Academic literature on the topic 'MET-EDS'

Objectives To evaluate the different policies to recognize child maltreatment in emergency departments (EDs) in Europe in order to define areas of improvement. Methods A survey was conducted on the recognition of child maltreatment in EDs in European countries with a focus on screening methods, parental risk factors, training and hospital policies. The survey was distributed through different key members from the EUSEM, REPEM and the EuSEN. A summary score based on the NICE guideline (4 questions on child characteristics, 4 questions on parental characteristics and 5 questions on hospital policy) was calculated. Results We analysed 185 completed surveys, representing 148 hospitals from 29 European countries. Of the respondents, 28.6% used a screening tool, and 31.8% had guidelines on parental risk factors. A total of 42.2% did not follow training based on child characteristics, and 57.6% did not follow training on parental characteristics. A total of 71.9% indicated that there was a need for training. 50.8% of the respondents reported a standardized policy for the detection of child maltreatment. Translating the survey results to NICE summary scores of the EDs in Europe, we found that 25.6% (34/133) met most, 22.6% (30/133) met some and 51.9% (69/133) met few of the NICE guideline recommendations. More specifically, with respect to hospital policies, 33.8% (45/133) met most, 15.0% (20/133) met some and 51.1% (68/133) met few of the NICE guideline recommendations. Conclusion There is high variability regarding policies for child maltreatment detection and only a quarter of the EDs met most of the NICE guideline recommendations for child maltreatment. There is a need for the use of screening tools, training of ED staff and implementation of local hospital policies.

This study examined clinical and subclinical eating disorders (EDs) in young Norwegian modern rhythmic gymnasts. Subjects were 12 members of the national team, age 13-20 years, and individually matched nonathletic controls. All subjects participated in a structured clinical interview for EDs, medical examination, and dietary analysis. Two of the gymnasts met the DSM-III-R criteria for anorexia nervosa, and 2 met the criteria for anorexia athletica (a subclinical ED). AH the gymnasts were dieting in spite of the fact that they were all extremely lean. The avoidance of maturity, menstrual irregularities, energy deficit, high training volume, and high frequency of injuries were common features among the gymnasts. There is a need to learn more about risk factors and the etiology of EDs in different sports. Coaches, parents, and athletes need more information about principles of proper nutrition and methods to achieve ideal body composition for optimal health and athletic performance.

Excessive daytime sleepiness (EDS) is a prevalent symptom among stroke survivors. This symptom is an independent risk factor for stroke and may reduce stroke survivors’ quality of life, cognitive functioning, and daytime functional performance. The lack of a universally accepted definition of EDS makes it difficult to measure EDS and synthesize research. The purpose of this integrative review is to describe poststroke EDS, ascertain conceptual and operational definitions of EDS, identify factors that contribute to EDS in stroke survivors, and explore outcomes associated with EDS in stroke survivors. We searched the following databases: PubMed and MEDLINE (OvidSP 1946—April; Week 2, 2015), Embase (OvidSP 1974—March; Week 1, 2015), and PsycINFO (OvidSP 1967—April; Week 2, 2015). Our search yielded 340 articles, 27 of which met inclusion criteria. The literature reveals EDS to be a multidimensional construct that is operationalized with both subjective and objective measures. Choosing measures that can quantify both the objective and subjective components is useful for gaining a comprehensive understanding of EDS. The antecedents of EDS are stroke, sleep-disordered breathing, reversed Robin Hood syndrome, and depression. The outcomes associated with EDS in stroke patients are serious and negative. Via synthesis of this research, we propose a possible framework for poststroke EDS, which may be of use in clinical practice and in research to identify valid quantifying methods for EDS as well as to prevent harmful outcomes in stroke survivors.

PURPOSE: Previous literature on dancers and athletes has shown a large impact of eating disorders (EDs) on these individuals, but there is limited research on EDs affecting non-dance performing artists (i.e., musicians, actors, etc.). This systematic review aimed to identify and evaluate the literature on EDs in non-dance performing artists. METHODS: A systematic review of the literature was performed on 24 databases, using search terms related to EDs and non-dance performing artists. All results from the databases were systematically screened for inclusion and exclusion criteria. RESULTS: The initial search returned 86,383 total articles, which after screening and removal of duplicates and irrelevant papers yielded 129 results. After screening the 129 full-text results for eligibility, 10 studies met criteria for inclusion: 6 papers addressed EDs in musicians, and 4 papers addressed EDs in theatre performers. Most studies used questionnaires and body mass index (BMI) as diagnostic tools for EDs. Most were small-scale studies and participants were mostly students. Because of the studies’ heterogeneity and varying quality, the results obtained were often contradictory and questionable. CONCLUSIONS: Although there has been a lot of literature in dancers, we found relatively few studies associating EDs with other performing artists, and most were inconsistent in their information.

