Learning curves for three specific procedures by anesthesiology residents using the learning curve cumulative sum (LC-CUSUM) test

Gregoire Weil,Cyrus Motamed,David J Biau,Marie Laurence Guye 대한마취통증의학회 2017 Korean Journal of Anesthesiology Vol.70 No.2

Background: The learning curve cumulative sum (LC-CUSUM) test is an innovative tool that allows quantitative monitoring of individual medical performance during the learning process by determining when a predefined acceptable level of performance is reached. This study used the LC-CUSUM test to monitor the learning process and failure rate of anesthesia residents training for specific subspecialty anesthesia procedures. Methods: The study included 490 tracheal punctures (TP) for jet ventilation, 340 thoracic epidural analgesia (TEA) procedures, and 246 fiberoptic nasal intubations (FONI) performed by 18 residents during their single 6-month rotation. Results: Overall, 27 (14–52), 19 (5–41), and 14 (6–33) TP, TEA, and FONI procedures were performed, respectively, by each resident. In total, 2 of 18 residents achieved an acceptable failure rate for TEA according to the literature and 4 of 18 achieved an acceptable failure rate for FONI, while none of the residents attained an acceptable rate for TP. Conclusions: A single 6-month rotation in a reference teaching center may not be sufficient to train residents to perform specific or sub-specialty procedures as required. A regional learning network may be useful. More patient-based data are necessary to conduct a risk adjustment analysis for such specific procedures.

Techniques for monitoring protein misfolding and aggregation in vitro and in living cells

Simpson Gregoire,권인찬,Jacob Irwin 한국화학공학회 2012 Korean Journal of Chemical Engineering Vol.29 No.6

Protein misfolding and aggregation have been considered important in understanding many neurodegenerative diseases and recombinant biopharmaceutical production. Various traditional and modern techniques have been utilized to monitor protein aggregation in vitro and in living cells. Fibril formation, morphology and secondary structure content of amyloidogenic proteins in vitro have been monitored by molecular probes, TEM/AFM, and CD/FTIR analyses,respectively. Protein aggregation in living cells has been qualitatively or quantitatively monitored by numerous molecular folding reporters based on either fluorescent protein or enzyme. Aggregation of a target protein is directly correlated to the changes in fluorescence or enzyme activity of the folding reporter fused to the target protein, which allows non-invasive monitoring aggregation of the target protein in living cells. Advances in the techniques used to monitor protein aggregation in vitro and in living cells have greatly facilitated the understanding of the molecular mechanism of amyloidogenic protein aggregation associated with neurodegenerative diseases, optimizing culture conditions to reduce aggregation of biopharmaceuticals expressed in living cells, and screening of small molecule libraries in the search for protein aggregation inhibitors.

FISSION PRODUCT AND ACTINIDE RELEASE FROM THE DEBRIS BED TEST PHEBUS FPT4: SYNTHESIS OF THE POST TEST ANALYSES AND OF THE REVAPORISATION TESTING OF THE PLENUM SAMPLES

A-C. GREGOIRE,D. JACQUEMAIN,G. GR?GOIRE,,P. CARBOL,J-P. GLATZ,D. KNOCHE,D. PAPAIOANNOU,D. SOLATIE,S. VAN WINCKEL,P.D.W. BOTTOMLEY 한국원자력학회 2006 Nuclear Engineering and Technology Vol.38 No.2

FISSION PRODUCT AND ACTINIDE RELEASE FROM THE DEBRIS BED TEST PHEBUS FPT4: SYNTHESIS OF THE POST TEST ANALYSES AND OF THE REVAPORISATION TESTING OF THE PLENUM SAMPLES

Bottomley P.D.W.,Gregoire A.C.,Carbol P.,Glatz J.P.,Knoche D.,Papaioannou D.,Solatie D.,Van Winckel S.,Gregoire G.,Jacquemain D. Korean Nuclear Society 2006 Nuclear Engineering and Technology Vol.38 No.2

