Differences between the healthcare systems of Quebec and France for the treatment of pain due to spinal disorders

In Quebec,Canada,the public healthcare system offers free medical services.However,patients with spinal pain often encounter long waiting times for specialist appointments and limited physiotherapy coverage.In contrast,private clinics provide expedited care but are relatively scarce and entail out-of-pocket expenses.Once a patient with pain caused by a spinal disorder meets a pain medicine specialist,spinal intervention is quickly performed when indicated,and patients are provided lifestyle advice.Transforaminal epidural steroid injections are frequently administered to patients with radicular pain,and steroid injections are administered on a facet joint to control low back or neck pain.Additionally,medial branch blocks are performed prior to thermocoagulation.France’s universal healthcare system ensures accessibility at controlled costs.It emphasizes physical activity and provides free physical therapy services.However,certain interventions,such as transforaminal and interlaminar epidural injections,are not routinely used in France owing to limited therapeutic efficacy and safety concerns.This underutilization may be a potential cause of chronic pain for many patients.By examining the differences,strengths,and weaknesses of these two systems,valuable insights can be gained for the enhancement of global spinal pain management strategies,ultimately leading to improved patient outcomes and satisfaction.

Early Quality Life Impairment in Alzheimer Disease’s Patients in Geriatric Department: About 214 Cases in Pitié Salpêtrière Hospital of Paris (France)

Alzheimer’s disease (AD) is the most common neurodegenerative disease causing an alteration of life quality in the terminal stage. The purpose was to report 14 years of experience about the early impact on the quality of life of patients with AD. Methodology: Descriptive retrospective study over 14 years in the geriatric department of Pitié Salpêtrière Hospital, using the activity of daily living, Instrumental activity of daily living, neuropsychological inventory and Hoen Yahr scale evaluated at the time of diagnosis of AD according to the National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer Disease’s and Related Disorders Association diagnostic criteria. Results: A total of 214 exploitable files had been listed. At the moment of diagnosis, the mean age was 82.1 years with extremes 68 to 95 with sex ratio 1.6 in women’s favor. The mean socio-cultural level was 4.9 with extremes about 0 to 7. There was poly pathology with a mean Cumulative Illness Rate Scale = 4.6 with extremes 0 to 16. the mean cognitive status was moderate = 22.5 with extremes 0 to 30. Quality life showed moderate impairment of IADL = 9.2 with extreme 3 to 11 compared to activity of daily living. The activity of daily living was more affected in 68 - 80-year-olds, while poly pathology impacted more on IADL in men. The cognitive impairment was more deficient in IADL when the MMSE test was low. The common disorders at the NPI were psychological, behavioral and psychotic. Conclusion: At the early diagnosis of Alzheimer’s Disease cognitive deficiencies were predominant and influenced on global Instrumental activity and psychological, behavioral disorders.

基于FRANC3D和LSTM的桥梁钢桁架裂纹寿命预测

为了对裂纹疲劳寿命进行快速准确预测,针对常用的疲劳实验和数值仿真实验中各自存在的实验条件受限、计算步骤繁琐、计算过程耗时较长等问题,以大型桥梁钢桁架中的裂纹为研究对象,提出一种结合裂纹分析软件FRANC3D和长短期记忆(long short term memory,简称LSTM)网络模型的裂纹疲劳寿命预测方法。首先,建立钢桁架的有限元模型,通过裂纹分析软件FRANC3D进行疲劳裂纹扩展分析并建立相关数据集;其次,通过疲劳裂纹的扩展仿真数据关注裂纹的扩展状况,收集裂纹特征信息对裂纹疲劳寿命进行预测。实验结果表明,所提出的方法具有较高的预测准确性,同时极大地提升了训练速度,可为裂纹疲劳寿命预测提供参考。