ABSTRACTObjectiveHealthLine is Saskatchewan's provincial 24-hour health information and support telephone line. A proportion of HealthLine's callers are referred to the emergency department (ED) for further assessment. The purpose of this study was to gain insight into the appropriateness of these referrals and assess whether they increased the burden on an already strained ED system.MethodsA list of callers referred from HealthLine to Saskatoon EDs from January 1, 2014, to March 31, 2014 was obtained. This list was cross-referenced with Saskatoon Health Region registration data to determine which of those callers had been registered in one of the three Saskatoon EDs within 48 hours of the original call.ResultsDuring the 90-day time period in question, 707/3,938 (17.9%) of callers were referred by HealthLine to the ED. Out of those referred, 601 were identifiable and 358 attended the ED. Hospital charts were pulled for full data extraction and analysis of the 276 who met inclusion criteria. Of those who presented to the ED and met inclusion criteria, 60% had investigations performed while 66% received some form of treatment. The overall admission rate for the patient population studied was 12.0% v. 16% for non-referred patients. Referred pediatric patients had fewer investigations and treatments with a lower admission rate compared with the adult patients.ConclusionThe Saskatchewan HealthLine is doing an effective job at directing callers both to and away from EDs in Saskatoon and not overburdening our local EDs with unnecessary referrals.

Purpose The purpose of this paper is to perform and report a systematic review of published research on patient safety attitudes of health staff employed in hospital emergency departments (EDs). Design/methodology/approach An electronic search was conducted of PsychINFO, ProQuest, MEDLINE, EMBASE, PubMed and CINAHL databases. The review included all studies that focussed on the safety attitudes of professional hospital staff employed in EDs. Findings Overall, the review revealed that the safety attitudes of ED health staff are generally low, especially on teamwork and management support and among nurses when compared to doctors. Conversely, two intervention studies showed the effectiveness of team building interventions on improving the safety attitudes of health staff employed in EDs. Research limitations/implications Six studies met the inclusion criteria, however, most of the studies demonstrated low to moderate methodological quality. Originality/value Teamwork, communication and management support are central to positive safety attitudes. Teamwork training can improve safety attitudes. Given that EDs are the “front-line” of hospital care and patients within EDs are especially vulnerable to medical errors, future research should focus on the safety attitudes of medical staff employed in EDs and its relationship to medical errors.

Introduction: Patients with end-stage conditions require integrated physical, spiritual, psychological and social care. Despite efforts to provide comprehensive community care, those with severe symptoms often present to emergency departments (EDs) with palliative care (PC) needs. The objective of this study was to identify patients with end-stage diagnoses presenting to EDs, and to document and compare their PC needs. Methods: A four-month prospective cohort study was conducted in two Canadian EDs. Using a modified PC screening tool, volunteer emergency physicians identified adult patients with end-stage illnesses and documented their PC needs. This tool has the ability to classify patients as having met vs. unmet PC needs based on the documentation of risk factors. Research assistants documented demographic information, severity at presentation (Canadian Triage and Acuity Scale {CTAS}), disposition and revisits from an electronic repository. Bivariate comparisons between patients with met vs. unmet PC needs were completed. Results: Overall, 663 patients were enrolled, of which 78% (n = 518/663) were identified as having unmet PC needs according to the screening tool. Cancer was the most prevalent condition in each group (43% unmet needs, 37% met needs). There was no significant difference between the two groups in terms of age, sex or CTAS score. The unmet PC needs group was more likely to be admitted (68% vs. 50%; p = 0.0001) when compared to patients with PC needs assessed as being met. No significant difference was noted in terms of time to physician assessment or ED length of stay. The two groups did not significantly differ in the proportion of return visits within 30 days (34% vs. 32%) or the average number of return visits (3 vs. 2 visits). A higher proportion of patients with unmet PC needs made at least one visit to the ED in the 6 months prior to their index visit compared to patients with met PC needs (74% vs. 51%, p < 0.001); yet, the average number of ED visits was similar between the groups (3 visits). Conclusion: This study revealed that patients with end-stage diagnoses, especially cancer, commonly have unmet PC needs. They are also more likely to present to the ED and to require hospitalization than patients in whom PC needs have been met. Further investigations into their clinical profile and health care utilization may clarify the impact of their unmet PC needs on the healthcare system.

