L’anormalité du dommage : une notion juridique stabilisée ?

Medical liability, in accordance with liability law, is traditionally based on the triad of operative event, causal link and damage. The emergence of systems of no-fault liability gave rise to the concept of abnormal damage, which is a necessary condition for liability. In terms of medical liability, in 1958 the administrative courts ruled that this criterion was necessary in order to compensate medical damage in situations of liability for alleged misconduct, then from 1990 in situations of no-fault liability. This condition was extended to compensate medical hazard from 1993. The Court of Cassation refused to adopt a no-fault liability system, leading to unequal treatment. Thus, the law of March 4, 2002 created a system which, in situations of no-fault liability, allowed national solidarity to be engaged in the event of abnormal damage. However, the legislation did not clearly set out the character of this abnormality, and jurisprudential hesitation over this criterion has made compensation uncertain. In 2014, the administrative and judicial courts clarified their jurisprudence by adopting a more specific definition of this criterion of abnormality. However, a very restrictive view taken of this criterion means that many victims now risk being excluded from the scope of compensation. As such, this jurisprudential stability is perhaps but temporary.     

双源 CT 低剂量 Flash 螺旋模式在全身大血管成像中的应用

评价双源 CT 低剂量 Flash 螺旋模式全身大血管成像的图像质量和辐射剂量,探讨其应用价值。收集我院行双源CT 低剂量 Flash 螺旋扫描全身大血管患者69例（全身大血管 CTA 组）,行相同扫描范围的平扫患者69例（对照 A 组）,行回顾性心电门控螺旋扫描冠状动脉患者69例（对照 B 组）。比较全身大血管 CTA 组与对照 B 组的图像噪声及全身大血管 CTA 组与对照 A 组、B 组的辐射剂量。结果发现,全身大血管 CTA 组颈总动脉、颈内动脉、肾动脉、腹主动脉的图像质量均可满足诊断要求,图像噪声与对照 B 组比较,差异无统计学意义（Z＝-0．42,P＞0．05）。全身大血管 CTA 组有效剂量低于对照 A 组、B 组（Z＝-10．14;Z＝-8．76,P 均＜0．001）。全身大血管 CTA 组平均扫描长度短于对照 A 组（Z＝-8．86,P＜0．001）。故本研究认为,双源 CT 低剂量 Flash 螺旋模式安全、无创、快捷,图像质量高,大范围 CTA 成像的辐射剂量低,是一种适合全身大血管检查的影像技术。     

晚期乳腺癌的非手术治疗进展

晚期乳腺癌患者的治疗一直存在争议。不同治疗方案优势人群的选择仍有待细化和确认,以便将“个体化治疗”的概念落到实处。新药的开发为我们带来更多的选择,但是经济条件的限制,带来的临床问题更需我们冷静思考。相信通过不断的尝试和努力,定会获得进一步的突破。     

On the structural unit model of grain boundary structure

Abstract

A critique of the structural unit model is presented. It is shown that the predictive capacity of the model is severely limited when it is applied to boundaries with relatively-high-index rotation axes. Recent computer simulations suggest that ‘high index’ means 〈221〉 and above. A new approach to grain boundary structure is needed for mixed tilt and twist boundaries.     

Midgap photon effects in As2S3 glass

Photo-induced phenomena in glasses excited by two-photon absorption have been studied and compared with those produced by bandgap illumination. The two-photon excitation of As₂S₃ gives a refractive-index increase, unaccompanied by photodarkening. Raman-scattering spectra show that the excitation increases the density of ‘wrong’ bonds. These observations are discussed and compared with photo-induced changes in SiO₂.     

Long-range interaction of radiation-generated self-interstitial atoms and adatoms on tungsten surface

ABSTRACT

The morphological modification of the W surface induced by specimen irradiation with 5?keV He atoms was studied at the atomic level using low-temperature ?eld ion microscope techniques. The major impact-induced damage mode on W {110} surface was found to be the formation of adatom sets produced by radiation-generated self-interstitial atoms emerging at the surface. The long-range interaction was revealed by evaluating the experimental probability density of finding two radiation-generated adatoms at a given separation in comparison with the probability density corresponding to a random distribution of adatoms. The statistically significant difference of these distributions consists of the absence or severe reduction of observed adatom pairs with separations in the range 5–11?Å. The experimental distribution was characterised by a relatively open arrangement of adatoms with the closest separation of about 11?Å. Our field ion microscope observations also reveal the self-organisation of radiation-generated W adatoms into atomic chains with the lateral interatomic separation substantially larger than the nearest-neighbor distance. These effects indicate the existence of long-range interactions between radiation-generated adatoms and radiation-generated self-interstitial atoms in the subsurface region.     

Cluster-ion bombardment studies to reveal the amorphization mode in strained Si0.8Ge0.2

Radiation damage caused by cluster ions of different sizes is predicted to be distinctly different if materials follow disparate phenomenological models of amorphization, namely overlap and direct amorphization methods. Determination of an amorphization model for a crystalline solid can be accomplished based on its radiation response to cluster sizes of bombarding ions. In the present study, we use this approach and apply it to study radiation damage in Si_0.8Ge_0.2 caused by Ag _n clusters with the number of atoms in a cluster, n, taking values from 1 to 4. The displacements measured by using channeling Rutherford backscattering spectrometry show size-enhanced damage accumulation, which is in good agreement with the atomistic detail obtained by molecular dynamics simulations. Our studies suggest that strained SiGe, a material known to have poor radiation tolerance, follows the overlap model rather than the direct amorphization model.     

Characterization of grain-boundary dislocation networks by a combination of large-angle convergent-beam electron diffraction and weak-beam techniques

The Burgers vector of very close intrinsic dislocations in a near-Σ = 11,{311} grain-boundary in nickel is identified using a geometrical method based on local and accurate measurements of the angular deviation from perfect coincidence Σ = 11 by large-angle convergent-beam electron diffraction and of the dislocation spacing from weak-beam images of the grain boundary.