composite (particles/fibers or structures) materials, consisting of auxetic reinforcements, with enhanced damping properties is studied herein. For such analysis, the auxetic behavior describing a negative Poisson's ratio needs to be understood as "structure effect" point of view than "material effect". Indeed, the "material effect" which treats of the topological and morphological textures of the composite constituents remains poorly documented in the literature. Based on the kinematic integral equation of Dederichs and Zeller, the design space of auxetic composite materials is explored initially through an analytical one-site formulation of the Mori-Tanaka micromechanics scheme. Then, more complex microstructures are investigated from micromechanics formalism as well as Finite Element Method (FEM) simulations. One can cite the multilayered hollow-cored microstructure and the microstructure describing a cluster of re-entrant ellipsoidal inclusions in which the interaction among them (inclusions) is taken into account. The results provided by these investigations show us for instance in the case of isotropic materials that auxeticity is achieved if and only if one of the material?s constituents (inclusion or matrix) is initially auxetic. Also, it is noticed in the case of ellipsoidal inclusions describing the re-entrant cluster that auxetic behavior can be recovered by introducing joints between inclusions. Otherwise, favorable issues are only expected with auxetic components. In addition to this preliminary analysis concerning the validity domain of auxetic behavior in composites, the effect of inserting auxetic reinforcements within a viscoelastic matrix for instance PolyVinylButyral (PVB) on the one hand, and the use of auxetic and viscoelastic layers in sandwich structures on the other hand, are studied. The response of these materials in terms of damping properties, such as the storage modulus and the loss factor are then identified and discussed versus non-auxetic (conventional) composite reinforcements
Dupuy, Jean-Sébastien. "Identification des propriétés mécaniques de matériaux composites par analyse vibratoire." Phd thesis, Montpellier 2, 2008. http://www.theses.fr/2008MON20200.
Full textThe mechanical performance of composites depends not only on the characteristics of fillers and matrix used, but also on the quality of interface between these constituents. Thus, poor interfacial adhesion generally results in a decrease of the behavior of composite, which may be likened to an overall damage of the material. The purpose of this study is to propose a means of quick characterization of materials damage from mechanical vibrations analyses. Indeed, bad cohesion within thematerial can lead to friction phenomena, which tend to increase the damping level of its dynamic response. Several experimental techniques, some of which based on the analysis of the structural resonant frequencies, are presented in this study. The viscoelastic properties of particulate composites with polymer matrix are analyzed. Some design parameters of these model materials have been tuned, in order to create different damage levels. The results, particularly in regard to the loss factor, are interpreted from a comparison with simple analytical homogenization models
Tufano, Giovanni. "K-space analysis of complex large-scale periodic structures." Thesis, Lyon, 2020. http://www.theses.fr/2020LYSEC008.
Full textDuring its operational mission, a transportation mean is subject to broadband acoustic, aerodynamic and structure-borne excitations. The transportation means, such as aircrafts, space launchers, ships, cars, trains, etc., are designed to accomplish a primary goal, usually to transfer a payload (passengers, goods, satellites, for example) from a point to another, always keeping a high level of comfort, safety and survivability of the payload. National and international regulations about noise pollution are more and more stringent; scientists and industrial players are facing with these challenges developing new materials and new design choices. Composite materials, complex geometries and new design concepts are investigated, making the analysis and the prediction of the vibroacoustic response of these structures a huge challenge. The complexity makes the derivation of analytical models harder to obtain; the use of numerical tools is of crucial importance. One of the most employed method is the Finite Element (FE) modeling, but the huge amount of degrees of freedom together with a high computational cost limits its use in the low frequency range. In the last decades, different methods are derived to obtain the dispersion characteristics of the structures; one of the most common is the Wave Finite Element Method (WFEM), that is based on the wave propagation. This method has been applied on various simple and complex structures, deriving both 1D and 2D formulations, extended also to curved structures. Recently, an energetic approach has been derived starting from the Prony’s method, the Inhomogeneous Wave Correlation (IWC) method. This approach has its applicability in the mid-high frequency range, where the modal overlap is quite high. The IWC method is based on the projection of the wavefield on an inhomogeneous traveling wave. The dominant wavenumber, at each frequency, is obtained by maximization of the correlation function between the projected wavefield and the inhomogeneous wave. In this context, an extended version of the IWC method is derived, allowing to describe the dispersion curves of complex structures: periodic narrow plates, composite plates, ribbed panels, composite curved shells and curved stiffened structures. The method has the advantage to be applied in an operational environment, making use of sparse acquisition locations. A complete dispersion characteristics analysis is conducted, even in presence of periodic elements and vibration-control devices, describing the directly correlated band-gaps in certain frequency regions and general vibration level attenuation. A numerical and experimental estimation of the structural damping loss factor is computed. A description of the local dynamics in presence of small-scale resonators, of the periodicity effect and the identification of the multi-modal behavior are also captured. All the results of the numerical simulations are experimentally validated on complex large-scale meta-structures, such as a 3D-printed sandwich panel, a curved composite laminated sandwich panel and a aluminum aircraft sidewall panel. The effect of industrially-oriented 3D-printed small-scale resonators on the vibro-acoustic response of the considered structures is conducted, taking in account both diffuse acoustic field and mechanical excitations