Introduction: Patients with renal colic present frequently to the emergency department (ED). Existing literature suggests management with medical expulsion therapy (MET) may improve outcomes, especially for those with stones > 5 mm in size. This study evaluates the use of MET in the management of adult patients seen in regional EDs with a diagnosis of renal colic. Methods: A multi-centered medical chart review study was conducted in seven Edmonton-Zone EDs. Approximately 100 cases from each site were randomly selected from administrative data from the 2014 calendar year, no repeat cases were permitted. Using a standardized data collection process and trained research assistance, data were abstracted from medical charts. Medians and inter-quartile ranges (IQR), proportions, and odds ratios (OR) with 95% confidence intervals (CIs) are reported. Results: Overall, 656 patient charts were included in the review; median age was 46 years (IQR: 35, 46) and 249 (38%) were female. Few (10%) arrived by ambulance or were on MET therapy at presentation; however, many (51%) reported a previous episode of renal colic. Many (191 {29%}) received no initial ED imaging; CT (236 {36%}) was favoured over ultrasound (39 {6%}) for initial imaging, either alone or with plain radiographs (8%). Plain radiographs were frequently ordered (204 {31%}). Only 198 (31%) of charts contained documentation of the use of MET at discharge and the median duration of therapy was 10 days (IQR: 7, 14). Initiation of MET therapy did not vary based on older age (OR = 0.8; 95% CI: 0.57, 1.14); sex (OR = 0.9; 95% CI: 0.67, 1.33); resident involvement (OR = 1.1; 95% CI: 0.63, 2.0); presentation to an academic centre (OR = 1.4; 95% CI: 0.96, 1.95) or stone size (OR = 1.3; 95% CI: 0.76, 2.06). Conclusion: Management of renal colic with MET is uncommon in this region and practice variation appears driven by physician preference rather than evidence. Practice guidelines with standardized order sets are urgently needed to improve care.

There has been no comparison of excessive daytime sleepiness (EDS) in patients with Alzheimer’s disease dementia (AD), dementia with Lewy bodies (DLB), and behavioral variant frontotemporal dementia (bvFTD). We identified patients with mild dementia who met criteria for these disorders who also had the Epworth Sleepiness Scale (ESS) completed. The sample included 17 bvFTD, 111 AD, and 31 DLB. An ESS score ≥10 was considered abnormal and consistent with EDS. Analyses with age and sex as covariates revealed higher mean ESS scores for DLB compared to the other groups (DLB 13.9 [5], bvFTD 9.6 [8], AD 8.8 [5], P < .05). An ESS score ≥10 was significantly more likely to occur in DLB compared to bvFTD or AD (DLB 81% vs bvFTD 47% vs AD 45%, P < .01). In patients with mild dementia, EDS is greatest in DLB and comparably lower in bvFTD and AD.

Background: Because of the important role of hospital emergency departments (EDs) in providing urgent care, EDs face a constantly large demand that often results in long wait times. Objective: To review and analyze the existing literature in ED simulation modeling and its contribution in reducing patient wait time. Methods: A literature review was conducted on simulation modeling in EDs. Results: A total of 41 articles have met the inclusion criteria. The papers were categorized based on their motivations, modeling techniques, data collection processes, patient classification, recommendations, and implementation statuses. Real impact is seldom measured; only four papers (~10%) have reported the implementation of their recommended changes in the real world. Conclusion: The reported implementations contributed significantly to wait time reduction, but the proportion of simulation studies that are implemented is too low to conclude causality. Researchers should budget resources to implement their simulation recommendations in order to measure their impact on patient wait time.