基于ABAQUS/FRANC3D的钢轨三维表面裂纹的扩展分析

为分析钢轨三维表面裂纹在轮轨载荷作用下的疲劳扩展路径和应力强度因子的变化,研究钢轨剥离掉块的损伤机理。运用Fortran语言编写用户子程序DLOAD和UTRACLOAD施加轮轨接触应力,利用有限元软件ABAQUS和FRANC3D模拟车轮在钢轨上的移动并分析钢轨三维表面裂纹的应力强度因子随车轮移动的变化情况,并基于PARIS公式和最大周向应力准则对钢轨三维表面裂纹的疲劳扩展行为进行分析。结果表明轮轨载荷仅为赫兹接触压力时,车轮在钢轨表面滚过,裂纹前缘距钢轨表面越深,越易发生扩展,裂纹主要在钢轨的深度方向扩展,可使半圆形裂纹变成长轴在深度方向的椭圆形裂纹;轮轨载荷为赫兹接触压力和滑动摩擦力共同作用时,随着车轮循环次数的增加,表面裂纹的等效应力强度因子Keq不断增大。车轮作用会使距钢轨表面越近的裂纹前缘越易发生扩展,裂纹主要向钢轨的宽度方向扩展,使半圆形裂纹变成形状较为复杂的长轴在钢轨宽度方向的近椭圆形裂纹。

法国阿尔卑斯山(Mt. Alps, France)溪流型喀斯特瀑布水生苔藓植物群落生态研究

对法国阿尔卑斯山(Mt.Alps,France)6个溪流型喀斯特瀑布水生苔藓植物群落进行了研究。报道典型瀑布水生苔藓群落14个,苔藓植物种类由11科16属20种(含变种亚种)组成;生殖系统由雌雄异株(Dioecious,95%)和雌雄同株异苞(Autoecious,5%)两种类型构成,无性繁殖是繁殖的主要方式;区系地理成分含北温带分布(60%)、欧洲-北美分布(10%)、旧世界温带分布(5%)和世界广泛分布(25%)等4种成分;生活型含高丛集型(20%)、矮丛集型(10%)、交织型(60%)和平铺型(10%)4种类型。根据喀斯特沉积环境特征,划分瀑布水生苔藓群落为峡谷瀑布苔藓群落、温泉瀑布苔藓群落、瀑布水帘洞苔藓群落、悬崖瀑布苔藓群落和悬崖季节性瀑布苔藓群落等5种生态类型。法国阿尔卑斯山溪流型瀑布生物喀斯特沉积物具有分布广泛,但沉积规模较小的特点。

Cultural Tourism Enlightenment from France for Hebei Province, China

French is one of the best cultural tourism destinations in the world. Its development experiences in terms of cultural tourism are valuable for Hebei, whose competitiveness of cultural tourism is weak comparatively in spite of rich cultural resources. Specifically, France achieves great successes of cultural tourism through scientific planning, producing tourism products injected by cultures, and developing tourism festivals. On this basis, four suggestions are recommended to improve cultural tourism in Hebei Province based on its actual situation, namely building cultural brand of tourism, strengthening government management, and developing tourism derivatives, and reinforcing talent training.

Brief History of Chinese Medicine in France

In the 17th century,Chinese medicine appeared in France;since then,it never stopped evolving and is applied by French practitioners.Today,acupuncture is widely used in clinic treatment in France.

A New Accumulation Model of Coal Seams in France Extensional Basins

This paper, based on the sedimentary features of the coal seams in the typical extensional (faulted) coal basins between two inland mountainous areas of the Central Massif (France) deals with the accumulation mechanism and the corresponding sedimentary tectonic conditions of these thick coalbeds, and proposes a new coal accumulation model for the inland lacustrine basin thick coalbeds. The presence of a great number of gravity flow sediments such as detrital flow, diluted slurry flow or turbidity current sediments in the coal seams, and that of the contemporaneous gravity slump and deformation structure in the coal seam itself both indicate that the lacustrine environment in the accumulation of the thick coalbeds was characterized by the relatively deep flood and violent sedimentation. This model can not only interpret reasonably the accumulation mechanism of the thick coalbeds developed in the fault basins in the Central Massif, France, but also show its features distinctively from those of the accumulation model of the traditional thick coalbeds.

