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129-605: The Union for Democracy and Social Progress ( French : Union pour la Démocratie et le Progrès Social , UDPS ) is a major political party in the Democratic Republic of the Congo (DRC). Founded in 1982, amid the one-party rule of Mobutu Sese Seko and his Popular Movement of the Revolution , it is the country's oldest existing party. During the presidency of Joseph Kabila , it was the largest opposition party in

258-414: A full blood count , clotting status ( PT , aPTT , TT ), and some screening tests ( erythrocyte sedimentation rate , kidney function , liver enzymes , electrolytes ). If one of these is abnormal, further investigations might be warranted to the issue. Troponin levels are increased in between 16 and 47% with pulmonary embolism. In typical people who are not known to be at high risk of PE, imaging

387-458: A sensitivity of 83% and a specificity of 96%, which means that it is a good test for ruling out a pulmonary embolism if it is not seen on imaging and that it is very good at confirming a pulmonary embolism is present if it is seen. This study noted that additional testing is necessary when the clinical probability is inconsistent with the imaging results. CTPA is non-inferior to VQ scanning, and identifies more emboli (without necessarily improving

516-744: A French official to teachers in the department of Finistère , in western Brittany, included the following: "And remember, Gents: you were given your position in order to kill the Breton language". The prefect of Basses-Pyrénées in the French Basque Country wrote in 1846: "Our schools in the Basque Country are particularly meant to replace the Basque language with French..." Students were taught that their ancestral languages were inferior and they should be ashamed of them; this process

645-641: A catheter, and some may require surgery (a pulmonary thrombectomy ). If blood thinners are not appropriate, a temporary vena cava filter may be used. Pulmonary emboli affect about 430,000 people each year in Europe. In the United States, between 300,000 and 600,000 cases occur each year, which contribute to at least 40,000 deaths. Rates are similar in males and females. They become more common as people get older. Symptoms of pulmonary embolism are typically sudden in onset and may include one or many of

774-409: A cause of DVTs, especially in young men without significant risk factors. DVTs are at risk for dislodging and migrating to the lung circulation. The conditions are generally regarded as a continuum known as a venous thromboembolism (VTE). VTE is much more common in immunocompromised individuals as well as individuals with comorbidities including: The development of thrombosis is classically due to

903-431: A comprehensive academic study entitled "The World's 10 most influential languages". In the article, Weber ranked French as, after English, the second-most influential language of the world, ahead of Spanish. His criteria were the numbers of native speakers, the number of secondary speakers (especially high for French among fellow world languages), the number of countries using the language and their respective populations,

1032-721: A cutoff of 4 points to create only two categories. There are additional prediction rules for PE, such as the Geneva rule . More importantly, the use of any rule is associated with reduction in recurrent thromboembolism . The Wells score : Traditional interpretation Alternative interpretation Recommendations for a diagnostic algorithm were published by the PIOPED investigators; however, these recommendations do not reflect research using 64 slice MDCT. These investigators recommended: The pulmonary embolism rule-out criteria (PERC) helps assess people in whom pulmonary embolism

1161-555: A foreign language. Due to the rise of French in Africa, the total French-speaking population worldwide is expected to reach 700 million people in 2050. French is the fastest growing language on the continent (in terms of either official or foreign languages). French is increasingly being spoken as a native language in Francophone Africa, especially in regions like Ivory Coast , Cameroon , Gabon, Madagascar , and

1290-573: A government immediately due to disagreements between member parties of the ruling coalition. An attempted coup on 19 May 2024 further delayed the formation of a government. A new government was finally announced on 29 May 2024. The 2023 election was marred by threats and attacks by UDPS supporters against opposition party leaders and journalists. Supporters of the opposition were also implicated in acts of political violence. A major incident occurred on 7 November, when UDPS supporters clashed with supporters of Moïse Katumbi 's opposition party, Together for

1419-404: A group of causes named Virchow's triad (alterations in blood flow, factors in the vessel wall, and factors affecting the properties of the blood). Often, more than one risk factor is present. Although most pulmonary embolisms are the result of proximal DVTs , there are still many other risk factors that can also result in a pulmonary embolism. After a first PE, the search for secondary causes

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1548-705: A period of prosperity and prominence among European nations. Richelieu established the Académie française to protect the French language. By the early 1800s, Parisian French had become the primary language of the aristocracy in France. Near the beginning of the 19th century, the French government began to pursue policies with the end goal of eradicating the many minorities and regional languages ( patois ) spoken in France. This began in 1794 with Henri Grégoire 's "Report on

1677-462: A pulmonary embolism, a review of clinical criteria to determine the need for testing is recommended. In those who have low risk, age less than 50, heart rate less than 100 beats per minute, oxygen level more than 94% on room air, and no leg swelling, coughing up of blood, surgery or trauma in the last four weeks, previous blood clots, or estrogen use, further testing is not typically needed. In situations with more high risk individuals, further testing

1806-494: A relic of the old nominal case system of Latin longer than most other Romance languages (with the notable exception of Romanian which still currently maintains a case distinction), differentiating between an oblique case and a nominative case. The phonology was characterized by heavy syllabic stress, which led to the emergence of various complicated diphthongs such as -eau which would later be leveled to monophthongs. The earliest evidence of what became Old French can be seen in

1935-634: A request by the UDPS for seats in the CEI, seats in the High Authority for the Media ( Haute Autorité des medias ), and the reopening of the electoral lists so that UDPS members could register as candidates for the election. The party won 42 seats in the 2011 parliamentary election . Tshisekedi finished runner-up in the concurrent presidential election with just under a third of the national vote. The election

2064-683: A result of French and Belgian colonialism from the 16th century onward, French was introduced to new territories in the Americas, Africa, and Asia. French has a long history as an international language of literature and scientific standards and is a primary or second language of many international organisations including the United Nations , the European Union, the North Atlantic Treaty Organization ,