Les illites et les chlorites sont des minéraux ubiquistes dans la plupart des roches diagénétiques. Leurs compositions chimiques dépendent des conditions physiques subies (pression, P ; température, T) et de la composition de l'encaissant (e.g. Vidal et al., 1999 ; Parra et al., 2002a, 2002b). Ces minéraux peuvent donc potentiellement être de très bons marqueurs de l'histoire de l'enfouissement, et sont à la base de nombreuses méthodes empiriques ou thermodynamiques d'estimation des conditions P-T.Une compilation de données naturelles et la comparaison des thermobaromètres existants ont permis d'établir leurs limitations respectives. Pour s'en affranchir, un nouveau modèle ordonné de solution solide pour les chlorites a été développé, qui rend compte des forts contenus en silicium observés dans les chlorites naturelles de basses températures. La calibration de ce nouveau thermobaromètre sur des domaines géologiques variés de BT-BP a été testée sur des analyses de chlorites naturelles de la Gulf Coast (Texas) au pic de température (où les données P-T ont été mesurées in situ) et montre d'excellents résultats. Concernant les illites, le modèle thermodynamique le plus abouti (Dubacq et al., 2010) a également été testé de manière à estimer sa précision. L'étude a été complétée par la quantification de l'influence du fer ferrique. Les analyses chimiques utilisées ont été obtenues grâce à un protocole analytique à haute résolution spatiale. Alliant FIB et MET-EDS, ce protocole a permis une étude microtexturale et chimique fine des chlorites et des illites. Il en ressort que ces minéraux possèdent une diversité intracristalline dans leurs compositions et que la zonation chimique résultante apparaît comme une potentielle source d'erreurs dans la calibration des thermobaromètres, tout en permettant d'envisager la notion d'équilibre à l'échelle locale.Cette approche a été utilisée pour quantifier les trajets P-T d'unités géologiques des Alpes de Glarus. Ces résultats, comparés à ceux obtenus avec des méthodes thermobarométriques conventionnelles, donnent une bonne image des processus d'enfouissement et d'exhumation des roches de basse température. Ainsi, il apparaît que chaque composition enregistre une portion du chemin P-T rétrograde. D'une manière générale, chaque zone d'un même cristal renvoie à une partie de l'histoire de la roche.

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Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES
The redox-active chemical properties of trace element copper make it an essential cofactor for several cellular mechanisms, as for ROS production. Polyphenols have been used in the pro-oxidant mechanism of action of interaction with endogenous Cu (II) ions for the production of reactive oxygen species in excess as a treatment for malignancies, leading to apoptosis. This work studied Cu (II) ions in the complex formation mechanism with Resveratrol in MCF-7 cells model. We analyzed the selectivity of Resveratrol in relation to the cupric metal ion using HPLC (High-Performance Liquid Chromatography) and the formation of the compound Resveratrol-Copper through UV-VIS (Ultra-Violet Visible Spectrophotometry). We analyzed the cellular morphology and location of the metal ion by MET-EDS (Electronic Transmission microscopy with Dispersive X-ray Spectroscopy). Cell death by apoptosis and quantification of ROS in said cell line with copper enrichment and treated with Resveratrol was made by flow cytometry. The results show the selectivity of the polyphenol compound by copper ion as well as the formation of the complex Resveratrol-Copper in extracellular conditions, however even with verification of endogenous copper accumulation in physiological conditions in vitro, the formation of that complex did not occur because there was no production of ROS and therefore, no cell death. In short, our research reveals that for in vitro conditions for the MCF-7 line, there's no Resveratrol-Copper complex formation as observed in sub-lethal quantities of chemically enriched cells with CuSO4 and treated with Resveratrol.
As propriedades qu?micas redox-ativas do oligoelemento cobre o tornam cofator essencial para diversos mecanismos celulares como o de produ??o de ROS. Polifen?is v?m sendo utilizados no mecanismo de a??o pr?-oxidante de intera??o com ?ons Cu (II) end?geno para a produ??o dessas esp?cies oxig?nio reativas em excesso como tratamento de malignidades, levando a apoptose. O presente trabalho estudou os ?ons Cu (II) no mecanismo de forma??o do complexo com Resveratrol em modelo de c?lulas MCF-7. Analisamos a seletividade do Resveratrol frente ao ?on met?lico c?prico utilizando CLAE (Cromatografia L?quida de Alta Efici?ncia) e verificou-se a forma??o do complexo Resveratrol-Cobre por meio de UV-VIS (Espectrofotometria de Ultra-Violeta Vis?vel). Analisou-se a morfologia celular e localiza??o do ?on met?lico por MET-EDS (Microscopia de Transmiss?o Eletr?nica com Espectroscopia Dispersiva de Raios-X). Morte celular por apoptose e quantifica??o de ROS na linhagem enriquecida com cobre e tratadas com Resveratrol foi feita por Citometria de Fluxo. Os resultados mostram a seletividade do composto polifen?lico pelo ?on cobre bem como a forma??o do complexo Resveratrol-Cobre em condi??es extracelulares, por?m mesmo com a verifica??o de ac?mulo de cobre end?geno, em condi??es fisiol?gicas in vitro n?o foi constatada a forma??o do referido, pois n?o houve forma??o de ROS e morte celular conseguinte. Em suma, Nossa pesquisa revela que em condi??es in vitro para a linhagem MCF-7, n?o h? forma??o de complexo Resveratrol-Cobre como observado quimicamente em quantidades sub-letais de c?lulas enriquecidas com CuSO4 e tratadas com Resveratrol.

