Éditeur(s) : HAL CCSD Elsevier
Résumé : International audience
BACKGROUND: Thrombophilias are common disorders that increase the risk of pregnancy-associated venous thromboembolism and pregnancy loss and can also increase the risk of placenta-mediated pregnancy complications (severe pre-eclampsia, small-for-gestational-age infants, and placental abruption). We postulated that antepartum dalteparin would reduce these complications in pregnant women with thrombophilia. METHODS: In this open-label randomised trial undertaken in 36 tertiary care centres in five countries, we enrolled consenting pregnant women with thrombophilia at increased risk of venous thromboembolism or with previous placenta-mediated pregnancy complications. Eligible participants were randomly allocated in a 1:1 ratio to either antepartum prophylactic dose dalteparin (5000 international units once daily up to 20 weeks' gestation, and twice daily thereafter until at least 37 weeks' gestation) or to no antepartum dalteparin (control group). Randomisation was done by a web-based randomisation system, and was stratified by country and gestational age at randomisation day with a permuted block design (block sizes 4 and 8). At randomisation, site pharmacists (or delegates) received a randomisation number and treatment allocation (by fax and/or e-mail) from the central web randomisation system and then dispensed study drug to the local coordinator. Patients and study personnel were not masked to treatment assignment, but the outcome adjudicators were masked. The primary composite outcome was independently adjudicated severe or early-onset pre-eclampsia, small-for-gestational-age infant (birthweight <10th percentile), pregnancy loss, or venous thromboembolism. We did intention-to-treat and on-treatment analyses. This trial is registered with ClinicalTrials.gov, number NCT00967382, and with Current Controlled Trials, number ISRCTN87441504. FINDINGS: Between Feb 28, 2000, and Sept 14, 2012, 292 women consented to participate and were randomly assigned to the two groups. Three women were excluded after randomisation because of ineligibility (two in the antepartum dalteparin group and one in the control group), leaving 146 women assigned to antepartum dalteparin and 143 assigned to no antepartum dalteparin. Some patients crossed over to the other group during treatment, and therefore for on-treatment and safety analysis there were 143 patients in the dalteparin group and 141 in the no dalteparin group. Dalteparin did not reduce the incidence of the primary composite outcome in both intention-to-treat analysis (dalteparin 25/146 [17.1%; 95% CI 11.4-24.2%] vs no dalteparin 27/143 [18.9%; 95% CI 12.8-26.3%]; risk difference -1.8% [95% CI -10.6% to 7.1%)) and on-treatment analysis (dalteparin 28/143 [19.6%] vs no dalteparin 24/141 [17.0%]; risk difference +2.6% [95% CI -6.4 to 11.6%]). In safety analysis, the occurrence of major bleeding did not differ between the two groups. However, minor bleeding was more common in the dalteparin group (28/143 [19.6%]) than in the no dalteparin group (13/141 [9.2%]; risk difference 10.4%, 95% CI 2.3-18.4; p=0.01). INTERPRETATION: Antepartum prophylactic dalteparin does not reduce the occurrence of venous thromboembolism, pregnancy loss, or placenta-mediated pregnancy complications in pregnant women with thrombophilia at high risk of these complications and is associated with an increased risk of minor bleeding. FUNDING: Canadian Institutes of Health Research, Heart and Stroke Foundation of Canada, and Pharmacia and UpJohn.
ISSN: 0923-7577

hal-01258557
http://hal.univ-brest.fr/hal-01258557
DOI : 10.1016/S0140-6736(14)60793-5
PUBMED : 25066248

Éditeur(s) : HAL CCSD Springer Verlag
Résumé : International audience
Random walk (RW) or Continuous Time Random Walk (CTRW) are recurring Monte Carlo methods used to model convective and diffusive transport in complex heterogeneous media. Many applications can be found, including fluid mechanic, hydrology, and chemical reactors modeling. These methods are easy to implement, very versatile and flexible enough to become appealing for many applications because they generally overlook of deeply simplify the building of explicit complex meshes required by deterministic methods. RW and CTRW provide a good physical understanding of the interactions between the space scales of het-erogeneities and the transport phenomena under consideration. In addition, they can result in efficient up-scaling methods, especially in context of flow and transport in fractured media. In the present study, we review the applications of RW or CTRW for several situations coping with various spatial scales, and different insights into up-scaling applications. RW and CTRW advantages and downsides are also discussed, thus providing a few avenues for further works and applications.
ISSN: 0169-3913

hal-01449131
https://hal.archives-ouvertes.fr/hal-01449131
https://hal.archives-ouvertes.fr/hal-01449131/document
https://hal.archives-ouvertes.fr/hal-01449131/file/0025972-02.pdf
DOI : 10.1007/s11242-016-0693-z