2193-415: A three-month risk of thromboembolic events being 0.14%. D-dimer is highly sensitive but not specific (specificity around 50%). In other words, a positive D-dimer is not synonymous with PE, but a negative D-dimer is, with a good degree of certainty, an indication of absence of a PE. A low pretest probability is also valuable in ruling out PE. The typical cut off is 500 μg/L, although this varies based on

2322-547: A variant of Canadian French , is spoken in parts of New England . Missouri French was historically spoken in Missouri and Illinois (formerly known as Upper Louisiana ), but is nearly extinct today. French also survived in isolated pockets along the Gulf Coast of what was previously French Lower Louisiana , such as Mon Louis Island , Alabama and DeLisle, Mississippi (the latter only being discovered by linguists in

2451-457: A working language along with English and German ; in some institutions, French is the sole working language (e.g. at the Court of Justice of the European Union ). French is also the 16th most natively spoken language in the world, the sixth most spoken language by total number of speakers , and is among the top five most studied languages worldwide, with about 120 million learners as of 2017. As

2580-437: Is 95%, and in the French collectivity of Wallis and Futuna , it is 84%. In French Polynesia and to a lesser extent Wallis and Futuna, where oral and written knowledge of the French language has become almost universal (95% and 84% respectively), French increasingly tends to displace the native Polynesian languages as the language most spoken at home. In French Polynesia, the percentage of the population who reported that French

2709-472: Is a widespread second language among the Lebanese people , and is taught in many schools along with Arabic and English. French is used on Lebanese pound banknotes, on road signs, on Lebanese license plates , and on official buildings (alongside Arabic). Today, French and English are secondary languages of Lebanon , with about 40% of the population being Francophone and 40% Anglophone. The use of English

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2838-489: Is also a working language in nonprofit organisations such as the Red Cross (alongside English, German, Spanish, Portuguese, Arabic and Russian), Amnesty International (alongside 32 other languages of which English is the most used, followed by Spanish, Portuguese, German, and Italian), Médecins sans Frontières (used alongside English, Spanish, Portuguese and Arabic), and Médecins du Monde (used alongside English). Given

2967-527: Is based primarily on validated clinical criteria combined with selective testing because the typical clinical presentation ( shortness of breath , chest pain ) cannot be definitively differentiated from other causes of chest pain and shortness of breath. The decision to perform medical imaging is based on clinical reasoning, that is, the medical history , symptoms, and findings on physical examination , followed by an assessment of clinical probability. The most commonly used method to predict clinical probability,

3096-810: Is detectable by decreased percussion note, audible breath sounds, and vocal resonance. Strain on the right ventricle may be detected as a left parasternal heave, a loud pulmonary component of the second heart sound , and/or raised jugular venous pressure . A low-grade fever may be present, particularly if there is associated pulmonary hemorrhage or infarction. As smaller pulmonary emboli tend to lodge in more peripheral areas without collateral circulation, they are more likely to cause lung infarction and small effusions (both of which are painful), but not hypoxia, dyspnea, or hemodynamic instability such as tachycardia. Larger PEs, which tend to lodge centrally, typically cause dyspnea, hypoxia, low blood pressure , fast heart rate and fainting , but are often painless because there

3225-652: Is enacted only in New Brunswick, where about one third of the population is Francophone. French is also an official language of all of the territories ( Northwest Territories , Nunavut , and Yukon ). Out of the three, Yukon has the most French speakers, making up just under 4% of the population. Furthermore, while French is not an official language in Ontario , the French Language Services Act ensures that provincial services are available in

3354-563: Is growing in the business and media environment. Out of about 900,000 students, about 500,000 are enrolled in Francophone schools, public or private, in which the teaching of mathematics and scientific subjects is provided in French. Actual usage of French varies depending on the region and social status. One-third of high school students educated in French go on to pursue higher education in English-speaking institutions. English

3483-519: Is helpful to confirm or exclude a diagnosis of PE after simpler first-line tests are used. Medical societies recommend tests such as the D-dimer to first provide supporting evidence for the need for imaging, and imaging would be done if other tests confirmed a moderate or high probability of finding evidence to support a diagnosis of PE. CT pulmonary angiography is the recommended first line diagnostic imaging test in most people. Ultrasound of

3612-404: Is known as Old French. The period of Old French spanned between the 8th and 14th centuries. Old French shared many characteristics with Latin. For example, Old French made use of different possible word orders just as Latin did because it had a case system that retained the difference between nominative subjects and oblique non-subjects . The period is marked by a heavy superstrate influence from

3741-419: Is needed. A CT pulmonary angiogram (CTPA) is the preferred method for diagnosis of a pulmonary embolism due to its easy administration and accuracy. Although a CTPA is preferred, there are also other tests that can be done. For example, a proximal lower limb compression ultrasound (CUS) can be used. This is a test which is primarily used as a confirmatory test, meaning it confirms a previous analysis showing

3870-420: Is no evidence of a difference between oral DTIs (dabigatran, rivaroxaban, edoxaban, apixaban) and standard anticoagulation in the prevention of recurrent pulmonary embolism. In people with cancer who develop pulmonary embolism, therapy with a course of LMWH is favored over warfarin or other oral anticoagulants. Similarly, pregnant women are treated with low molecular weight heparin until after delivery to avoid

3999-571: Is no lung infarction due to collateral circulation. The classic presentation for PE with pleuritic pain, dyspnea, and tachycardia is likely caused by a large fragmented embolism causing both large and small PEs. Thus, small PEs are often missed because they cause pleuritic pain alone without any other findings and large PEs are often missed because they are painless and mimic other conditions often causing ECG changes and small rises in troponin and brain natriuretic peptide levels. PEs are sometimes described as massive, submassive, and nonmassive depending on

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4128-469: Is often considered to be a useful skill by business owners in the United Kingdom; a 2014 study found that 50% of British managers considered French to be a valuable asset for their business, thus ranking French as the most sought-after foreign language there, ahead of German (49%) and Spanish (44%). MIT economist Albert Saiz calculated a 2.3% premium for those who have French as a foreign language in