Tijdens zijn operationele opdracht, is een vervoersgemiddelde onderworpen aan breedband akoestische, aërodynamische en structuur - gedragen excitaties. De transportmiddelen, zoals vliegtuigen, ruimtelanceerders, schepen, auto’s, treinen, enz., zijn ontworpen om een primair doel te verwezenlijken, gewoonlijk om een lading (passagiers, goederen, satellieten, bijvoorbeeld) van een punt naar een andere over te brengen, altijd houdend een hoog niveau van comfort, veiligheid en overleefbaarheid van de lading. De nationale en internationale regelgeving inzake geluidshinder is steeds strenger; wetenschappers en industriële spelers worden geconfronteerd met deze uitdagingen bij de ontwikkeling van nieuwe materialen en nieuwe ontwerpkeuzes. Samengestelde materialen, complexe geometrieën en nieuwe ontwerpconcepten worden onderzocht, waardoor de studie en de voorspelling van de vibroakoestische respons van deze structuren een enorme uitdaging. De complexiteit maakt de afleiding van analytische modellen moeilijker te verkrijgen; het gebruik van numerieke tools is van cruciaal belang. Een van de meest gebruikte methoden is de FE-modellering (Finite Element), maar de enorme hoeveelheid vrijheidsgraden in combinatie met hoge computerkosten beperkt het gebruik ervan in het lage frequentiebereik. In de afgelopen decennia zijn verschillende methoden afgeleid om de verspreidingskenmerken van de structuren te verkrijgen; een van de meest voorkomende methoden is de Wave Finite element Method (WFEM), die gebaseerd is op de golfvoortplanting. Deze methode is toegepast op verschillende eenvoudige en complexe structuren, die een 1D- en 2D-formulering afleiden, ook uitgebreid tot gebogen structuren. Onlangs is een energieke benadering afgeleid van de methode van Prony, de Inhomogeneous Wave Correlation (IWC) methode. Deze benadering heeft haar toepasbaarheid in het middenhoge frequentiebereik, waar de modale overlapping vrij hoog is. De IWC-methode is gebaseerd op de projectie van het golfveld op een inhomogene golf. De dominante golvenumber wordt bij elke frequentie verkregen door maximalisatie van de correlatiefunctie tussen het geprojecteerde golfveld en de inhomogene golf. In dit verband wordt een uitgebreide versie van de IWC-methode afgeleid, waarmee de verspreidingscurves van complexe structuren kunnen worden beschreven: Periodieke smalle platen, samengestelde platen, geribde panelen, samengestelde gebogen schalen en gebogen geribbelde panelen. De methode heeft het voordeel om te worden toegepast in een operationele omgeving, waarbij gebruik wordt gemaakt van sparse acquisitielocaties. Er wordt een volledige analyse van de verspreidingskenmerken uitgevoerd, zelfs in aanwezigheid van periodieke elementen en apparatuur voor trillingscontrole, die de direct met elkaar verband houdende bandhiaten in bepaalde frequentiegebieden en de verzwakking van het trillingsniveau beschrijven. Er wordt een numerieke en expexiii rimentele schatting van de verliesfactor van de structurele demping berekend. Een beschrijving van de lokale dynamiek in aanwezigheid van kleinschalige resonatoren, van het periodiciteitseffect en de identificatie van het multimodale gedrag worden ook vastgelegd. Alle resultaten van de numerieke simulaties worden experimenteel gevalideerd op complexe grootschalige meta-structuren, zoals een 3D-gedrukt sandwichpaneel, een gebogen samengesteld gelamineerd sandwichpaneel en een aluminium zijpaneel aan de zijkant van het vliegtuig. Het effect van industrieel georiënteerde 3D-gedrukte kleinschalige resonatoren op de trillings-akoestische respons van de overwogen structuren wordt uitgevoerd, waarbij rekening wordt gehouden met zowel diffuus akoestisch veld als mechanische excitaties
Bimou, Charlotte. "Analyse de trajectoires, perte d'autonomie et facteurs prédictifs : Modélisation de trajectoires." Thesis, Limoges, 2019. http://www.theses.fr/2019LIMO0030/document.
Full textThe increase in life expectancy of baby boom generations in developed countries would often be accompanied by functional limitations, disability, increasingly observed in the geriatric population. The general objective of this thesis was to contribute to the knowledge of the evolution of the functional independence of older people in a heterogeneous population. First, it was to identify homogeneous groups in a heterogeneous population of elderly people following the same functional independence trajectory over a two-year period, and potential predictive factors. Second, it was to analyze the clinical consequences of trajectories and patient survival over the same observation period. The SMAF (Système de Mesure de l'Autonomie Fonctionnelle) and ADL (Activities of Daily Living) scales were used as indicators for measuring independence. Analysis were performed from a sample of 221 patients of UPSAV (Unit for Prevention, Monitoring and Analysis of Aging) cohort. We used three methods including trajectory analysis including GBTM (Group-Based Trajectory Modeling), k-means and ascending hierarchical classification. The results suggest three distinct trajectories of functional independence: stable, stable then decline, continuously decline. The predictors of trajectories obtained using logistic regression are socio-demographic, medical and biological criteria. Patients assigned to the loss of independence trajectory (continuously altered trajectory) reported high proportions of injurious falls. Based on a Cox model, neurocognitive disorders, heart failure, involuntary weight loss and alcohol were revealed as predictors of death. We conclude from this work that the two-year longitudinal analysis identified homogeneous subgroups of elderly people in terms of changes in functional independence. The prevention of UPSAV becomes a useful even if the utility level is not the same. Prevention and screening of the loss of independence of the elderly person followed at home must be anticipated in order to delay the deterioration and to maintaining the autonomy. Future analyses should focus on exploring large cohorts of older people to confirm and generalize our research
Guyonnet-Gillette, Sophie. "Perte de poids et maladie d'alzheimer : facteurs associés et prise en charge." Toulouse 3, 2002. http://www.theses.fr/2002TOU30016.
Full textSeguin, Bruno. "Les pertes dans les condensateurs bobines utilisées en électronique de puissance : mesure calorimétrique et modélisation." Grenoble INPG, 1997. http://www.theses.fr/1997INPG0061.