Cette thèse propose une nouvelle méthodologie pour l‟étude de la fiabilité des Transistors Bipolaires à Hétérojonctions (TBHs) en technologie SiGe. L‟originalité de cette étude vient de l‟utilisation d‟une contrainte électromagnétique efficace et ciblée à l‟aide du banc champ proche. Ce type de contrainte a permis de dégrader les performances de ce composant en mettant en évidence certains mécanismes de défaillance. Les caractérisations statiques ont montré la présence des courants de fuite à l‟interface Si/SiO2, non seulement entre la base et l‟émetteur, mais aussi entre la base et le collecteur. Ceci est attribué à un phénomène de piégeage induit par des porteurs chauds qui ont été engendrés pendant la durée du vieillissement. Ce phénomène a été abordé par la modélisation physique en étudiant l‟influence des pièges d‟interfaces sur la dérive des performances électriques du TBH. Afin de visualiser les défaillances qui peuvent être détectées par microscopie, des observations en haute résolution MET (Microscope Electronique à Transmission) et des analyses EDS (Energy Dispersive Spectroscopy) ont été présentées. Ces analyses microscopiques ont mis en évidence les dégradations des couches de titane autour de l‟émetteur, de la base et du collecteur. Ces dégradations sont attribuées à un phénomène de migration de l‟or (Au) vers le titane (Ti) due à la forte densité de courant induite par vieillissement. Ces réactions Au-Ti provoquent une augmentation de la résistivité des couches conductrices et expliquent une partie de la dégradation significative des performances dynamiques du TBH
This work proposes a new methodology for studying the reliability of the Heterojunction Bipolar Transistors (HBTs) in SiGe technology. The originality of this study comes from the use of a targeted electromagnetic field stress by using the near field bench. This type of stress has to degrade the performance of this component causing failure mechanisms. The DC characterizations showed the presence of leakage currents at Si/SiO2 interface, not only between the base and the emitter, but also between the base and the collector. This is attributed to a trapping phenomenon induced by hot carriers which have been generated during stress. This phenomenon has been addressed by the physical modeling, by studying the influence of interface traps on the drift of the HBT characteristics. To identify the failures that can be detected by microscopy, characterization of the structure before and after ageing was performed by Transmission Electron Microscopy (TEM) and energy dispersive spectroscopy (EDS). These analyses revealed the degradation of the titanium layers around the emitter, the base and the collector. The degradations are attributed to the gold (Au) migration into the titanium (Ti) due to the high current density induced by stress. Some of these Au–Ti reactions are known to increase the resistivity of the conducting layers which directly affects the HBTs‟ dynamic performances