4257-828: Is one of the official languages of such major international and regional courts, tribunals, and dispute-settlement bodies as the African Court on Human and Peoples' Rights , the Caribbean Court of Justice , the Court of Justice for the Economic Community of West African States , the Inter-American Court of Human Rights , the International Court of Justice , the International Criminal Tribunal for

4386-716: Is suspected, but unlikely. Unlike the Wells score and Geneva score , which are clinical prediction rules intended to risk stratify people with suspected PE, the PERC rule is designed to rule out the risk of PE in people when the physician has already stratified them into a low-risk category. People in this low risk category without any of these criteria may undergo no further testing for PE: low oxygen saturations – Sa O 2 <95%, unilateral leg swelling, coughing up blood, prior DVT or PE, recent surgery or trauma, age >50, hormone use, fast heart rate. The rationale behind this decision

4515-639: Is taught in universities around the world, and is one of the world's most influential languages because of its wide use in the worlds of journalism, jurisprudence , education, and diplomacy. In diplomacy, French is one of the six official languages of the United Nations (and one of the UN Secretariat 's only two working languages ), one of twenty official and three procedural languages of the European Union , an official language of NATO ,

4644-425: Is that further testing (specifically CT angiogram of the chest) may cause more harm (from radiation exposure and contrast dye) than the risk of PE. The PERC rule has a sensitivity of 97.4% and specificity of 21.9% with a false negative rate of 1.0% (16/1666). In people with a low or moderate suspicion of PE, a normal D-dimer level (shown in a blood test ) is enough to exclude the possibility of thrombotic PE, with

4773-407: Is the best available treatment in those without contraindications and is supported by clinical guidelines. It is also recommended in those in cardiac arrest with a known PE. Catheter-directed thrombolysis (CDT) is a new technique found to be relatively safe and effective for massive PEs. This involves accessing the venous system by placing a catheter into a vein in the groin and guiding it through

4902-553: Is the language of business and communication, with French being an element of social distinction, chosen for its emotional value. French is an official language of the Pacific Island nation of Vanuatu , where 31% of the population was estimated to speak it in 2023. In the French special collectivity of New Caledonia , 97% of the population can speak, read and write French while in French Polynesia this figure

5031-483: Is the native language of about 23% of the Swiss population, and is spoken by 50% of the population. Along with Luxembourgish and German, French is one of the three official languages of Luxembourg , where it is generally the preferred language of business as well as of the different public administrations. It is also the official language of Monaco . At a regional level, French is acknowledged as an official language in

5160-492: Is the second-most spoken language (after English) in the states of Maine and New Hampshire . In Louisiana , it is tied with Spanish for second-most spoken if Louisiana French and all creoles such as Haitian are included. French is the third most spoken language (after English and Spanish) in the states of Connecticut , Rhode Island , and New Hampshire . Louisiana is home to many distinct French dialects, collectively known as Louisiana French . New England French , essentially

5289-424: Is the sole official language in the province of Quebec , where some 80% of the population speak it as a native language and 95% are capable of conducting a conversation in it. Quebec is also home to the city of Montreal , which is the world's fourth-largest French-speaking city, by number of first language speakers. New Brunswick and Manitoba are the only officially bilingual provinces, though full bilingualism

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5418-482: Is usually brief. Only when a second PE occurs, and especially when this happens while still under anticoagulant therapy, a further search for underlying conditions is undertaken. This will include testing ("thrombophilia screen") for Factor V Leiden mutation , antiphospholipid antibodies, protein C and S and antithrombin levels, and later prothrombin mutation, MTHFR mutation, Factor VIII concentration and rarer inherited coagulation abnormalities. To diagnose

5547-764: The Aosta Valley region of Italy where it is the first language of approximately 50% of the population, while French dialects remain spoken by minorities on the Channel Islands . It is also spoken in Andorra and is the main language after Catalan in El Pas de la Casa . The language is taught as the primary second language in the German state of Saarland , with French being taught from pre-school and over 43% of citizens being able to speak French. The majority of

5676-539: The Democratic Republic of Congo . There is not a single African French , but multiple forms that diverged through contact with various indigenous African languages . Sub-Saharan Africa is the region where the French language is most likely to expand, because of the expansion of education and rapid population growth. It is also where the language has evolved the most in recent years. Some vernacular forms of French in Africa can be difficult to understand for French speakers from other countries, but written forms of

5805-412: The Democratic Republic of the Congo . In some North African countries, though not having official status, it is also a first language among some upper classes of the population alongside indigenous languages, but only a second one among the general population. In 2015, approximately 40% of the Francophone population (including L2 and partial speakers) lived in Europe, 36% in sub-Saharan Africa and

5934-533: The European Union , French was the dominant language within all institutions until the 1990s. After several enlargements of the EU (1995, 2004), French significantly lost ground in favour of English, which is more widely spoken and taught in most EU countries. French currently remains one of the three working languages, or "procedural languages", of the EU, along with English and German. It is the second-most widely used language within EU institutions after English, but remains

6063-559: The Francien dialect is one that not only continued but also thrived during the Middle French period (14th–17th centuries). Modern French grew out of this Francien dialect. Grammatically, during the period of Middle French, noun declensions were lost and there began to be standardized rules. Robert Estienne published the first Latin-French dictionary, which included information about phonetics, etymology, and grammar. Politically,

6192-452: The INR has reached therapeutic levels (if warfarin is used). Increasingly, however, low-risk cases are managed at home in a fashion already common in the treatment of DVT. Evidence to support one approach versus the other is weak. Anticoagulant therapy is the mainstay of treatment. For many years, vitamin K antagonists (warfarin or less commonly acenocoumarol or phenprocoumon ) have been

6321-877: The International Olympic Committee , the Council of Europe , the Organisation for Economic Co-operation and Development , Organization of American States (alongside Spanish, Portuguese and English), the Eurovision Song Contest , one of eighteen official languages of the European Space Agency , World Trade Organization and the least used of the three official languages in the North American Free Trade Agreement countries. It

