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  • The metabolic benefits of different bariatric operations: what procedure to choose?

    Sudlow, Alexis; le Roux, Carel W; Pournaras, Dimitri J
    Intercritical annealing (IA) of medium-Manganese (Mn) steels is an AHSS design concept for the production of formable sheet steel. The microstructure after IA includes retained austenite (5-40 volume pct), which forms from an initial microstructure of either cold-rolled ferrite or martensite, and is stabilized to room temperature via C and Mn enrichment. Retained austenite is essential to the elevated strength-elongation, and can be engineered with equilibrium modelling and judicious selection of alloy composition and heat treatment.Long IA times (i.e. batch annealing) are expected to result in near-equilibrium microstructures with uniform Mn distributions within austenite. Relatively short IA times (<1000 s), however, may be more attractive due to energy conservation and more flexible processing routes. With shorter IA times, the phase transformation mechanism associated with austenite growth is of interest, as the sluggish diffusion of Mn in austenite is likely to result in the retention of any Mn gradients in austenite which develop during austenite growth. This thesis primarily focuses on elucidating austenite formation mechanisms during IA, and investigating the efficacy of generating Mn enrichment in austenite during relatively short IA treatments. In particular, the effect of cementite on the austenite formation mechanism, and the kinetics of Mn and carbon (C) partitioning to austenite, were investigated. Additional work focused on the effect of prior cold deformation on austenite growth and Mn redistribution during double soaking (DS) heat treatments. Scanning transmission electron microscopy with energy dispersive X-ray spectroscopy, transmission kikuchi diffraction, and field emission scanning electron microscopy were utilized for microstructural characterization, while in situ high energy X-ray diffraction, ex-situ X-ray diffraction, and dilatometry were used for bulk assessments. Phase field simulations using MICRESS®, and one dimensional diffusional simulations with the DICTRATM module of Thermo-Calc®, were also conducted for austenite formation and Mn partitioning. Austenite growth was found to be controlled predominantly by Mn diffusion. C-diffusion controlled kinetics were inhibited due to Mn enrichment in cementite, which stabilized cementite and caused dissolution to be controlled via Mn diffusion. Formation of film-like austenite from martensitic microstructures did not require the preservation of initial austenite films during heating. Phase field simulations predicted Mn-partitioning or massive transformation of austenite during DS, depending on the secondary soaking temperature. Experimental results for DS treatments were consistent with phase field simulations, which indicated that a bimodal Mn distribution can be maintained in a fully austenitic microstructure during DS treatments.
  • Pierre Pichot et ses rapports avec la psychiatrie espagnole. Notes de sa présence au Pays basque espagnol, 1993–2006

    Ezcurra, Jesus, 2020-; Gutiérrez, Miguel (Elsevier, 2018-12-31)
    Résumé Pierre Pichot est fortement lié au développement de la psychiatrie espagnole au cours de la deuxième moitié du xxe siècle. Ses rapports avec les figures les plus importantes de la vie académique espagnole sont montrés dans cette communication. Mais il s’agit surtout ici de remarquer sa présence dès 1993 et jusqu’à 2007 de façon non interrompue à Vitoria pour son cours d’Actualisation en Psychiatrie. Celle-ci constitue la réunion psychiatrique espagnole la plus ancienne, hors les congrès nationaux. Pendant les 15 séances inaugurales que Pierre Pichot développa s’étendent toute une pensée et une réflexion sur les grandes questions de la psychiatrie. Son livre La Psychiatrie à l’époque actuelle est le compendium de toutes ses conférences. Enfin l’influence de Pierre Pichot sur la psychiatrie espagnole est représentée aussi par la formation de nombreux psychiatres espagnols dans sa chaire de la Clinique de Santé mentale et de l’Encéphale. Abstract Not only is Pierre Pichot closely connected to the development of Spanish psychiatry in the second half of the 20th century, but is known for his ties with the most significant people in the Spanish academic world. As an expert in Spanish history, he maintains a close relationship with Hispanists in France, which makes him a reference in Spanish psychiatry. However, our intention is to highlight his uninterrupted presence from 1993 until 2006 to inaugurate the Psychiatric Convention in Vitoria on the latest psychiatric developments. At present this Congress is the longest – lasting gathering of experts in Psychiatry in Spain apart from the National Yearly Congress of Psychiatry. During these 15 inaugural conferences presented by Pichot, one can find a complete thought and reflection on the important questions and debates in Psychiatry. His book, Present Day Psychiatry, is a compendia of each one of his presentations. The studies found in this work do not shy away from the most controversial topics. Pierre Pichot's rigour of psychiatric thought is initially found in the 60s with the publication of Los Test Mentales. As has been previously pointed out, this text replaced the Pieron Tratado. Undoubtedly, Pichot is the one to whom today's psychologists and psychiatrists owe the advance of psychometry in dealing with mental pathology. In the best sense of the word Pichot was an eclectic, capable of dealing with topics of interest from a wide range of perspectives. Therefore, he reflected on psychotherapy and to need to avoid sectarianism in schools, which is so closely related to present day efforts to spread and insure psychotherapeutic trading for psychiatric professionals. This, in this article we will summarize some of the contributions Pichot carried out in his presentations while he attended the congresses in Vitoria for 15 years. The first contribution to be covered is the evolution of the concept of affective disorders. This is proof of how week he was familiar with the semiological evolution itself concerning this matter. In addition, the term, psychosis and its lack of clarity will be dealt with. This will provide the opportunity to later continue on with the history of severe psychotic disorder and the influence Pichot holds as a representative of the French school for the autonomous inclusion of severe psychotic disorder in DSM-III and above all in CIE-10. Pichot does not shy away from the debate on the medical discipline to which the treatment of Alzheimer's belongs. In his opinion the discovery of cerebral lesions from Alzheimer's is not a decisive argument to include Alzheimer's or any mental disorder in the field of neurology. Finally and beyond all that is the importance of Pichot as the one who introduced DSM-III in Europe, which definitely makes him worthy to form part of Psychiatry itself in Europe. Without a doubt, Pichot forms part of a line of psychiatrists who have changed everything, who defined what mental illness was as well as what a psychiatrist was. Together with the group from Washington University in Saint Louis, Pichot dealt with the question of diagnosis in a rational way, far from the unclear way of DSM-II. The contribution of all those men and women to modern Psychiatry is fundamental to the history of our specialization.