La porcelaine à décor bleu et blanc, ou porcelaine qinghua, est l'une des céramiques les plus célèbres au monde. Produite dès le XIIIe siècle dans les fours de Jingdezhen (province du Jiangxi), elle se caractérise par l'usage d'un décor sous glaçure à base de métaux de transition (cobalt principalement mais également fer ou manganèse). Ce type de porcelaine est constitué d'une structure en couche qui se prête particulièrement bien à une décomposition en différents systèmes (glaçure, zone pigmentaire, pâte, interface entre la pâte et la glaçure dans les zones sans décor). Notre thèse a pour objet l'étude de la microstructure des différents systèmes et sous-systèmes constituants la porcelaine afin, par une approche de type " rétro-ingénierie ", de remonter aux procédés techniques à l'origine de la fabrication de ces objets. Pour ce faire, 33 échantillons datés des dynasties Yuan (1279-1368), Ming (1368-1644) et Qing moyenne (1736-1850), fabriqués sur le site de Jingdezhen, ont été étudiés selon une approche multi-analytique. L'étude a permis de mettre en évidence une homogénéité de la composition et des conditions de cuissons des pâtes à haute température, traduisant la standardisation du procédé technique. Les glaçures sont également relativement homogènes à l'exception de certaines glaçures plus riches en calcium qui permettaient une cuisson à plus basse température. Les évolutions technologiques les plus importantes concernent le pigment de cobalt employé pour peindre le décor bleu sous glaçure. Les analyses ont permis de confirmer deux origines différentes du minerai : un cobalt riche en fer probablement originaire de Perse, employé sous la dynastie Yuan (1279-1368), et un cobalt local riche en manganèse et nickel utilisé à partir de la dynastie Ming moyenne (1436-1572). On voit également se développer au Ming moyen (1436-1572), un pigment de synthèse, l'aluminate de cobalt (CoAl2O4) probablement formé par la réaction à haute température du minerai de cobalt et d'une argile alumino-siliceuse. Le pigment de cobalt obtenu est ensuite mélangé à des phases riches en calcium entraînant la croissance de cristaux aciculaires d'anorthite (CaAl2Si2O8), autour des grains de pigment, durant la cuisson. La présence de nombreux gros grains de pigments riches en cobalt, entourés d'une couche épaisse de cristaux d'anorthite permet l'obtention de la couleur bleue la plus intense. Enfin, l'étude fine de la microstructure a permis d'identifier des microstructures "déviantes" appartenant à des vases qui pourraient être des copies modernes
Blue-and-white porcelain, or qinghua porcelain, is one of the most famous types of ceramics in the world. Produced since the 13th century in Jingdezhen kilns (Jiangxi Province), it is defined by the use of an underglazed decoration based on transition elements (mainly cobalt but also iron or manganese). This type of porcelain presents a layered structure easily divided in different systems (glaze, pigment zone, body, body-glaze interface in white zones). Our thesis is dedicated to the microstructural study of the different systems and sub-systems by a "reverse-engineering" approach to uncover the manufacturing process. To do so, we studied 33 samples from the Yuan (1279-1368), Ming (1368-1644) and Middle Qing (1736-1850) Dynasties, produced in Jingdezhen, using a multi-analytical approach. This study highlighted the uniformity in chemical composition and firing conditions of the body implying the standardisation of the manufacturing process. Glaze chemical compositions are also rather homogeneous except from some glazes richer in calcium, which could allow the use of a lower firing temperature. The main technological evolutions concern the underglazed blue pigment. The chemical composition confirmed two geological origins: a Fe-rich cobalt probably from Persia used during the Yuan Dynasty (1279-1368), and a local Mn-rich and Ni-rich cobalt used since the Middle Ming Dynasty (1279-1368). We also observed the development of a synthesis pigment, cobalt aluminate (CoAl2O4), during the Middle Ming Dynasty (1436-1572). It was probably synthesised from the high temperature reaction of cobalt ore with an alumino-siliceous clay. The cobalt pigment is then mixed with Ca-rich phases leading to the growth of anorthite crystals (CaAl2Si2O8) around the pigment grains during firing. The bright blue colour is obtained with the presence of large Co-rich pigment grains surrounded by a thick anorthite layer. Finally, the microstructure study allows us to identify "deviant" microstructure on wares which could be modern copies