6450-626: The Oaths of Strasbourg and the Sequence of Saint Eulalia , while Old French literature began to be produced in the eleventh century, with major early works often focusing on the lives of saints (such as the Vie de Saint Alexis ), or wars and royal courts, notably including the Chanson de Roland , epic cycles focused on King Arthur and his court , as well as a cycle focused on William of Orange . It

6579-632: The Progressive Alliance and the Socialist International . Membership cards can be purchased by party members. They are issued by the UDPS general secretariat in Kinshasa, sent to members' respective federations (either by region or abroad), and distributed among local party sections or cells in their respective jurisdictions. Members who lose their card may be issued a " 'proof of membership' after making inquiries with

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6708-631: The Roman Empire . French evolved from Gallo-Romance , the Latin spoken in Gaul , and more specifically in Northern Gaul. Its closest relatives are the other langues d'oïl —languages historically spoken in northern France and in southern Belgium, which French ( Francien ) largely supplanted. French was also influenced by native Celtic languages of Northern Roman Gaul like Gallia Belgica and by

6837-541: The Wells score , is a clinical prediction rule , whose use is complicated by multiple versions being available. In 1995, Philip Steven Wells , initially developed a prediction rule (based on a literature search) to predict the likelihood of DVT, based on clinical criteria. A new prediction score for PE was created in 1998 This prediction rule was revised by Wells et al. in 2000. In the 2000 publication, Wells proposed two different scoring systems using cutoffs of 2 or 4 with

6966-775: The World Trade Organization , the International Olympic Committee , the General Conference on Weights and Measures , and the International Committee of the Red Cross . French is a Romance language (meaning that it is descended primarily from Vulgar Latin ) that evolved out of the Gallo-Romance dialects spoken in northern France. The language's early forms include Old French and Middle French . Due to Roman rule, Latin

7095-571: The embolization of air , fat , or amniotic fluid . Diagnosis is based on signs and symptoms in combination with test results. If the risk is low, a blood test known as a D-dimer may rule out the condition. Otherwise, a CT pulmonary angiography , lung ventilation/perfusion scan , or ultrasound of the legs may confirm the diagnosis. Together, deep vein thrombosis and PE are known as venous thromboembolism (VTE). Efforts to prevent PE include beginning to move as soon as possible after surgery, lower leg exercises during periods of sitting, and

7224-652: The gold standard for diagnosis was pulmonary angiography by fluoroscopy , but this has fallen into disuse with the increased availability of non-invasive techniques that offer similar diagnostic accuracy. The primary use of the ECG is to rule out other causes of chest pain. An electrocardiogram (ECG) is routinely done on people with chest pain to quickly diagnose myocardial infarctions (heart attacks), an important differential diagnosis in an individual with chest pain. While certain ECG changes may occur with PE, none are specific enough to confirm or sensitive enough to rule out

7353-626: The provinces of Quebec, Ontario, and New Brunswick); Belgium ( Wallonia and the Brussels-Capital Region ); western Switzerland (specifically the cantons forming the Romandy region); parts of Luxembourg; parts of the United States (the states of Louisiana, Maine, New Hampshire, and Vermont); Monaco; the Aosta Valley region of Italy; and various communities elsewhere. French is estimated to have about 310 million speakers, of which about 80 million are native speakers. According to

7482-427: The ( Germanic ) Frankish language of the post-Roman Frankish invaders. Today, owing to the French colonial empire , there are numerous French-based creole languages , most notably Haitian Creole . A French-speaking person or nation may be referred to as Francophone in both English and French. French is an official language in 27 countries , as well as one of the most geographically widespread languages in

7611-506: The 1990s) but these varieties are severely endangered or presumed extinct. French is one of two official languages in Haiti alongside Haitian Creole . It is the principal language of education, administration, business, and public signage and is spoken by all educated Haitians. It is also used for ceremonial events such as weddings, graduations, and church masses. The vast majority of the population speaks Haitian Creole as their first language;

7740-593: The 1990s, but Mobutu allegedly interfered and prevented Tshisekedi from carrying out his mandate each time. The UDPS was a major opposition party during the presidency of Joseph Kabila from 2001 to 2019. The party called for a boycott of the 2005 constitutional referendum and the 2006 general election . Prior to the latter, the Commission Electorale Indépendante (CEI) – the DRC's electoral body – had refused

7869-576: The 2018 presidential election. He was confirmed as the winner by the Constitutional Court of the DRC on 20 January 2019, after a failed challenge from the runner-up Martin Fayulu . Tshisekedi was sworn in as president shortly after on 24 January. It was the first peaceful transition of power in the country since it became independent from Belgium in 1960. Tshisekedi's critics at the time described him as unproven, inexperienced, and lacking

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7998-773: The 20th century, when it was replaced by English as the United States became the dominant global power following the Second World War . Stanley Meisler of the Los Angeles Times said that the fact that the Treaty of Versailles was written in English as well as French was the "first diplomatic blow" against the language. During the Grand Siècle (17th century), France, under the rule of powerful leaders such as Cardinal Richelieu and Louis XIV , enjoyed

8127-703: The Canadian capital, is also effectively bilingual, as it has a large population of federal government workers, who are required to offer services in both French and English, and is just across the river from the Quebecois city of Gatineau . According to the United States Census Bureau (2011), French is the fourth most spoken language in the United States after English, Spanish, and Chinese, when all forms of French are considered together and all dialects of Chinese are similarly combined. French

8256-917: The Caribbean that are collectively referred to as the French West Indies , namely Guadeloupe , Saint Barthélemy , Saint Martin , and Martinique . French is the official language of both French Guiana on the South American continent, and of Saint Pierre and Miquelon , an archipelago off the coast of Newfoundland in North America. French was the official language of the colony of French Indochina , comprising modern-day Vietnam , Laos , and Cambodia . It continues to be an administrative language in Laos and Cambodia, although its influence has waned in recent decades. In colonial Vietnam,