Full textLosses in wound capacitors used in power electronic : calorimetric measurement and modelling The heating of capacitors used in power electronic, is a conséquence of the electrical losses, which are usualy represented by an Equivalent Séries Résistance ESR. The ratio P/Q (=tan5, dissipation factor), berween the dissipated power P and Oie reactive power Q, is so weak (10"1 to I0"2) thaï the measurement of ESR by classical means becoraes very difficult. An expérimental device based on calorimetry hâve been built in order to carry oui this measurement. It allows a characterizarion of very low-loss capacitors (tan5 < 5. 10"4), such as wound PP capacitors. The capacitors can be tested under rated voltage, from IfcHz to 1MHz, while the test température is kept berween -50°C and +100°C. Various wound capacitors made with différent dielectric materials : PP. PC and PET hâve been characterized. Losses in the dielectric material and those in metalic parts of thé components hâve been separated. Which allowed us to study the dissipation factor tanS of thèse polymers as a fonction of température, for few frequencies. According to thèse results, an équivalent circuit composed of R, L and C éléments, hâve been pioposed in order to modelize the ESR variations with frequency. This mode! bave been validatcd for non sinusoïdal voltages, such as those existing in power electronic, by comparison between a calorimetric measurement of the losses in capacitors, and their évaluation by simulation using the équivalent circuits
Dupuy, Jean-Sébastien. "Identification des propriétés mécaniques de matériaux composites par analyse vibratoire." Phd thesis, Université Montpellier II - Sciences et Techniques du Languedoc, 2008. http://tel.archives-ouvertes.fr/tel-00383234.
Full textMahdi, Ibtissam J. "Les facteurs qui affaiblissent le rendement économique dans l'enseignement supérieur en Irak : étude sur la perte quantitative." Paris 7, 1985. http://www.theses.fr/1985PA07A003.
Full textLorans, Alice. "Dénutrition en cancérologie : repérage des patients à risque." Thesis, Saint-Etienne, 2010. http://www.theses.fr/2010STET013T.
Full textModification of the nutritional status is a frequent complication in patients with cancer, and its consequences on the pronotic of the disease, on the therapeutic management and on quality of life are probably not negligible. In routine practice, it’s not always easy to process at systematics nutritional assessments. The objective of this work is firstly to measure the importance of weight loss in cancer patients and secondly to identify predictors that might be useful to identifying patients at risk. We report the results of two independent studies : the first study was conducted from 2 cross- sectional surveys conducted in cancer patients, all sites and all stages combined, in the Institut de Cancérologie de la Loire at Saint-Etienne and The Centre Jean Perrin at Clermont-Ferrand. Nearly a third of patients had lost more than 10% of their usual weight since the beginning of the disease. The profile of patients at risk were identified : Male, Location of the tumor in the digestive or ENT, Scheduled chemotherapy, Depressive syndrome and Low socio- economic statut. In this study we demonstrated a significant association between weight loss and overall quality of life. The second study was conducted as part as a chemoprevention trial in patients treated with radiotherapy for early stage head and neck cancer in Quebec. Five predictors of weight loss have been identified : Location of the tumor at the supraglottic larynx, the oral cavity oropharynx and hypopharynx, High weight in the beginning of radiotherapy, Stage II, Dypshagia or odynophagia, Functional capacity impairments. These simple elements can be a tool for tracking patients at risk of malnutrition which require intervention early preventive nutrition
Berlin, Ivan. "Etude des facteurs modifiant la réponse aux médicaments agissant sur les systèmes catécholaminergiques." Paris 6, 1988. http://www.theses.fr/1988PA061001.
Full textGiroux, Valérie. "La perte d'un parent par suicide : analyse rétrospective de l'expérience ainsi que des facteurs de vulnérabilité et de protection." Thesis, Université Laval, 2010. http://www.theses.ulaval.ca/2010/27005/27005.pdf.
Full textTurgeon, Sabrina. "Amélioration d'un service d'évaluation clinique de l'obésité." Thesis, Université Laval, 2008. http://www.theses.ulaval.ca/2008/25131/25131.pdf.
Full textFranco, Stéphanie Bertagnoli Stéphane. "Epidémiologie de la peste porcine africaine dans la région du lac Alaotra (Madagascar) étude des facteurs de risque et estimation de la prévalence /." [S.l.] : [s.n.], 2007. http://oatao.univ-toulouse.fr/1744/1/debouch_1744.pdf.
Full textLaude, Isabelle. "Etude des autoanticorps, des facteurs de risque de thrombose et des microparticules circulantes dans les pertes foetales." Paris 5, 1998. http://www.theses.fr/1998PA05P035.
Full textDuchesne, de Ortiz Isabelle. "L'effet du climat sur les plantes fourragères au Québec : estimation des pertes par la modélisation." Doctoral thesis, Université Laval, 2010. http://hdl.handle.net/20.500.11794/22397.
Full textComtet, Christophe. "Etude du facteur de qualité mécanique des multicouches diélectriques des optiques de VIRGO : influence sur le bruit thermique." Lyon 1, 2008. http://www.theses.fr/2008LYO10202.
Full textWu, Yuanfei. "Pathogenèse moléculaire du carcinome hépatocellulaire : rôle de facteurs viraux et mécanismes génétiques." Paris 7, 2003. http://www.theses.fr/2003PA077191.
Full textLechowski, Laurent. "Perte d'autonomie pour les activités de la vie quotidienne dans la maladie d'Alzheimer : description, facteurs déterminants et évolution argumentés par les données de la cohorte REAL.FR." Toulouse 3, 2008. http://thesesups.ups-tlse.fr/464/.
Full textThe aim of our studies was to explore the loss of autonomy for the instrumental activities of the daily living in Alzheimer's disease with the IADL Lawton scale, in the multicentric French REAL. FR cohort (687 patients). Design of studies was prospective. At first, main explanation for the loss of autonomy were age, cognitive impairment but not behavioural disturbance. Then, we identified severe cognitive impairment as predisctive factor of faster loss of autonomy. Those patients were probably " fast decliners ". Finally, we determined a hierarchy in the loss of abilities in instrumental activities of daily living in the majority of women. Such of hierarchy permit a best understanding of the progression of Alzheimer's disease, and a significant impact in care of patients
Mao, Mathieu. "Optimisation multi-facteurs / multi-objectifs : application à l'optimisation des profil organoleptique de produits secs par le contrôle des paramètres de matières premières et procédés." Institut national agronomique Paris-Grignon, 2007. http://www.theses.fr/2007AGPT0067.