Les alliages binaires FeCr de structure FM (ferrito/martensitique) sont actuellement les candidats les plus prometteurs comme matériaux de structure pour les réacteurs rapides refroidis au sodium et les futurs systèmes de fusion. Cependant, l'impact de Cr sur l'évolution de la microstructure irradié dans ces matériaux n’est pas bien compris. De plus, particulièrement pour les applications de fusion, le scénario de dégâts d'irradiation devrait être compliquée en outre par la présence de grandes quantités d'hélium produit par transmutation nucléaire (~ 10 appm He / dpa). Dans ce contexte, une étude spécifique des effets de l'irradiation ionique (influence du Cr et de l’He sur l’évolution de la microstructure) a été menée à 500 ° C sur une grande variété d’alliages FeCr de haute pureté (à teneur en Cr allant de ~ 3 wt.% À 14 wt.%) ainsi que sur du Fe pur. Les irradiations ont été effectuées à l'aide ions Fe, en mode mono-faisceau et mode dual-beam (irradiation par des ions Fe et co-implantation d'He) afin de pouvoir séparer le dommage ballistique de l’implantation couplée avec de l’He. Trois différentes doses ont été étudiées: dose élevée (157 dpa, avec 17 appm He / dpa), dose intermédiaire (45 dpa, avec 57 appm He / dpa) et in situ à faible dose (0,33 dpa, avec 3030 appm He / dpa). Les expériences ont été effectuées en utilisant l'installation JANNuS triple faisceau du CEA-Saclay et la plateforme in-situ du CSNSM-Orsay. L’évolution microstructurale des échantillons est essentiellement faite par MET, SAT et par EDS en mode STEM. Les principaux résultats sont les suivants : 1) L’étude détaillée de la population des cavités dans du Fe irradié à forte dose a révélé une forte réduction du gonflement du fait de l'ajout d’He. Une réduction drastique de la taille des cavités en dépit d’une densité plus élevée a été observée. Ce comportement a été observé tout au long zone irradié, jusqu’au pic d’endommagement. 2) La microstructure de cavités a également été étudiée dans les alliages FeCr irradiés en double faisceau à forte dose, et les résultats ont été comparés à ceux obtenus dans le Fe pur. L'analyse a été effectuée à une profondeur intermédiaire de 300 à 400 nm sous la surface (pour éviter les effets des interstitiels injectés et les effets de surface), correspondant à 128 dpa, 13 appm He / dpa. L’étude par TEM a montré que l'addition de petites quantités de Cr, aussi basse que 3wt.%, est très efficace pour réduire fortement le gonflement. Une réduction drastique de la taille des cavités a été mise en évidence. Par exemple, la taille moyenne des cavités pour l’alliage Fe3% Cr est de l’ordre de 0,9 nm alors qu’elle est voisine de 6,8 nm pour le Fe pur. De plus, la variation du gonflement en fonction de la teneur en Cr n’est pas monotone et présente un maximum local à environ 9 -. 10wt% Cr. 3) Le couplage des différentes techniques d’analyse, MET classique, STEM/EDS et analyse SAT appliqué à l’étude des alliages FeCr irradiés à faible et moyenne dose révèle la présence de zones enrichies en Cr sur le plan d’habitat des boucles de dislocation. Ce phénomène est relié à un phénomène de ségrégation induite par irradiation (RIS) de Cr au voisinage du coeur des boucles de dislocation. Quand la boucle se développe sous irradiation, les zones de ségrégation ne peuvent probablement pas se redissoudre du fait de la présence d'impuretés telles que le C. Lorsque les boucles sont imagées par MET, ces zones enrichies produisent des franges de contraste au voisinage du plan de la boucle. Une estimation quantitative de cet enrichissement a été déduit par STEM / EDS et l'SAT. La teneur en Cr dans ces domaines se situe entre 23 -. 35% par EDS et 22 % par SAT, ce qui est bien en dessous de la teneur en Cr de la phase α’ riche en Cr
FeCr binary alloys are a simple representative of the reduced activation ferritic/martensitic (F-M) steels, which are currently the most promising candidates as structural materials for the sodium cooled fast reactors (SFR) and future fusion systems. However, the impact of Cr on the evolution of the irradiated microstructure in these materials is not well understood in these materials. Moreover, particularly for fusion applications, the radiation damage scenario is expected to be complicated further by the presence of large quantities of He produced by the nuclear transmutation (~ 10 appm He/dpa). Within this context, an elaborate ion irradiation study was performed at 500 °C on a wide variety of high purity FeCr alloys (with Cr content ranging from ~ 3 wt.% to 14 wt.%) and a bcc Fe, to probe in detail the influence of Cr and He on the evolution of microstructure. The irradiations were performed using Fe self-ions, in single beam mode and in dual beam mode (damage by Fe ions and co-implantation of He), to separate ballistic damage effect from the impact of simultaneous He injection. Three different dose ranges were studied: high dose (157 dpa, 17 appm He/dpa for the dual beam case), intermediate dose (45 dpa, 57 appm He/dpa for dual beam case) and in-situ low dose (0.33 dpa, 3030 appm He/dpa for the dual beam case). The experiments were performed at the JANNuS triple beam facility and dual beam in situ irradiation facility at CEA-Saclay and CSNSM, Orsay respectively. The microstructure was principally characterized by conventional TEM, APT and EDS in STEM mode. The main results are as follows: 1) A comparison of the cavity microstructure in high dose irradiated Fe revealed strong swelling reduction by the addition of He. It was achieved by a drastic reduction in cavity sizes and an increased number density. This behaviour was observed all along the damage depth, upto the damage peak. 2) Cavity microstrusture was also studied in the dual beam high dose irradiated FeCr alloys, and the results were compared to bcc Fe. The analysis was performed at an intermediate depth 300 – 400 nm below the surface (to avoid injected interstitial effect and surface effects), corresponding to 128 dpa, 13 appm He/dpa. TEM study revealed that the addition of small quantities of Cr, as low as 3wt.%, is highly efficient in strongly reducing void swelling. It was achieved by a drastic reduction of cavity sizes. For instance, average cavity size in Fe3%Cr was 0.9 nm as opposed to 6.8 nm in bcc Fe. Furthermore, the variation of void swelling as a function of Cr content is non-monotonic, with alocal maxima around 9 - 10wt.%Cr. 3) Coupling of conventional TEM, STEM/EDS and APT analysis on low and intermediate dose irradiated FeCr alloys revealed the presence of Cr enriched zones on the habit plane of the dislocation loops. This is expected to be due to radiation induced segregation (RIS) of Cr close to the core of the loops. As the loop grows under irradiation, the segregated areas are probably prevented from re-dissolution by impurity elements such as C. When imaged by TEM using classical diffraction contrast imaging techniques, these enriched zones produce displacement fringe contrast on the loop plane. A quantitative estimate of this enrichment was deduced by STEM/EDSand APT. The Cr content in these areas was between 23 - 35 at.% measured by EDS and 22 ± 2 at.% obtained by APT, whichis well below the Cr content of the Cr-rich α’ phase