8385-820: The ECG are sinus tachycardia , right axis deviation, and right bundle branch block . Sinus tachycardia, however, is still only found in 8–69% of people with PE. ECG findings associated with pulmonary emboli may suggest worse prognosis since the six findings identified with RV strain on ECG (heart rate > 100 beats per minute, S1Q3T3, inverted T waves in leads V1-V4, ST elevation in aVR, complete right bundle branch block, and atrial fibrillation) are associated with increased risk of circulatory shock and death. Cases with inverted T in leads V 1-3 are suspected with PE or inferior myocardial infarction. PE cases show inverted T waves in leads II and aV F , but inferior myocardial infarction cases do not show inverted T waves in II and aV F . In massive and submassive PE, dysfunction of

8514-408: The Empire, this local elite had been slowly abandoning Gaulish entirely, but the rural and lower class populations remained Gaulish speakers who could sometimes also speak Latin or Greek. The final language shift from Gaulish to Vulgar Latin among rural and lower class populations occurred later, when both they and the incoming Frankish ruler/military class adopted the Gallo-Roman Vulgar Latin speech of

8643-416: The Germanic Frankish language , which non-exhaustively included the use in upper-class speech and higher registers of V2 word order , a large percentage of the vocabulary (now at around 15% of modern French vocabulary ) including the impersonal singular pronoun on (a calque of Germanic man ), and the name of the language itself. Up until its later stages, Old French , alongside Old Occitan , maintained

8772-626: The INR window may be increased to e.g. 2.5–3.5 (unless there are contraindications) or anticoagulation may be changed to a different anticoagulant e.g. LMWH. In recent years, many anticoagulants have been introduced that offer similar to warfarin but without a need for titration to the INR. Known as the directly acting oral anticoagulants , these treatments are now preferred over vitamin K antagonists by American professional guidelines. Two of these ( rivaroxaban and apixaban ) do not require initial heparin or fondaparinux treatment, whereas dabigatran and edoxaban do. A Cochrane review found that there

8901-410: The Indian Ocean, 15% in North Africa and the Middle East, 8% in the Americas, and 1% in Asia and Oceania. French is the second most widely spoken mother tongue in the European Union . Of Europeans who speak other languages natively, approximately one-fifth are able to speak French as a second language. French is the second most taught foreign language in the EU. All institutions of the EU use French as

9030-402: The OIF, approximately 321 million people worldwide are "able to speak the language" as of 2022, without specifying the criteria for this estimation or whom it encompasses. In Francophone Africa, it is spoken mainly as a second language. However it has also become a native language in a number of urban areas, especially in regions like Ivory Coast , Cameroon , Gabon, Madagascar , and

9159-403: The Republic (French abbreviation: Ensemble), at a rally in Kasumbalesa , in southeastern Haut-Katanga Province . Witnesses charged Ensemble supporters with ransacking a local UDPS office and UDPS supporters with attacking and injuring six people, raping at least two women, and sexually assaulting three others. Logistical delays also arose once again, leading to accusations of fraud levied against

9288-413: The UDPS' alleged coordination with pro-Kabila parties in the lead up to the election. Pro-Kabila parties won a majority of seats in the concurrent parliamentary election. The UDPS won a plurality of seats in the 2023 parliamentary election . Parties allied with the UDPS also won a significant number of seats. However, Tshisekedi, who was reelected in the concurrent presidential election, was unable to form

9417-462: The UDPS. In August 2024, the UDPS' disciplinary body dismissed party leader Augustin Kabuya, who had held the position since February 2022. The decision came amid accusations from his internal opponents of nepotism and mismanagement, among other things. The UDPS identifies as a social democratic party. Its slogan is le peuple d'abord , meaning "the people first". The UDPS is a full member of

9546-407: The accuracy of CT pulmonary angiography is hindered by the rapid changes in the number of rows of detectors available in multidetector CT (MDCT) machines. According to a cohort study , single-slice spiral CT may help diagnose detection among people with suspected pulmonary embolism. In this study, the sensitivity was 69% and specificity was 84%. In this study which had a prevalence of detection

9675-412: The assay. However, in those over the age of 50, changing the cut-off value to the person's age multiplied by 10 μg/L (accounting for assay which has been used) is recommended as it decreases the number of falsely positive tests without missing any additional cases of PE. When a PE is being suspected, several blood tests are done in order to exclude important secondary causes of PE. This includes

9804-454: The charisma of his father. For example, Valentin Mubake, the UDPS' former secretary-general, commented: "His father was a man of the country. The son is very limited." Tshisekedi had never held a high office or managerial role, in contrast to his father's long career as a prominent figure of the country's opposition. Analysts described Tshisekedi's victory as a victory for Kabila as well, due to

9933-495: The clinical signs and symptoms. Although the exact definitions of these are unclear, an accepted definition of massive PE is one in which there is hemodynamic instability. This is a cause of obstructive shock, which presents as sustained low blood pressure, slowed heart rate , or pulselessness. About 90% of emboli are from a deep vein thrombosis located above the knee termed a proximal DVT , which includes an iliofemoral DVT . The rare venous thoracic outlet syndrome can also be

10062-534: The cornerstone. As vitamin K antagonists do not act immediately, initial treatment is with rapidly acting injectable anticoagulants: unfractionated heparin (UFH), low molecular weight heparin (LMWH), or fondaparinux , while oral vitamin K antagonists are initiated and titrated (usually as part of inpatient hospital care) to the international normalized ratio , a test that determines the dose. In terms of injectable treatments, LMWH may reduce bleeding among people with pulmonary embolism as compared to UFH. According to

10191-646: The country near French-speaking Quebec, however, it is the foreign language more commonly taught. Vowel phonemes in French Pulmonary embolism PE usually results from a blood clot in the leg that travels to the lung. The risk of blood clots is increased by advanced age , cancer , prolonged bed rest and immobilization, smoking , stroke , long-haul travel over 4 hours, certain genetic conditions, estrogen-based medication , pregnancy , obesity , trauma or bone fracture , and after some types of surgery. A small proportion of cases are due to