The $Ph{\acute{e}}bus$ FP project is an international reactor safety project. Its main objective is to study the release, transport and retention of fission products in a severe accident of a light water reactor (LWR). The FPT4 test was performed with a fuel debris bed geometry, to look at late phase core degradation and the releases of low volatile fission products and actinides. Post Test Analyses results indicate that releases of noble gases (Xe, Kr) and high-volatile fission products (Cs, I) were nearly complete and comparable to those obtained during $Ph{\acute{e}}bus$ tests performed with a fuel bundle geometry (FPT1, FPT2). Volatile fission products such as Mo, Te, Rb, Sb were released significantly as in previous tests. Ba integral release was greater than that observed during FPT1. Release of Ru was comparable to that observed during FPT1 and FPT2. As in other $Ph{\acute{e}}bus$ tests, the Ru distribution suggests Ru volatilization followed by fast redeposition in the fuelled section. The similar release fraction for all lanthanides and fuel elements suggests the released fuel particles deposited onto the plenum surfaces. A blockage by molten material induced a steam by-pass which may explain some of the low releases. The revaporisation testing under different atmospheres (pure steam, $H_2/N_2$ and steam /$H_2$) and up to $1000^{\circ}C$ was performed on samples from the first upper plenum. These showed high releases of Cs for all the atmospheres tested. However, different kinetics of revaporisation were observed depending on the gas composition and temperature. Besides Cs, significant revaporisations of other elements were observed: e.g. Ag under reducing conditions, Cd and Sn in steam-containing atmospheres. Revaporisation of small amounts of fuel was also observed in pure steam atmosphere.

변제불능으로 인한 집단적 절차의 일반 구조

미쉘 그레그와(Michele Gregoire),남궁술(번역자) 한국법학원 2014 저스티스 Vol.- No.141

채권자는 우선 채무자가 채무를 이행하지 않을 수 있다는 잠정적 사실에 위협을 받는다. 악의적 채무자로 인한 위험에 대하여, 채권자는 채권(재산)의 보호로 불리는 여러 소권(채권자취소권, 채권자대위권, 허위표시 확인소권, 절대적 무효청구소권 등)과, 벨기에 담보법 제7조에 규정되어 있는, 채권자의 만족을 위한 ‘채무자 재산의 통합 예속의 원칙’으로 대비하고 있다. 채무자 재산의 통합 예속은 채무자가 개인적으로 구속된 경우에만 발생한다. 이 원칙은 ‘물상 의무’(obligation propter rem)에는 적용되지 않는다. 통합 예속의 원칙은 모든 동산과 부동산을 그 대상으로 하고 있다. 채무자는 현존 재산뿐 아니라 장래의 재산도 제공해야 함을 명시하면서, 담보법 제7조는 채무자가 계약체결 시에 소유하고 있던 재산은 물론 강제 집행 시에 그의 소유로 될 재산도 채권자의 추급에 응해야 한다고 하고 있다. 통합 예속의 원칙은 일반적이긴 하나 절대적이지는 않다. 그러나 이 원칙에는 여러 예외가 있다. : 일반 또는 특별 압류 금지 재산, 재산 분할의 기법, 벨기에 공법상 법인 또는 외국 기관의 집행 면제 특권 등이 그러하다. 다음으로 채권자는 동일 채무자의 현금화된 적극재산 총액의 분할 과정에서 다른 채권자들과 충돌할 수 있는 위협을 받는다. 담보와 ‘평등성의 원칙’ 그리고 ‘재산의 집단적 청산에 관한 규칙’의 만남에서 발생하는 핵심 문제는 물적 담보의 실행의 경우에만 나타난다. 인적 담보의 경우 일반적으로 평등성 원칙이나 채무자 재산의 집단적 청산에 관한 규칙과는 부딪히지 않는다. 담보법 제8조는 《채무자의 재산은 그의 채권자들의 공동의 질물이며, 그로 인한 금액은 채권자들 사이에 채권 비율에 따라 분배된다.》고 규정하고 있다. 본 조항의 전반부는 통합 예속의 원칙을 의미한다. 채무자는 자신의 전 재산을 통해 채무를 부담하기 때문이다. 즉 이 재산은 그에 대한 모든 채권의 변제에 제공된다. 제7조를 위반한 것은 제8조의 후반부이다. : 《그로 인한 금액은 채권자들 사이에 채권 비율에 따라 분배된다.》 법률은 여기에서 채권자 평등의 원칙을 표현하고 있다. 채무자 재산의 가액은 채권자들 사이에 안분비례로 할당된다. 각 채권자는, 자신에게 부여될 몫의 비율에 따라, 채무자의 변제 불능 위험을 감수한다.

