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Avec l’avènement des nouveaux anticoagulants oraux dans la prise en charge de la fibrillation auriculaire et l’augmentation des comorbidités de ce genre de maladies, leur utilisation concomitante avec les antiagrégants plaquettaires pose de plus en plus question. En effet, les risques de saignement d’une triple thérapie, prise en charge classique d’un syndrome coronarien aigu et/ou d’une intervention coronarienne percutanée, ne sont plus à démontrer et viennent à balancer l’efficacité d’une telle thérapie. Il devient alors impératif de définir quel traitement serait le plus judicieux dans une telle situation, question à laquelle ce mémoire a tenté de répondre en réalisant une revue systématique de la littérature à ce sujet et en proposant des pistes de traitements alternatifs moins dangereux. Ce mémoire conclut alors que le rivaroxaban en bithérapie avec le clopidogrel semble être l’alternative la plus sûre. Cependant, le manque d’étude sur le sujet renforce l’idée qu’il est plus que nécessaire d’investiguer davantage les différentes possibilités qui existent pour la prise en charge de patients souffrant à la fois de FA et d’un SCA. With the advent of new oral anticoagulants in the management of atrial fibrillation and the increase of comorbidities from this kind of diseases, their concomitant use with platelet aggregation inhibitors raise more and more the question. Indeed, the risks of bleeding from a triple therapy, conventional management of acute coronary syndrome and / or percutaneous coronary intervention, are well established and come to balance the effectiveness of such therapy. It then becomes imperative to define which treatment would be the most judicious in such situation, a question to which this essay has tried to answer by carrying out a systematic review of the literature on this subject and proposing less dangerous alternative treatment. This essay leads to the conclusion that rivaroxaban in dual therapy with clopidogrel seems to be safest alternative. However, the lack of study on the subject reinforces the idea that is more than necessary to fully investigate the different possibilities that exist for the management of patients suffering from both FA and SCA.

Platelet Aggregation Inhibitors --- Anticoagulants

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This study focuses on the Patagonian region, where significant Foehn events are observed on both sides of the Andes throughout the whole year. These climatic phenomena are not yet well simulated by General Circulation Models (GCM) and Regional Climate Models (RCM). It has been agreed that one source of this shortcoming is related to the Digital Elevation Model (DEM) generalization, which means the generalization of the altitudes from a high-resolution DEM to a coarser resolution model grid. At low resolution, most current GCMs and RCMs use DEM generalization methods that smooth the relief, a key controlling factor in Foehn events modelling. The aim of this study is to compare three additional methods of DEM generalization (percentile 90 - P90, envelope maximum - EM, and thalweg and crests - TC methods) and evaluate their influence on simulated precipitation and temperature fields (at 10 km resolution) on the eastern part of Patagonia, where warm and dry air masses are expected. Thanks to the Modèle Atmosphérique Régional (MAR), an RCM specifically developed for polar regions, we perform three sensitivity experiments showing a significant decrease in precipitation for the P90 and EM methods and an increase in mean temperature by P90 and TC methods in our region of interest. However, the mean temperature increase and precipitation decrease are not sufficient to cope with the biases observed with the Climate Research Unit (CRU) gridded climate datasets. We conclude that none of these three methods are perfect and present different strengths and weaknesses. This study serves as a recommendation for a better representation of Foehn events and a better use of DEM generalization to existing climate models performing in Patagonia but also for regions sharing the same orographic features as the Patagonian relief. Cette étude se concentre sur la Patagonie, où d’importants événements Foehn sont observés des deux côtés des Andes tout au long de l’année. Ces phénomènes climatiques ne sont pas encore bien simulés par les General Circulation Models (GCM) et les Regional Climate Models (RCM). Il a été convenu que l’une des sources de ce manque est liée à la généralisation du modèle numérique d’élévation de terrain ou Digital Elevation Model (DEM), qui consiste en une généralisation des altitudes d’un DEM à haute résolution à une grille à plus basse résolution. À basse résolution, la plupart des GCMs et des RCMs actuels utilisent la méthode de généralisation du DEM qui lisse le relief, un facteur de contrôle clé dans la modélisation des événements de Foehn. Le but de cette étude est de comparer trois méthodes originales de généralisation du DEM (percentile 90 - P90, envelope maximum - EM, et thalweg et crests - TC methods) et d’évaluer leur influence sur les champs simulés de précipitations et de températures (à 10 km de résolution) sur la partie est de la Patagonie, où des masses d’air chaud et sec peuvent être observées tout au long de l’année. Grâce au Modèle Atmosphérique Régional (MAR) , un RCM développé spécifiquement pour les régions polaires, nous réalisons trois expériences de sensibilité montrant une diminution significative des précipitations pour les méthodes P90 et EM et une augmentation de la température moyenne par les méthodes P90 et TC dans notre région d’intérêt. Cependant, l’augmentation de la température moyenne et la diminution des précipitations ne sont pas suffisantes pour faire face aux biais observés dans les ensembles de données climatiques quadrillés du Climate Research Unit (CRU). Nous concluons qu’aucune de ces trois méthodes n’est parfaite et présente des forces et des faiblesses différentes. Cette étude sert de recommandation pour une meilleure représentation des événements de Foehn et une meilleure utilisation de la généralisation du DEM aux modèles climatiques existants fonctionnant en Patagonie mais aussi pour des régions partageant les mêmes caractéristiques orographiques que le relief patagonien.