10320-399: The country. The party identifies as social democratic . The party is led by Félix Tshisekedi , who has served as President of the DRC since his election in 2018 . Tshisekedi's assumption of the presidency was the first peaceful transition of power in the country since it became independent from Belgium in 1960. He was reelected in 2023 . His father Étienne Tshisekedi previously led

10449-426: The creation of the party; Mobutu, however, disagreed. The party's leaders were arrested the next month and all sentenced to 15 years in prison. Following the 1991 Sovereign National Conference  [ fr ] , UDPS leader Étienne Tshisekedi emerged as the main rival to Mobutu. Bowing to international pressure, Mobutu appointed Tshisekedi to the office of Prime Minister of Zaire on three separate occasions in

10578-519: The demographic prospects of the French-speaking nations of Africa, researcher Pascal-Emmanuel Gobry wrote in 2014 that French "could be the language of the future". However, some African countries such as Algeria intermittently attempted to eradicate the use of French, and as of 2024 it was removed as an official language in Mali and Burkina Faso . Significant as a judicial language, French

10707-531: The diagnosis. An ECG may show signs of right heart strain or acute cor pulmonale in cases of large PEs – the classic signs are a large S wave in lead I, a large Q wave in lead III, and an inverted T wave in lead III (S1Q3T3), which occurs in 12–50% of people with the diagnosis, yet also occurs in 12% without the diagnosis. This is occasionally present (occurring in up to 20% of people), but may also occur in other acute lung conditions, and, therefore, has limited diagnostic value. The most commonly seen signs in

10836-448: The economic power of the countries using the language, the number of major areas in which the language is used, and the linguistic prestige associated with the mastery of the language (Weber highlighted that French in particular enjoys considerable linguistic prestige). In a 2008 reassessment of his article, Weber concluded that his findings were still correct since "the situation among the top ten remains unchanged." Knowledge of French

10965-439: The effects of anticoagulation is unknown as it has not been properly studied as of 2020. Massive PE causing hemodynamic instability (shock and/or low blood pressure, defined as a systolic blood pressure <90 mmHg or a pressure drop of 40 mmHg for >15 min if not caused by new-onset arrhythmia, hypovolemia or sepsis) is an indication for thrombolysis , the enzymatic destruction of the clot with medication. In this situation, it

11094-519: The efforts of the Zairean interior ministry, many of the authors would return to the capital Kinshasa later that same year to speak with other opposition figures. On 15 February 1982, the Union for Democracy and Social Progress (French abbreviation: UDPS) was founded in Kinshasa with a declared commitment to the 1967 constitution. The party's founding members asserted that the 1967 constitution permitted

11223-594: The elites primarily spoke French, while many servants who worked in French households spoke a French pidgin known as " Tây Bồi " (now extinct). After French rule ended, South Vietnam continued to use French in administration, education, and trade. However, since the Fall of Saigon and the opening of a unified Vietnam's economy, French has gradually been effectively displaced as the first foreign language of choice by English in Vietnam. Nevertheless, it continues to be taught as

11352-516: The first government authority to adopt Modern French as official was the Aosta Valley in 1536, while the Ordinance of Villers-Cotterêts (1539) named French the language of law in the Kingdom of France . During the 17th century, French replaced Latin as the most important language of diplomacy and international relations ( lingua franca ). It retained this role until approximately the middle of

11481-413: The following: dyspnea (shortness of breath), tachypnea (rapid breathing), chest pain of a "pleuritic" nature (worsened by breathing), cough and hemoptysis (coughing up blood). More severe cases can include signs such as cyanosis (blue discoloration, usually of the lips and fingers), collapse, and circulatory instability because of decreased blood flow through the lungs and into the left side of

11610-915: The former Yugoslavia , International Criminal Tribunal for Rwanda , the International Tribunal for the Law of the Sea the International Criminal Court and the World Trade Organization Appellate Body . It is the sole internal working language of the Court of Justice of the European Union , and makes with English the European Court of Human Rights 's two working languages. In 1997, George Weber published, in Language Today ,

11739-542: The former federation, section or cell where the applicant claims to have been a member to confirm whether or not they were a member of the UDPS." French language French ( français [fʁɑ̃sɛ] or langue française [lɑ̃ɡ fʁɑ̃sɛːz] ) is a Romance language of the Indo-European family . Like all other Romance languages, it descended from the Vulgar Latin of

11868-829: The gender of the corresponding word in Gaulish. The estimated number of French words that can be attributed to Gaulish is placed at 154 by the Petit Robert , which is often viewed as representing standardized French, while if non-standard dialects are included, the number increases to 240. Known Gaulish loans are skewed toward certain semantic fields, such as plant life ( chêne , bille , etc.), animals ( mouton , cheval , etc.), nature ( boue , etc.), domestic activities (ex. berceau ), farming and rural units of measure ( arpent , lieue , borne , boisseau ), weapons, and products traded regionally rather than further afield. This semantic distribution has been attributed to peasants being

11997-504: The heart. About 15% of all cases of sudden death are attributable to PE. While PE may present with syncope (fainting), less than 1% of syncope cases are due to PE. On physical examination, the lungs are usually normal. Occasionally, a pleural friction rub may be audible over the affected area of the lung (mostly in PE with infarct ). A pleural effusion is sometimes present that is exudative (fluid that leaks out of blood vessels). This

12126-462: The known teratogenic effects of warfarin, especially in the early stages of pregnancy, but it can be used while breastfeeding. Anticoagulation therapy is usually continued for 3–6 months, or "lifelong" if there have been previous DVTs or PEs, or none of the usual transient risk factors is present. In those without a known cause that can be reversed 2 years of treatment may be better than 6 months. For those with small PEs (known as subsegmental PEs)

12255-454: The language are very closely related to those of the rest of the French-speaking world. French is the second most commonly spoken language in Canada and one of two federal official languages alongside English. As of the 2021 Canadian census , it was the native language of 7.7 million people (21% of the population) and the second language of 2.9 million (8% of the population). French