Acquired diaphragmatic hernia after hepatectomy and liver transplantation in adults and children: A case series and literature review

Valentine Martin,Emilie Gregoire,Sophie Chopinet,Olivier Scatton,Remi Dubois,Antoinette Lasseur,Jerome Dumortier,Olivier Boillot 한국간담췌외과학회 2021 Annals of hepato-biliary-pancreatic surgery Vol.25 No.4

Backgrounds/Aims: Acquired diaphragmatic hernia is a rare complication following liver surgery in adult and pediatric patients. This study aims to describe main features occurring in adult and pediatric patients after liver surgery and report an up-date review of the literature. Methods: All adult and pediatric patients who were diagnosed with postoperative acquired diaphragmatic hernia in Lyon and Marseille University Hospitals were included in this study. Diagnosis, clinical, radiologic, and therapeutic data were analysed retrospectively from medical papers and/or electronic records. Results: Thirteen adults with a median age of 50 years (range, 30–67 years) and 5 children aged 2.4 years (range, 0.9–4 years) were diagnosed with acquired diaphragmatic hernia after a median time of 65.1 (range, 1.8–244.7) and 2 (range, 0.33–10.9) months, respectively, following surgeries (5 live-donor right hepatectomies, 5 right and 1 left hepatectomies for tumors and cysts, and 2 whole liver transplantations in adults; and 5 liver transplantations with left lateral section in children). Eleven patients presented digestive and/or thoracic symptoms whereas seven were asymptomatic and diagnosed by routine imaging follow-up. All patients were re-operated with a median delay of 2.4 months (range, 0–25.3 months) for adults and 1 day (range, 0–2 days) for children. Two recurrences resulted in a secondary surgical repair. Conclusions: Acquired diaphragmatic hernia is a rare and potentially serious event after liver surgery. Recognition and surgical repair of this particular complication should be considered in the setting of unexplained abdominal and/or thoracic symptoms. Preventive measures should be taken intraoperatively.

When 5004 is Said “Five Thousand Zero Hundred Remainder Four”: The Influence of Language on Natural Number Transcoding; Cross-National Comparison

( Nguyen Hien Thi Thu ),( Gregoire Jacques ) 한국수학교육학회 2014 수학교육연구 Vol.18 No.2

The Vietnamese language has a specific property related to the zero in the name-number system. This study was conducted to examine the impact of linguistic differences and of the zero’s position in a number on a transcoding task (verbal number into Arabic number). Vietnamese children and French-speaking Belgian children, from grades 3 to 6, participated in the study. The success rate and the type of errors they made varied, depending on their grade and language. At Grade 4, Vietnamese childrenshowed performances equivalent to Grade 6 Belgian children. Our results confirmed the support provided by language to the understanding and performances in a transcoding task. Results also showed that a syntactic zero is easier to manipulate than a lexical zero for Vietnamese children. The relative influence of language and the source of errors are discussed.

Lignin signatures of vegetation and soils in tropical environments

Belanger, E.,Lucotte, M.,Gregoire, B.,Moingt, M.,Paquet, S.,Davidson, R.,Mertens, F.,Passos, C.J.S.,Romana, C. Techno-Press 2015 Advances in environmental research Vol.4 No.4

The few lignin biomarker studies conducted in tropical environments are hampered by having to use references signatures established for plants and soils characteristic of the temperate zone. This study presents a lignin biomarker analysis (vanillyls (V), p-hydroxyls (P), syringyls (S), cinnamyls (C)) of the dominant plant species and soil horizons as well as an analysis of the interrelated terrigenous organic matter (TOM) dynamics between vegetation and soil of the $Tapaj{\acute{o}}s$ river region, an active colonization front in the Brazilian Amazon. We collected and analyzed samples from 17 fresh dominant plant species and 48 soil cores at three depths (0-5 cm, 20-25 cm, 50-55 cm) from primary rainforest, fallow forest, subsistence agriculture fields and pastures. Lignin signatures in tropical plants clearly distinguish from temperate ones with high ratios of Acid/aldehyde of vanillyls ((Ad/Al)v) and P/V+S. Contrary to temperate environments, similarly high ratios in tropical soils are not related to TOM degradation along with pedogenesis but to direct influence of plants growing on them. Lignin signatures of both plants and soils of primary rainforest and fallow forest clearly distinguish from those of non-forested areas, i.e., agriculture fields and pastures. Attalea speciosa Palm trees, an invasive species in all perturbed landscapes of the Amazon, exhibit lignin signatures clearly distinct from other dominant plant species. The study of lignin signatures in tropical areas thus represents a powerful tool to evaluate the impact of primary rainforest clearing on TOM dynamics in tropical areas.