A Lion of France

Born in Corsica, a place reigned[统治] by the French, Napoleon was predestined[注定的] to be extraordinary. It was the historical background that shaped Napoleon’s strong belief in nationalism and his determination, which became the momentum[动力] in his personal success. Few people are born with the required knowledge and power to support their dreams, neither was Napoleon. In his early youth, he read all the books available related to the history of his hometown and France, knowing that his ambition to reverse[完全改变] the destiny of his country would be impossible unless he had learned enough lessons from the past.

Acute Renal Failure during Progressive Systemic Sclerosis in the Regional University Teaching Hospital of Brest-La Cavale Blanche (France)

Systemic scleroderma is a rare disease in which visceral manifestations occur, particularly peripheral vascular, digestive, cardiopulmonary and renal. It is pathology with a predilection for women. The present clinical case is that of a man with the renal complications of scleroderma and the difficulties of the treatment even in the developed countries like France. In the present case, the management of this disease required a high dose of corticosteroid therapy and extra-renal purification. Early detection of complications through a minimal clinical examination supplemented with paraclinic tests has proved necessary.

The Séchilienne (France) Landslide:a Non-typical Progressive Failure Implying Major Risks

The National Road RN 91 has been threatened for about twenty-five years by a huge landslide, located 25 km south-east to the town of Grenoble (France). If several million cubic meters of rock fall down, the debris will dam the valley. Then the failure of the dam by overtopping and rapid erosion might result in a catastrophic flood and dramatic consequences for human life, environment and economy throughout the valley. The paper presents the hazard assessment based on geological and hydrological surveys, including small scale hydraulic tests, as well as the risk evaluation that has been performed. The risk management relies first upon a high level monitoring and an emergency plan; various mitigation strategies have been considered.

To Know the World to Know Oneself——My 40 Years of Experience with France

FORTY years ago,in 1978,1 was working in a factory in Shanghai.At that time,the gateway to foreign countries seemed to me even more remote than that of paradise.I had already heard of the French Republic,but only because my father was Zheng Yonghui,an illustrious literary translator who spoke fluent French.My father was born in Vietnam(formerly under the control of the French colonial empire),but at a very young age he arrived in Shanghai,and then

The Central Academy of Fine Arts Art Museum Reproducing the Journey of Pioneering Chinese Artists Abroad in France

At the opening ceremony of this exhibition on January 12, Fan Di'an, Chairman of Chinese Artists Association and CAFA President, said:"The exhibition is a demonstration of the academic research and achievements of a generation of Chinese artists abroad in France.

France’s Strategy on Migration Issues in the Mediterranean

The Mediterranean Sea is recognized by France as the most important adjacent area and also the gate to Africa,France’s vast sphere of influence beyond the Mediterranean.The political turmoil here since the Arab Spring has begun,especially emergence of a flood of refugees coming to the EU,was a serious problem for France.The current situation of EU,which is shaken over the acceptance of immigrants and refugees,is grave for France,having a strategic pillar which is to raise the own presence in global politics by obtaining the leadership in the EU.France sets out to put the migration and refugee issues to rest,to maintain EU’s political power and to seize the initiative in the EU.This article will analyze such a national strategy of France focusing on the process from Chirac’s administration to Macron’s.

FRANCE:TURNING TO“NEW GAULLISM”

On May 7th, Jacques Chirac, candidate of the Rally for the Republic (RPR)and Mayor of Paris, defeated the Socialist candidate Lionel Jospin in the secondround of the French presidential election and was elected the fifth president of theFifth Republic. Alain Juppe, Chirac’s close assistant and former foreign minister,was appointed as the prime minister of the new cabinet. Thus ended the formerPresident Francois Mitterrand’s Socialist rule of 14 years and ushered in an epochof Gaullist Chirac, a man who will lead France into the 21st century.

A Review of Influential Chinese Artists Studying Abroad in France in the Early 1900s (II)

Editor's note : About a hundred years ago, a large number of progress young Chinese with great ambitions went to France for Work-Study programs to introduce French science and arts to China, so as to save the nation and the people. Among them, a generation of Chinese artists studying in France created splendid works which had played an essential role in the history of Chinese arts in the 20th century.