12384-479: The language, although it has now given way to Tamil and English. A former French mandate , Lebanon designates Arabic as the sole official language, while a special law regulates cases when French can be publicly used. Article 11 of Lebanon's Constitution states that "Arabic is the official national language. A law determines the cases in which the French language is to be used". The French language in Lebanon

12513-612: The language. The Act applies to areas of the province where there are significant Francophone communities, namely Eastern Ontario and Northern Ontario . Elsewhere, sizable French-speaking minorities are found in southern Manitoba, Nova Scotia , Prince Edward Island and the Port au Port Peninsula in Newfoundland and Labrador, where the unique Newfoundland French dialect was historically spoken. Smaller pockets of French speakers exist in all other provinces. The Ontarian city of Ottawa ,

12642-479: The last to hold onto Gaulish. The beginning of French in Gaul was greatly influenced by Germanic invasions into the country. These invasions had the greatest impact on the northern part of the country and on the language there. A language divide began to grow across the country. The population in the north spoke langue d'oïl while the population in the south spoke langue d'oc . Langue d'oïl grew into what

12771-518: The legs can confirm the presence of a PE but cannot rule it out. CT pulmonary angiography (CTPA) is a pulmonary angiogram obtained using computed tomography (CT) with radiocontrast rather than right heart catheterization. Its advantages are that it is accurate, it is non-invasive, it is more often available, and it may identifying other lung disorders in case there is no pulmonary embolism. The accuracy and non-invasive nature of CTPA also make it advantageous for people who are pregnant. Assessing

12900-536: The letter has been cited as the first non-violent challenge to Mobutu and his one-party rule , the letter attempted to justify its proposals by citing the 1967 constitution and Manifesto of N'sele , which were authored by Mobutu and his party. Mobutu quickly had the letter's authors arrested but granted them amnesty shortly afterwards in January 1981. However, the authors were stripped of their mandates and exiled to their respective home provinces. Nonetheless, despite

13029-420: The necessity and means to annihilate the patois and to universalize the use of the French language". When public education was made compulsory , only French was taught and the use of any other ( patois ) language was punished. The goals of the public school system were made especially clear to the French-speaking teachers sent to teach students in regions such as Occitania and Brittany . Instructions given by

13158-534: The other main foreign language in the Vietnamese educational system and is regarded as a cultural language. All three countries are full members of La Francophonie (OIF). French was the official language of French India , consisting of the geographically separate enclaves referred to as Puducherry . It continued to be an official language of the territory even after its cession to India in 1956 until 1965. A small number of older locals still retain knowledge of

13287-917: The outcome) compared to VQ scanning. A ventilation/perfusion scan (or V/Q scan or lung scintigraphy ) shows that some areas of the lung are being ventilated but not perfused with blood (due to obstruction by a clot). This type of examination is as accurate as multislice CT, but is less used, due to the greater availability of CT technology. It is particularly useful in people who have an allergy to iodinated contrast , impaired kidney function, or are pregnant (due to its lower radiation exposure as compared to CT). The test can be performed with planar two-dimensional imaging, or single-photon emission computed tomography (SPECT) which enables three-dimensional imaging. Hybrid devices combining SPECT and CT (SPECT/CT) further enable anatomic characterization of any abnormality. Tests that are frequently done that are not sensitive for PE, but can be diagnostic. Historically,

13416-498: The party. The party can trace its origins to a group of dissenting parliamentarians during the dictatorship of Mobutu Sese Seko and his Popular Movement of the Revolution . In December 1980, Mobutu received a 52-page open letter calling for the democratization of the political system in Zaire (as the DRC was then known) and the permittance of opposition parties. It was signed by 13 parliamentarians and dated 1 November 1980. Although

13545-471: The preferred language of certain institutions or administrations such as the Court of Justice of the European Union , where it is the sole internal working language, or the Directorate-General for Agriculture . Since 2016, Brexit has rekindled discussions on whether or not French should again hold greater role within the institutions of the European Union. A leading world language , French

13674-403: The presence or suspected presence of a pulmonary embolism. According to a cross-sectional study, CUS tests have a sensitivity of 41% and specificity of 96%. If there are concerns this is followed by testing to determine a likelihood of being able to confirm a diagnosis by imaging, followed by imaging if other tests have shown that there is a likelihood of a PE diagnosis. The diagnosis of PE

13803-471: The rest largely speak French as a first language. As a French Creole language , Haitian Creole draws the large majority of its vocabulary from French, with influences from West African languages, as well as several European languages. It is closely related to Louisiana Creole and the creole from the Lesser Antilles . French is the sole official language of all the overseas territories of France in

13932-600: The return of key opposition figures from exile, the release of political prisoners, and the de-escalation of tensions between supporters of the government and the opposition. The opposition had been in open conflict with the Commission Electorale Nationale Indépendante (formerly the Commission Electorale Indépendante or CEI), which they charged with being pro-Kabila. Tshisekedi contested and won

14061-571: The right side of the heart may be seen on echocardiography , an indication that the pulmonary artery is severely obstructed and the right ventricle , a low-pressure pump, is unable to match the pressure. Some studies (see below) suggest that this finding may be an indication for thrombolysis . Not every person with a (suspected) pulmonary embolism requires an echocardiogram, but elevations in cardiac troponins or brain natriuretic peptide may indicate heart strain and warrant an echocardiogram, and be important in prognosis. The specific appearance of

14190-646: The right ventricle on echocardiography is referred to as the McConnell's sign . This is the finding of akinesia of the mid-free wall but a normal motion of the apex. This phenomenon has a 77% sensitivity and a 94% specificity for the diagnosis of acute pulmonary embolism in the setting of right ventricular dysfunction. Pulmonary embolism may be preventable in those with risk factors. People admitted to hospital may receive preventative medication, including unfractionated heparin , low molecular weight heparin (LMWH), or fondaparinux , and anti-thrombosis stockings to reduce