Evaluating the Visualization of What a Deep Neural Network Has Learned

Samek, Wojciech,Binder, Alexander,Montavon, Gregoire,Lapuschkin, Sebastian,Muller, Klaus-Robert IEEE 2017 IEEE transactions on neural networks and learning Vol.28 No.11

<P>Deep neural networks (DNNs) have demonstrated impressive performance in complex machine learning tasks such as image classification or speech recognition. However, due to their multilayer nonlinear structure, they are not transparent, i.e., it is hard to grasp what makes them arrive at a particular classification or recognition decision, given a new unseen data sample. Recently, several approaches have been proposed enabling one to understand and interpret the reasoning embodied in a DNN for a single test image. These methods quantify the 'importance' of individual pixels with respect to the classification decision and allow a visualization in terms of a heatmap in pixel/input space. While the usefulness of heatmaps can be judged subjectively by a human, an objective quality measure is missing. In this paper, we present a general methodology based on region perturbation for evaluating ordered collections of pixels such as heatmaps. We compare heatmaps computed by three different methods on the SUN397, ILSVRC2012, and MIT Places data sets. Our main result is that the recently proposed layer-wise relevance propagation algorithm qualitatively and quantitatively provides a better explanation of what made a DNN arrive at a particular classification decision than the sensitivity-based approach or the deconvolution method. We provide theoretical arguments to explain this result and discuss its practical implications. Finally, we investigate the use of heatmaps for unsupervised assessment of the neural network performance.</P>

Compositional variations of chromian spinels from peridotites of the Spontang ophiolite complex, Ladakh, NW Himalayas, India: petrogenetic implications

Mallika K. Jonnalagadda,Nitin R. Karmalkar,Mathieu Benoit,Michel Gregoire,Raymond A. Duraiswami,Shivani Harshe,Sagar Kamble 한국지질과학협의회 2019 Geosciences Journal Vol.23 No.6

The Spontang ophiolite complex exposed along the Indus Tsangpo Suture Zone (ITSZ) represents a fragment of oceanic lithosphere emplaced after the closure of the Neo-Tethyan Ocean. The complex lying south of the ITSZ forms the highest tectonic thrust slice above the Mesozoic–Early Tertiary continental margin in the Ladakh-Zanskar Himalaya. The complex consists of a well-preserved ophiolite sequence dominated by peridotites, gabbros and ultramafic cumulates along with highly tectonized sheeted dykes and pillow lavas. The mantle suite of rocks is represented by minor lherzolites, harzburgites and dunites. Chromian spinel is brown to reddish, and its morphology and textural relationship with coexisting silicates varies with strain. Spinel occurs as blebs and vermicular exsolutions within orthopyroxene to spherical inclusions within olivine, characteristic of which is the elongate holly leaf shape. Chrome spinels are characterized by low TiO2 and high Cr2O3 indicative of their depleted nature. Cr# [= atomic ratio Cr/(Cr + Al)] in the studied spinels are characterized by a small decrease in TiO2 for a larger increase in Cr# consistent with observations for spinels aligned along the Luobusa trend of the Yarlung Zangpo Suture Zone (YZSZ) ophiolites. Variations in Cr-spinel Cr# and Mg# observed in the investigated peridotites may have resulted from a wide range of degrees of mantle melting during their evolution. Mineral and whole-rock chemistry of the Spontang peridotites is characterized by interaction between depleted magma and pre-existing oceanic lithosphere, typical of supra-subduction zone settings. The Spontang peridotites have olivine, clinopyroxene and orthopyroxene compositions similar to those from both abyssal and fore-arc peridotites and display spoon shaped REE profiles characteristic of interaction between LREE-enriched melt, derived from the subducting slab and LREE depleted mantle residues. Equilibration temperatures calculated for the above rocks indicate that the studied samples represent typical mantle peridotites formed within the spinel stability field.