The Seminar on the changes of Fine Arts Between China and France

On March 26, the Centennial Seminar on es of Fine Arts between China and France, cosponsored by China Cultural Center in Paris,National Art Museum of China (NAMOC) and Network of International Culturalink Entities, was held at China Cultural Center in Paris? Experts from China and France conducted in-depth discussions on the theme of Centennial Exchanges of Fine Arts and. Academic Communication between China and France? The experts include Yan Zhenquan, Director of China Cultural Center in Paris, Wu Weishan, Director of NAMOC and Claude Abeille and Jean Cardot, academicians of Academy of F ine Art, Insititute of France.

How value relevant are earnings when they are transitory？ Empirical evidence for France

Capital market participants take seriously into consideration the value relevance of earnings for security valuation. This study examines the value relevance of earnings when earnings are transitory, i.e., there is great variability in earnings. It hypothesizes that the relationship between earnings and security returns worsens when earnings are transitory and this robustness is country specific. The dataset consists of more than 1,100 French firm-year observations over a nine year period. Empirical results show that when earnings are transitory, investors pay more attention to operating cash flows and less attention to earnings, a result indicating that investors penalize firms with unstable earnings. These results should be of great importance to financial analysts, investors and bankers for investing and credit decisions, especially after the recent global financial crisis.

Major Results and Research Challenges in Cotton Molecular Genetics at CIRAD(France)

CIRAD(Montpellier,France) develops research activities centered on tropical and sub-tropical agricultural systems.Among others crops,cotton is the focus of a series of research programs in different disciplines from economics to breeding.Major areas in genetics and breeding relate to(1) genetic diversity,(2) cultivar development through classical and molecular breeding,and(3)

The Custodians of State Policies Dealing With the Financial Crisis： A Comparison Between France and the US

Following the 2008 global economic crisis and rolling out of austerity measures, elites of the state seem to have become a ＂political species＂ of their own, now under threat of extinction. The study of the health and defense policy reforms in France and the US during the 1990s and 2000s shows that far from disappearing, the influence of state elites is being strategically reconfigured to defend some sector-specific policies. Similarly to those ＂custodians of policy＂ dear to P. Selznick, small groups of elites are gaining expertise within strategic sectors of public policy; they are also making the need to control the cost of public spending their royal battle, in order to safeguard what they see as the crucial role of the public good. In the American cases study, the image of the ＂revolving door＂, which encapsulates the idea of professional mobility back and forth from the private to the public sector, implies a fragmented state, open to external pressures of social groups. We document career and professional trajectories marked by a strong commitment to a given policy area. Circulation, we note, is frequent between these positions in the public sector. While these findings do not in and of themselves allow us to fully assess the influence wielded by these elites, this study identifies the social and political resources and forms of specialization which predispose them to play important roles in shaping public policy. For the past 30 years, the question of varieties of liheralisation has been put forward as an explanatory factor for a wide range of public policies （Schrnidt ＆ Thatcher, 2013; Thelen, 2014）. In this perspective, numerous authors have theorised the dismantling of democratic states and the weakening of public authority that would follow （Suleiman, 2003; Fukuyama, 2004; Bez^s, 2009; Bonneli ＆ Pelletier, 2010; Lodge, 2013）. Research on public policy has focused on the success of neoliberal ideas among European and North American political elites （Pierson, 1994; Prasad, 2006; Fourcade, 2009） on the calling into question of the neo-Keynesian paradigm （Hall, 1986; Crouch, 2011） and on the development of budgetary constraints （Bezbs ＆ Sinr, 2011; Streeck ＆ Schafer, 2013; Blyth, 2013）. Other work emphasises the idea that the effects of economic globalization-reinforced by those of the financial crisis of 2008-have accelerated the weakening of state capacity in western democracies by accelerating the expansion of market relations within national political systems （Streeck ＆ Thelen, 2005; Jabko, 2012）. At the same time, this period has seen renewed interest in national regulation （Lodge, 2011）. Even so, if analysis is limited to the evolution of public policies as a simple functional response to the evolution of the international, financial, or ideological contexts in which they are found, research tends to underestimate the role played by competition among the elite groups involved with their elaboration and their capacity for resilient attachment to the power of public authority. For this reason, the hypothesis of the dismantling of the state, allegedly accelerated by the crisis of 2008, should be revisited.