Climate Models --- DEM aggregation --- Orography --- Surface elevation --- Physique, chimie, mathématiques & sciences de la terre > Sciences de la terre & géographie physique

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This book seeks to construct a consistent fundamental quantum theory of gravity, which is often considered one of the most challenging open problems in present-day physics. It approaches this challenge using modern functional renormalization group techniques, and attempts to realize the idea of “Asymptotic Safety” originally proposed by S. Weinberg. Quite remarkably, the book makes significant progress regarding both the fundamental aspects of the program and its phenomenological consequences. The conceptual developments pioneer the construction of a well-behaved functional renormalization group equation adapted to spacetimes with a preferred time-direction. It is demonstrated that the Asymptotic Safety mechanism persists in this setting and extends to many phenomenologically interesting gravity-matter systems. These achievements constitute groundbreaking steps towards bridging the gap between quantum gravity in Euclidean and Lorentzian spacetimes. The phenomenological applications cover core topics in quantum gravity, e.g. constructing a phenomenologically viable cosmological evolution based on quantum gravity effects in the very early universe, and analyzing quantum corrections to black holes forming from a spherical collapse. As a key feature, all developments are presented in a comprehensive and accessible way. This makes the work a timely and valuable guide into the rapidly evolving field of Asymptotic Safety.

Quantum gravity. --- Gravity, Quantum --- General relativity (Physics) --- Gravitation --- Quantum theory --- Cell aggregation --- Classical and Quantum Gravitation, Relativity Theory. --- Cosmology. --- Manifolds and Cell Complexes (incl. Diff.Topology). --- Mathematics. --- Aggregation, Cell --- Cell patterning --- Cell interaction --- Microbial aggregation --- Gravitation. --- Manifolds (Mathematics). --- Complex manifolds. --- Analytic spaces --- Manifolds (Mathematics) --- Geometry, Differential --- Topology --- Astronomy --- Deism --- Metaphysics --- Field theory (Physics) --- Matter --- Physics --- Antigravity --- Centrifugal force --- Relativity (Physics) --- Properties

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This book provides an introduction to topology, differential topology, and differential geometry. It is based on manuscripts refined through use in a variety of lecture courses. The first chapter covers elementary results and concepts from point-set topology. An exception is the Jordan Curve Theorem, which is proved for polygonal paths and is intended to give students a first glimpse into the nature of deeper topological problems. The second chapter of the book introduces manifolds and Lie groups, and examines a wide assortment of examples. Further discussion explores tangent bundles, vector bundles, differentials, vector fields, and Lie brackets of vector fields. This discussion is deepened and expanded in the third chapter, which introduces the de Rham cohomology and the oriented integral and gives proofs of the Brouwer Fixed-Point Theorem, the Jordan-Brouwer Separation Theorem, and Stokes's integral formula. The fourth and final chapter is devoted to the fundamentals of differential geometry and traces the development of ideas from curves to submanifolds of Euclidean spaces. Along the way, the book discusses connections and curvature--the central concepts of differential geometry. The discussion culminates with the Gauß equations and the version of Gauß's theorema egregium for submanifolds of arbitrary dimension and codimension. This book is primarily aimed at advanced undergraduates in mathematics and physics and is intended as the template for a one- or two-semester bachelor's course.

Mathematics. --- Global analysis (Mathematics). --- Manifolds (Mathematics). --- Differential geometry. --- Complex manifolds. --- Manifolds and Cell Complexes (incl. Diff.Topology). --- Differential Geometry. --- Global Analysis and Analysis on Manifolds. --- Analysis, Global (Mathematics) --- Differential topology --- Functions of complex variables --- Geometry, Algebraic --- Math --- Science --- Analytic spaces --- Manifolds (Mathematics) --- Differential geometry --- Geometry, Differential --- Topology --- Cell aggregation --- Global differential geometry. --- Global analysis. --- Aggregation, Cell --- Cell patterning --- Cell interaction --- Microbial aggregation --- Global analysis (Mathematics)

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Chemical processes. --- Flocculation. --- Ferric hydroxides. --- Ferric hydrates --- Hydrated iron oxides --- Iron hydroxides --- Hydroxides --- Iron oxides --- Aggregation (Chemistry) --- Processes, Chemical --- Chemical engineering --- Chemical reactions --- Manufacturing processes