Full textBarthes, Julien. "Adressage et contrôle de nanosources optiques par plasmonique intégrée ou fibrée." Thesis, Dijon, 2015. http://www.theses.fr/2015DIJOS011/document.
Full textSurface plasmon polariton (SPP) can confine light on subwavelength dimensions. Since they are not diffraction limited, they are of great interest for addressing and controlling optical nanosources. For example, a metal nanowire defines 1D plasmonic waveguide with a great potential for either addressing or coupling quantum emitters. Therefore, SPP opens great opportunities for integrated optical applications. However, SPP suffer from ohmic losses that jeopardize the applications of plasmonic components. In this context, we study the possibilities provided by an hybrid plasmonic-photonicstructure to couple efficiently an emitter to a fiber mode. Such a structure paves the way for fibered single photon nanosource or high resolution optical probe. In this thesis manuscript, we first study the coupling rate between a fluorescent molecule and a metallic nanowire thanks to Green’s dyad formalism. This leads us to distinguish the different relaxation channels and the enhancement of the energy transferred into the plasmonic guided mode by optimizing the shape of the guide (crystalline nano-wire,slow modes). Then, we investigate the energy propagation in a metal coated taperedoptical fiber. Finally, we achieve an optimal configuration for which more than 50% of the energy emitted by a quantum emitter laid on a substrat is transferred into an optical fiber
Marchetti, Fabien. "Modelling and characterisation of anisotropic multilayered plates on a wide frequency range." Thesis, Lyon, 2019. http://www.theses.fr/2019LYSEI130.
Full textThis PhD thesis concerns the modelling and the dynamic characterisation of anisotropic multilayered structures. In the first chapter, a classification of some analytical models and experimental methods of characterisation is presented in the form of a bibliographical synthesis where the main published results are gathered. The second chapter introduces an extension of an equivalent model of multilayered structures to the case of anisotropic materials. This model describes the first dispersion curves of the structure and considers the shear phenomena that can affect the bending mode in high frequencies. The main advantage of the model lies in its simplicity and rapidity thanks to a number of kinematic variables independent of the number of layers. The characteristics of the multilayer are defined by the 5 flexural rigidities of a thin equivalent plate which is compared to the multilayer. The results of the model are validated by means of an experimental study on carbon fiber composite plates. A particular interest is dedicated to the modelling of structural damping. An energetic loss factor, based on a temporal and spatial definition of the attenuation, is compared to an equivalent one. A new definition of the spatial attenuation is suggested for high damped structures and is compared to literature. In the third chapter, the methodology of the characterisation technique CFAT is adapted for anisotropic plates. This inverse method is based on the displacement field analysis of the structure and has, by means of its local aspect, relevant advantages for industrial applications. This adaptation is, as a first step, introduced for the identification of sources (initial objective of the method) and applied, in a second step, for the characterisation. Several numerical and experimental applications are presented to validate the results of the method. Finally, the fourth chapter deals with the experimental characterisation of a honey comb sandwich on a high frequency range (1 to 300 kHz). The complex dynamic behaviour of this thick structure is described through the promissing results given by the simulations of our model and the estimations of RIC. These results are also compared to the ones of a reference model and other characterisation methods
Bahrouni, Hassouna. "Caractérisation de l'efficacité technique des systèmes de pulvérisation et des pertes de pesticides appliqués aux cultures basses dans les régions méditerranéennes : cas de la Tunisie." Phd thesis, Montpellier, SupAgro, 2010. http://tel.archives-ouvertes.fr/tel-00508302.
Full textPereira, de Oliveira Rémi. "Mécanismes de transmission vectorielle du virus de la Peste Porcine Africaine et facteurs influençant cette transmission : étude de différentes associations tique-virus." Thesis, Montpellier, 2020. http://www.theses.fr/2020MONTG013.
Full textThere is currently no vaccine available to control African Swine Fever (ASF), one of the most important swine diseases that ravages Africa, Europe and Asia. To fight the ASF virus (ASFV) that induces infectious disease, understanding the different modes of transmission is essential to apply adequate sanitary measures. One mode of transmission is through the bite of an infected tick. The main objective of my thesis was to understand the mechanisms and factors that determine the vectorial competence of the Ornithodoros soft ticks for ASFV. First, this thesis project showed that the ticks present in Europe are not competent for the strains currently circulating in Eurasia, but can maintain the virus for several months and be infectious to pigs, at least by ingestion. This study also showed that dissemination of ASFV inside ticks towards transmission organs is not enough and must be completed by a sufficient level of viral replication to allow transmission. However, our results also suggest the existence of other factors, partially unknown, that modulate each of these stages. A comparative analysis of two ASFV genomes with different vectorial transmission patterns showed several genetic differences, which may contribute to determining vector competence. In addition, a preliminary study conducted in this PhD project demonstrated that the infection of ticks with ASFV induced modulation of some antimicrobial peptides, highlighting that there is an interaction at the molecular level between the tick and the ASFV. All these results were discussed in regard to potential risks for the establishment of a tick-suid transmission cycle and the implementation of appropriate sanitary measures in these peculiar areas
Obame, Ndong Elysée. "Développement d'un dispositif de calorimétrie par rayonnement thermique : application à la mesure des pertes dans les composants électriques." Phd thesis, Université de Grenoble, 2010. http://tel.archives-ouvertes.fr/tel-00523756.