Dans la perspective de prédire les transformations chimico-minéralogiques possibles d'une bentonite placée en conditions de stockage profond de déchets radioactifs, plusieurs séries d'expériences ont été réalisées utilisant la bentonite MX80 en présence d'une solution chlorurée sodi-calcique, en absence ou en présence de fer (magnétite + hématite ou fer métal + magnétite), à 80 et 300 °C et pour des durées de 1 jour à 9 mois. Les produits de réactions ont fait l'objet de caractérisations multi-échelles et multi-techniques : diffraction des rayons X, microscope électronique à balayage et en transmission (imagerie haute résolution, EDS et EELS), microsonde électronique, spectroscopie Mössbauer et analyse ICP AES et ICP MS des solutions. Le code de calcul EQ3/6 a été utilisé pour simuler les expériences réalisées. Une nouvelle méthode ponctuelle de détermination de la valence du fer dans les argiles au MET par spectroscopie de perte d'énergie des électrons (EELS) a été développée.

Background: Because of the important role of hospital emergency departments (EDs) in providing urgent care, EDs face a constantly large demand that often results in long wait times. Objective: To review and analyze the existing literature in ED simulation modeling and its contribution in reducing patient wait time. Methods: A literature review was conducted on simulation modeling in EDs. Results: A total of 41 articles have met the inclusion criteria. The papers were categorized based on their motivations, modeling techniques, data collection processes, patient classification, recommendations, and implementation statuses. Real impact is seldom measured; only four papers (~10%) have reported the implementation of their recommended changes in the real world. Conclusion: The reported implementations contributed significantly to wait time reduction, but the proportion of simulation studies that are implemented is too low to conclude causality. Researchers should budget resources to implement their simulation recommendations in order to measure their impact on patient wait time.