Éditeur(s) : HAL CCSD Elsevier
Résumé : Our method for the simultaneous determination of the four natural Ra isotopes (Ra-226, Ra-228, Ra-224 and Ra-223) in thermal waters involves a separation of Ra on a selective filter (3 M EMPORE (TM) Radium Rad disk), and a single counting using a broad-energy HPGe detector (BE Ge manufactured by CANBERRA (TM)). The calculation of Ra-223 and (228)a activities requires interference and cascade summing corrections. The Ra-226 activities in CO2-rich thermal waters of the Lodeve Basin (South of France) range from 530 to 2240 mBq/l. The low (Ra-228/Ra-226) activity ratios (0.19-0.29) suggest that Ra is mostly derived from the aquifer carbonates. The short-lived Ra-224 and Ra-223 are probably added to the water through recoil or desorption processes from Th-enriched coatings on the fracture walls.
ISSN: 0969-8043

hal-00475587
https://hal.archives-ouvertes.fr/hal-00475587
DOI : 10.1016/j.apradiso.2009.10.056

Éditeur(s) : HAL CCSD Elsevier
Résumé : International audience
We study diffusion in a heterogeneous medium that is characterized by spatially varying diffusion properties from a random walk point of view. We show that an inhomogeneous continuous time random walk (CTRW) with a spatially variable exponential transition time distribution solves the spatially discretized heterogeneous diffusion equation. This demonstrates the equivalence of the widely used time-domain random walk (TDRW) scheme and spatially inhomogeneous CTRW and at the same time provides a demonstration of the formal equivalence of the TDRW particle formulation and the heterogeneous diffusion equation. Based on this equivalence, we develop a TDRW method for heterogeneous diffusion under spatially variable multirate mass transfer properties. We discuss the implementation of these schemes and study the diffusion behavior in the presence of traps that are characterized by a truncated power-law trapping time distribution.
ISSN: 0309-1708

hal-00767566
https://hal.archives-ouvertes.fr/hal-00767566
DOI : 10.1016/j.advwatres.2012.07.015

Éditeur(s) : HAL CCSD Elsevier
Résumé : International audience
Almost all Red Sea deeps contain metal-rich sediments covered by brine pools. It is generally agreed that these metal-rich deposits precipitated from overlying metal-rich brines that originated from migrating hydrothermal fluids. No brine pool has ever been reported in Thetis Deep, inciting us to evaluate if such a brine layer ever occurred in the deep during the past. In order to address that questioning, a study combining mineralogical, geochemical (major-, minor-, rare-earth elements) and isotopic (Sr. Nd. Pb) approaches was completed on cored sediments and extracted interstitial waters from inside and outside the deep.;The sediments have an overall hydrothermal origin, as shown by the REE concentrations and patterns, metal contents, and Pb-Nd isotopic data, all pointing to a mantle signature. The intensity of the hydrothermal activity varied with time in the deep; the most intense episode resulting in an almost pure Fe-oxi-hydroxide layer. Varied chemical arguments, especially the Zr and REE data of the sediments, favor the fact that the whole sedimentation in Thetis Deep occurred in the absence of a stable, salt-rich and mineralized brine pool, and that no brine layer ever existed. This conclusion is supported by the constant Sr isotope composition of the sediment and its interstitial waters that are almost identical to that of the Red Sea seawater. The study also suggests that hydrothermal activity monitored fluid supplies that interacted differently with seawater in the different Red Sea deeps, resulting in an overall formation of metal-rich sediments, but along varied local conditions. (C) 2009 Elsevier B.V. All rights reserved.
ISSN: 0375-6742

hal-00475646
https://hal.archives-ouvertes.fr/hal-00475646
DOI : 10.1016/j.gexplo.2009.10.001