Full textBlanchet, Charlène. "Identification de facteurs génétiques contrôlant la résistance de lignées de souris consanguines à une infection expérimentale par Yersinia pestis, l'agent de la peste." Phd thesis, AgroParisTech, 2009. http://pastel.archives-ouvertes.fr/pastel-00606835.
Full textRenault, Anne-Laure. "Identification de facteurs génétiques modifiant le risque de cancer chez les porteuses d'une mutation constitutionnelle d'ATM & profil tumoral des tumeurs du sein associées à une perte de fonction d'ATM." Thesis, Université Paris-Saclay (ComUE), 2017. http://www.theses.fr/2017SACLS389/document.
Full textInherited biallelic mutations in the ATM gene cause Ataxia Telangiectasia (A-T), a multisystemic disorder characterized by neurological, cutaneous and immunological abnormalities. The disease is associated with an elevated risk of malignancies, particularly of lymphoma or leukemia, and a high radiosensitivity. Epidemiological studies have shown that female heterozygote carriers (HetAT) younger than 50 years are at increased risk of breast cancer, as compared to women from the general population (RR 4,94, 95%CI 1,90 - 12,09). Despite the rarity of A-T disease, 0.5 to 1% of the population is estimated to be HetAT. Epidemiological studies have confirmed that some specific truncating or missense variants in ATM are associated with increased breast cancer risk but this risk is not yet well estimated. The first part of my thesis project has consisted in characterizing inherited genetic factors modifying cancer risk in women participating in the prospective cohort CoF-AT (“cohorte de femmes apparentées à un enfant atteint d’A-T). In the second part of my work, I described the morphological and molecular features of ATM breast tumours with the aim to identify biomarkers allowing to distinguished ATM-associated tumours from sporadic tumours.Assessment of the contribution of inherited factors such as SNPs of telomere length on the risk of cancer was performed on 284 HetAT individuals and 174 non-HetAT individuals belonging to 103 A-T families. We showed that HetAT individuals have longer telomeres than their non-HetAT counterparts (p=0.0008). However, we found that telomere length was not associated with cancer risk in our study population. The SNP rs9257445 (ZNF311), which is associated with telomere length in HetAT participants, was not associated with cancer risk. Conversely, SNPs rs6060627 (BCL2L1) and rs2380205 (ANKRD16) modified cancer risk in HetAT and non-HetAT women.Pathology review of 41 ATM-associated breast tumours revealed that these tumours mostly belonged to luminal B molecular subtype. The molecular characterization of 23 ATM-associated tumours did not revealed the BRCAness profile associated with Large-Scale State Transitions. However, we found that ATM tumours were mostly tetraploïd and observed loss of heterozygosity at 11q22-23 in the majority of the tumours and loss of ATM wild type allele. Moreover, copy number losses at loci 13q14.11-q14.3, 21p11.2-p11.1 and 22q11.23 appeared to be specific of ATM tumours.Altogether, this project allowed to better characterize the genetic background of the CoF-AT participants and to highlight biomarkers of ATM breast tumours
Dubois, Marie-France. "Identification des facteurs associés à la qualité des soins et développement d'un outil de repérage des ressources d'hébergement dispensant des soins inadéquats à leur clientèle âgée en perte d'autonomie." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape11/PQDD_0005/NQ40522.pdf.
Full textDubois, Marie France. "Identification des facteurs associés à la qualité des soins et développement d'un outil de repérage des ressources d'hébergement dispensant des soins inadéquats à leur clientèle âgée en perte d'autonomie." Sherbrooke : Université de Sherbrooke, 1998.
Find full textChevallier, Lucie. "Recherche de facteurs génétiques contrôlant la résistance de lignées de souris consanguines à une infection expérimentale par Yersinia pestis, l'agent de la peste." Phd thesis, AgroParisTech, 2012. http://pastel.archives-ouvertes.fr/pastel-00880257.
Full textBlanchet, Charlène. "Identification de facteurs génétiques contrôlant la résistance de lignées de souris consanguines à une infection expérimentale par Yersinia pestis, l'agent de la peste." AgroParisTech, 2010. http://pastel.archives-ouvertes.fr/docs/00/60/68/35/PDF/These_Charlene_BLANCHET.pdf.
Full textPlague is a zoonotic disease affecting mainly rodents and accidentally humans. The etiologic agent of bubonic and pneumonic plague is the Gram-negative bacterium Yersinia pestis. The mechanisms by which the host is able or not to resist the infection are poorly understood. We have shown that some mouse inbred strains, like C57BL/6J, die after the subcutaneous injection of 100 bacteria of a virulent strain (CO92), while others, like SEG/Pas, derived from Mus spretus, survive. A backcross between these two strains led to identification, on chromosomes 3, 4, and 6, of three QTL controlling survival rate. The first two were found only in females, while the chromosome 6 QTL was also found in males. Congenic mice carrying the SEG chromosome 6 in a C57BL/6J background were produced. After infection, they die in the same proportion as C57BL/6, but somewhat later. Bi- and tri-congenic strains are under production to assess the effect of other QTLs. We have tested a collection of 55 interspecific recombinant congenic strains between C57BL/6J and SEG/Pas. Several strains significantly differed from C57BL/6 in survival rate or time to death. The analysis of strain 120G, which dies earlier than C57BL/6J, suggests that the proximal region of chromosome 6 would be responsible for this phenotype. Altogether, our data show that genetic control of resistance to plague in SEG/Pas mice is complex, and we have identified several genomic regions which play an important role in this phenotype
Chevallier, Lucie. "Recherche de facteurs génétiques contrôlant la résistance de lignées de souris consanguines à une infection expérimentale par Yersinia pestis, l’agent de la peste." Thesis, Paris, AgroParisTech, 2012. http://www.theses.fr/2012AGPT0077/document.
Full textYersinia pestis, the agent of plague, is a deadly gram-negative bacterium classified as a re-emerging pathogen and class A biological weapon. The appearance of a multi-resistant strain highlights the need to better understand how this pathogen kills its host. To identify genetic factors of host susceptibility to plague, our laboratory is investigating the response of resistant versus susceptible mice to Y. pestis. Our strategy to decipher genetic determinants involved in resistance to plague combines Quantitative Trait Loci (QTL) mapping with gene expression analysis. We previously described the Mus spretus-derived SEG/Pas strain as the first to resist fully virulent Y. pestis, while most inbred strains, such as C57BL/6, are highly susceptible. Crosses between these two strains identified three QTLs (located on chromosome 3, 4 and 6) contributing to resistance. Two of the QTLs (on chromosome 4 and 6) were confirmed through creation of congenic mice. Up to 40% of the congenic mice heterozygous at these two QTLs, on a C57BL/6J background, survived the infection while all C57BL/6J mice died. Further dissection of these two QTLs, through the use of subcongenic strains, enabled us to refine the genetic architecture of resistance to plague in SEG/Pas mice. We concluded that a minimum of four genetic factors, within these two QTLs, are required to increased resistance to Y. pestis in mice. Despite production of numerous congenic strains, including triple congenic mice, we were not able to confirm the existence of the third QTL identified on chromosome 3. In parallel to genetic studies, we determined that SEG/Pas and C57BL/6J macrophages exhibit distinct characteristics upon in vitro exposure to Y. pestis. The underlying molecular differences were investigated by using microarrays. Our results show strong activation of cytokines in SEG/Pas macrophages in response to Y. pestis, which is not found in C57BL/6J macrophages. These results suggest that SEG/Pas mice are able to better activate innate immune response to Y. pestis than C57BL/6J mice.We further studied the expression of 44 genes in a kinetic study on macrophages in vitro of SEG/Pas, C57BL/6J and bicongenic mice (carrying QTLs on chromosome 4 and 6). This study confirmed that SEG/Pas mice are able to build a stronger inflammatory response at early time of infection. Nevertheless no significant differences were observed in the bicongenic strain compared to C57BL/6J. Further studies will be required to understand the mechanisms involved in the intermediate resistance of this strain. This combination of genetic dissection and gene expression analysis of resistant and susceptible mouse strains will enhance our ability to better understand the host response to plague
Viale-Garrone, Audrey. "Période de la ménopause, état de santé orale et facteurs systémiques." Thesis, Aix-Marseille, 2014. http://www.theses.fr/2014AIXM5028/document.
Full textIn a cross-sectional study of 202 postmenopausal and premenopausal women,the objectives of this study are to demonstrate a link between menopause and altered state of oral health.To evaluate the action of HRT on dental disease and finally on the tooth mortality. To assess and clarify the relationship between oral health and various general diseases and links between psyche and soma in postmenopausal women.Also discussed was the influence of bisphosphonates on the state of periodontal health.Finally,it was decided to place the study links oral menopausal status in a social and anthropological perspective.It appears then that menopause results in an altered state of oral health,(p = 0.003).HRT has a beneficial effect on the periodontal disease.The biological effects of diabetes are related to dental mortality (p = 0.050). This study emphasize the influence "per se" a bad oral health status for coronary artery disease (OR = 1.214).In postmenopausal women, stressful events, dry mouth, joint and bone diseases, hormonal deficiency are factors variously related dental mortality during this period. Moreover, it was found that women who have recently been treated for breast cancer developed more dental caries (p = 0.031 OR = 2.161).The study related the effects of bisphosphonates on the alteration of periodontal (p = 0.011), despite taking HRT (p = 0.020).In addition,background socio-economic favored contribute to the medicalization of physiological phenomenon. The fact of living alone would affect the loss of dental organs (p = 0.035). Finally, the regular practice of a sport improve the state of oral health (p = 0.036)
Velha, Philippe. "Ingénierie de modes en optique intégrée sur silicium sur isolant." Paris 11, 2008. http://www.theses.fr/2008PA112023.
Full textThis thesis enters upon the localization and the handling of the light at the wavelength scale. The work initially concerned microcavities with high quality factors (Q) integrated on ridge waveguides relying on a substrate (SOI). The optimization of the mirrors thanks to an engineering of mode based on the modes profiles adaptation, permits us to achieve Q factors up to 60000 for a modal volume of 0,6 (lambda/n) ^3. Confinement could be observed by near-field microscopy and we showed that it was possible to control these cavities by a SNOM tip. Lastly, we investigate the slow modes approach by tackling theoretically the issue of the injection of light in slow modes
Ndiaye, Bakhao. "Facteurs de risque de l'accès tardif aux soins et de la perte de vue chez les patients infectés par le VIH suivis à Bruxelles et dans la région Nord Pas-de-Calais." Lille 2, 2009. http://www.theses.fr/2009LIL2S046.
Full textElidor, Hélène. "Facteurs associés au regret décisionnel chez les proches aidants des personnes âgées en perte d'autonomie ayant fait face à la décision de déménager ou non : une analyse secondaire d'un essai randomisé par grappes." Master's thesis, Université Laval, 2020. http://hdl.handle.net/20.500.11794/67882.
Full textGiven the foreseeable increase in the number of older adults with cognitive impairment, the involvement of their family caregivers in decision-making processes is essential. However, caregivers often face difficult decisions for these cognitively impaired older adults. Such a situation can lead to regret about the decision made. We conducted a secondary analysis of data collected in a cluster randomized control trial. This trial aimed to evaluate the effect of a shared decision-making intervention on the proportion of family caregivers who report playing an active role in housing decision making for a cognitively impaired older adult. Decision regret was measured using the Decision Regret Scale (DRS). The choice of independent variables was guided by a conceptual framework illustrating the factors that may be associated with decision regret among informal caregivers. The average DRS score was 12.4/100 (standard deviation=18.4). Factors associated with decision regret were mapped onto the following dimensions of the framework: caregiver's characteristics (level of education, total family income, employment status, marital status and burden of care), decision-making process (decision conflict and caregivers' perception of the occurrence of a joint process in decision-making) and advance care planning (the cognitively impaired older adults’ housing preference). Our results may be used to help providers develop strategies to mitigate the risk of decision regret in this population.
Cortes, Frédéric. "Apport des études d'observation dans la connaissance de l'histoire naturelle de la maladie d'alzheimer et de ses facteurs d'évolutivité." Toulouse 3, 2007. http://www.theses.fr/2007TOU30002.
Full textA better understanding of the evolution of Alzheimer's disease is a major issue in current research. Prospective observational studies allow us to study the evolution of the disease and the factors associated with this evolution in more general populations than in clinical trials. Our work analysed data obtained in two French observational studies and results suggest a positive influence of specific medication and adapted management on the evolution of the disease and a real effectiveness of acetylcholine esterase inhibitors treatments. Results also show that the deterioration of the nutritional status or the occurrence of weight loss are risk factors for an accelerated decline whereas the existence of a family history of dementia does not influence the progression of the disease
Latulippe, Karine. "Pour une cybersanté contributive à la réduction des inégalités sociales de santé : identification et exploration des facteurs de conversion pour un outil de cybersanté s’adressant aux proches aidants de personnes âgées en perte d’autonomie." Doctoral thesis, Université Laval, 2020. http://hdl.handle.net/20.500.11794/66978.
Full textIntroduction: E-health, or any digital tool that we use to take care of our health, has become an integral part of our lives. However, a segment of the population does not use these methods, which results in social health inequalities (SHI). SHI represent differences in disease prevalence and life expectancy for groups of people, caused by social and modifiable factors. E-health can contribute significantly to mitigating SHI by providing efficient access to health services anytime, anywhere, while reducing stigma. However, due to the existing digital divide, E-health can also exacerbate SHI. The term “digital divide” refers to the discrepancy that exists between groups of the population in access to technologies and in technological skills. People with poorer health, who are more at risk of SHI, are also more likely to experience this digital divide. This is a health justice issue. Methodology: In order to understand how to better equip researchers and designers to promote the development of inclusive E-health tools that effectively combat rather than amplify SHI, a social justice approach was chosen. Based on Amartya Sen’s social justice theoretical framework, a systematic review identified conversion factors that promote the development of inclusive E-health tools. A conversion factor, which can be personal, social, or environmental, is a facilitator (or barrier) in the achievement of a given goal. Subsequently, these conversion factors were explored in an empirical study through participant observation. For the purposes and feasibility of this study, this exploration focused on the development of an E-health tool for caregivers of functionally dependent elderly people. Because of the role they play, caregivers are more at risk of developing physical and mental health problems than the rest of the population and, consequently, to being exposed to SHI. The E-health tool (prototype) was developed in the context of eight co-design sessions combined with three working sessions with an advisory committee. Each of these sessions, as well as the research team’s preparation and debriefing sessions, were recorded and analyzed according to the methods proposed by Miles and Huberman and Paillé in order to describe how the conversion factors were (or failed to be) taken into account by the co-designers. Results: Seven conversion factors were drawn from the literature review: 1) providing physical, technical, and financial access to E-health; 2) involving people at risk of SHI in the research and development of digital projects that concern them; and 3) having regard for future users’ (FU) digital health literacy, 4) technological skills, 5) help-seeking process, 6) v learning abilities, and 7) cultural context. The involvement of persons at risk of SHI in the development of an E-health tool for caregivers of functionally dependent elderly people appears to be a key conversion factor through which the other factors are realized. However, although the research team initially intended to leave decision-making on the prototype to coders, time constraints required the team to become more involved in the decision process. The participation of caregivers and stakeholders triggered two debates regarding peer support and the evaluation of formal services. The help-seeking process and digital health literacy are the two other conversion factors that were more fully integrated into the process. Conclusion: From a social justice perspective, researchers and designers have a role to play in ensuring that the tools developed in E-health are inclusive and accessible to all. This project highlights conversion factors that can foster this solidarity and informs researchers and designers about an E-health tool development process that considers people at risk of SHI.
Hamidou, Bello. "Epidémiologie de la sclérose latérale amyotrophique : Facteurs de risque, incidence et phénotypes." Thesis, Limoges, 2015. http://www.theses.fr/2015LIMO0062/document.
Full textAmyotrophic Lateral Sclerosis (ALS) is a rare neurodegenerative disease. Currently in France, there is no population-based incidence data. The phenotypic profile of French patients with ALS, has not been studied. Lastly, no risk factors are confirmed for this pathology. In this context, to improve knowledge in these fields, our work consisted of three studies: (1) a study on the incidence of ALS in the Limousin region based on the database from the first French ALS register (2) a study of the phenotypes of patients from 11 French ALS centers and (3) a literature review of original epidemiological studies focusing on physical activity (PA) and ALS risk. Our work has highlighted a high crude and standardized incidence (on Europe population): 3.19 / 100 000 person-years (PY) and 2.58 / 100,000 PY respectively. Regarding phenotypic aspects, our work identified eight ALS phenotypes: (1) bulbar, (2) cervical spinal (3) lumbar spinal (4) flail leg, (5) flail arm, (6) respiratory, (7) ALS-FTD and (8) dropped head. We demonstrated that the PA itself is probably not a risk factor for ALS. As a first perspective we hope to expand the ALS Register to other French regions. In a second perspective, it would be very important to confirm our work on phenotypes on a larger and representative sample of ALS patients. Finally, regarding the relationship between PA and ALS, other work of high level of evidence are desirable to confirm the synthetic result we brought in this thesis work
Kelner, Maëlle. "Analyse des processus de glissements gravitaires sous-marins par une approche géophysique, géotechnique et expérimentale : cas de la pente continentale de Nice." Thesis, Université Côte d'Azur (ComUE), 2018. http://www.theses.fr/2018AZUR4113/document.
Full textSmall submarine landslides, when triggered near the coast represent a major coastal hazard due to erosion of the coastline and marine submersion. In October 1979, a submarine landslide generated a part of the airport platform of Nice (France) to collapse at sea and provoked a tsunami. Because the continental slope off this region is abrupt, close to the coast and subject to moderate seismic activity it is a natural laboratory to study small-scale submarine mass movements processes. This work is based on a multidisciplinary approach allowing a global study of landslide processes in the source area. It integrates data from marine geophysics, sedimentology, geotechnics and numerical modelling. For the first time morphology and architecture of the Var delta deposits are investigated using very high resolution data. It allows identification of numerous small-size gravitational processes signatures as well as their embedding at depth. In the case of the 1979 landslide previously unknown features are identified: 1) eastern and western scars, 2) in-situ blocks and lateral spreading’s traces, 3) in-depth sliding surface, 4) estimation of a total displaced volume, which is different from the evacuated sediment volume. The sedimentary cores are then used to discuss the proximal distribution of deposits, erosion and paleo-landslides records from the deposits overconsolidation. The landslide activity has been estimated over time in terms of return frequencies. The largest landslides (>106 m3) have return frequencies nearing 50 years; the medium-size landslides (105 > V > 106 m3) between 3 and 25 years; and the numerous small landslides (<105 m3) every 1-2 months to 5 years during the most active periods in the last 50 years. Landslides deposits recorded in the source area show return frequencies of 3-7 years during periods of greater activity over the last 400 years. The morphology’s evolution follows successive cycles of sliding/quiescence/reloading. In recent times, two main cycles can be observed (from 1967 to 1999 and from 1999 to 2011) during which triggering are clustered in 5-10 years. On a longer time scale, the turbidites clusters span 20-40 years and quiescence periods ~100 years. Finally, this study brings new constraints on preconditioning and triggering factors acting on the Var delta. The stability of the area seems to be strongly conditioned by the complexity of the topography, the sediments consolidation and the quantity of sediments brought by the Var river. The deposits architecture mainly constrains the depth of the instabilities. Among the external drivers known in the area the extension of the gas-rich zone as well as fluids plumes in the water column have been considered and mapped. Looking at other external drivers, the analysis shows that the magnitude of rainfall and floods, and the alluvial water level would be too low over the past 50 years to act as an isolated triggering factor. In order to destabilize slopes, these external drivers need to be tackled together or associated to earthquakes. Relationships between databases analyses, landslides activity and numerical tests suggest that regional seismicity and historical earthquakes are either too small or too distant from the source areas to generate sufficient peak ground acceleration (0.2 g) and to have an individual impact on the delta slopes
Roques, Cécile. "Étude des facteurs influençant la conservation des racines de betteraves sucrières, et des changements physiologiques au cours du stockage en lien avec la qualité industrielle." Thesis, Lille 1, 2017. http://www.theses.fr/2017LIL10204.
Full textSearching for innovative and favourable solutions in order to adapt to the abolition of production quotas, Tereos, an agricultural cooperative, leader of the French sugar market, is interested in the physiological changes which occur in the sugar beet roots during storage. The study of factors affecting the storability of roots, the analysis of physical and biochemical changes, and the identification of degradation indicators, are the main objectives of this thesis. This work was carried out in collaboration with the industrial direction. The link between the agronomical quality and the industrial quality is addressed for the first time in a joint project. Indeed, the physical and biochemical transformations suffered by roots during the conservation in piles induce the production of new molecules, and some of them are harmful for the sucrose extraction.With physical resistance tests and chromatographic analysis, some of the physiological changes of the roots are identified, and the sugar losses during storage are extended. Thanks to the introduction of new projects, as the study of volatile organic compounds and microbiological analysis, indicators of root degradation are suggested
Lafon, Arnaud. "Evaluation du rôle de l'inflammation buccale sur l'athérogénèse dans la survenue des accidents vasculaires cérébraux ischémiques." Thesis, Dijon, 2013. http://www.theses.fr/2013DIJOMU08.
Full textThe aim of this work is to investigate the suspected link between oral inflammation and the occurrence of ischemic stroke. In Western countries, the incidence of ischemic stroke is rising despite prevention campaigns aiming at limiting the exposure to common risk factors for ischemic diseases. Nearly 9% of strokes are of unknown etiology. The triggering factor for ischemic stroke or "trigger key" remains unknown. Recent studies have shown that ischemic stroke is more likely to occur in the week following an infectious event. Therefore, oral inflammation, that causes a rise in various inflammatory biomarkers is studied as potentially increasing the risk of stroke. Firstly, a meta-analysis was performed to synthesize data about the relationship between oral inflammation and the occurrence of stroke. It has shown that the risk of fatal ischemic stroke increases by 38% in patients with severe periodontitis. Secondly, two observational clinical studies have been implemented to strengthen the validity of the supposed epidemiological links and bring new elements in our understanding about the pathophysiological mechanisms linking oral inflammation and the occurrence of ischemic stroke. The results show a proportional relationship between the degree of oral-inflammation and biological assessments that demonstrate pro-atherosclerotic and pro-inflammatory state. Indeed, we observe an increase in CRP levels, VLDL triglycerides and a decrease in HDL in patients with severe periodontal disease. Bone loss, that is easily measurable on a dental panoramic radiograph, appears to be the main risk factor of the occurrence of ischemic stroke.The results of this thesis show that the presence of an inflammatory oral environment is an additional marker for the discovery of a cardiovascular risk in patients combining other conventional risk factors of ischemic stroke. In addition, our results suggest the need for cooperation between the neurologists and odontologists to improve the management of cardiovascular risk in patients with ischemic stroke and oral inflammation