14319-453: The risk of a DVT in the leg that could dislodge and migrate to the lungs. Following the completion of anticoagulation in those with prior PE, long-term aspirin is useful to prevent recurrence. Anticoagulant therapy is the mainstay of treatment. Acutely, supportive treatments, such as oxygen or analgesia , may be required. People are often admitted to hospital in the early stages of treatment, and tend to remain under inpatient care until

14448-439: The same prediction rule, and also included D-dimer testing in the rule-out of PE in low probability patients. In 2001, Wells published results using the more conservative cutoff of 2 to create three categories. An additional version, the "modified extended version", using the more recent cutoff of 2 but including findings from Wells's initial studies were proposed. Most recently, a further study reverted to Wells's earlier use of

14577-505: The same review, LMWH reduced the incidence of recurrent thrombotic complications and reduced thrombus size when compared to heparin. There was no difference in overall mortality between participants treated with LMWH and those treated with unfractionated heparin. Vitamin K antagonists require frequent dose adjustment and monitoring of the international normalized ratio (INR). In PE, INRs between 2.0 and 3.0 are generally considered ideal. If another episode of PE occurs under warfarin treatment,

14706-466: The total number of French speakers will reach approximately 500 million in 2025 and 650 million by 2050, largely due to rapid population growth in sub-Saharan Africa . OIF estimates 700 million French speakers by 2050, 80% of whom will be in Africa. In a study published in March 2014 by Forbes , the investment bank Natixis said that French could become the world's most spoken language by 2050. In

14835-679: The two official languages—along with Dutch —of the Brussels-Capital Region , where it is spoken by the majority of the population (approx. 80%), often as their primary language. French is one of the four official languages of Switzerland, along with German, Italian, and Romansh , and is spoken in the western part of Switzerland, called Romandy , of which Geneva is the largest city. The language divisions in Switzerland do not coincide with political subdivisions, and some cantons have bilingual status: for example, cities such as Biel/Bienne and cantons such as Valais , Fribourg and Bern . French

14964-508: The urban intellectual elite. The Gaulish language likely survived into the sixth century in France despite considerable Romanization . Coexisting with Latin, Gaulish helped shape the Vulgar Latin dialects that developed into French contributing loanwords and calques (including oui , the word for "yes"), sound changes shaped by Gaulish influence, and influences in conjugation and word order. Recent computational studies suggest that early gender shifts may have been motivated by

15093-496: The use of blood thinners after some types of surgery. Treatment is with anticoagulants such as heparin , warfarin or one of the direct-acting oral anticoagulants (DOACs). These are recommended for at least three months. However, treatment using anticoagulants is not recommended for those at high risk of bleeding, as well as those with renal failure. Severe cases may require thrombolysis using medication such as tissue plasminogen activator (tPA) given intravenously or through

15222-485: The use of French in official government publications, public education except in specific cases, and legal contracts; advertisements must bear a translation of foreign words. In Belgium, French is an official language at the federal level along with Dutch and German. At the regional level, French is the sole official language of Wallonia (excluding a part of the East Cantons , which are German-speaking ) and one of

15351-455: The veins by using fluoroscopic imaging until it is located next to the PE in the lung circulation. Medication that breaks up blood clots is released through the catheter so that its highest concentration is directly next to the pulmonary embolus. CDT is performed by interventional radiologists or vascular surgeons , and in medical centers that offer CDT, it may be offered as a first-line treatment. Catheter-based ultrasound-assisted thrombolysis

15480-536: The workplace. In 2011, Bloomberg Businessweek ranked French the third most useful language for business, after English and Standard Mandarin Chinese . In English-speaking Canada, the United Kingdom, and Ireland, French is the first foreign language taught and in number of pupils is far ahead of other languages. In the United States, French is the second-most commonly taught foreign language in schools and universities, although well behind Spanish. In some areas of

15609-402: The world's French-speaking population lives in Africa. According to a 2023 estimate from the Organisation internationale de la Francophonie , an estimated 167 million African people spread across 35 countries and territories can speak French as either a first or a second language . This number does not include the people living in non-Francophone African countries who have learned French as

15738-503: The world, with about 50 countries and territories having it as a de jure or de facto official, administrative, or cultural language. Most of these countries are members of the Organisation internationale de la Francophonie (OIF), the community of 54 member states which share the official use or teaching of French. It is spoken as a first language (in descending order of the number of speakers) in France; Canada (especially in

15867-490: Was 32%, the positive predictive value of 67.0% and negative predictive value of 85.2%. However, this study's results may be biased due to possible incorporation bias, since the CT scan was the final diagnostic tool in people with pulmonary embolism. The authors noted that a negative single slice CT scan is insufficient to rule out pulmonary embolism on its own. A separate study with a mixture of 4 slice and 16 slice scanners reported

15996-819: Was during the period of the Crusades in which French became so dominant in the Mediterranean Sea that became a lingua franca ("Frankish language"), and because of increased contact with the Arabs during the Crusades who referred to them as Franj , numerous Arabic loanwords entered French, such as amiral (admiral), alcool (alcohol), coton (cotton) and sirop (syrop), as well as scientific terms such as algébre (algebra), alchimie (alchemy) and zéro (zero). Within Old French many dialects emerged but

16125-400: Was gradually adopted by the inhabitants of Gaul. As the language was learned by the common people, it developed a distinct local character, with grammatical differences from Latin as spoken elsewhere, some of which is attested in graffiti. This local variety evolved into the Gallo-Romance tongues, which include French and its closest relatives, such as Arpitan . The evolution of Latin in Gaul

16254-652: Was known in the Occitan-speaking region as Vergonha . Spoken by 19.71% of the European Union's population, French is the third most widely spoken language in the EU, after English and German and the second-most-widely taught language after English. Under the Constitution of France , French has been the official language of the Republic since 1992, although the Ordinance of Villers-Cotterêts made it mandatory for legal documents in 1539. France mandates

16383-418: Was marred by violence and delays; voting was extended to a second day due to the failed deliveries of ballot boxes to some parts of the country. Etienne Tshisekedi died of pulmonary embolism on 1 February 2017. He was succeeded as president of the UDPS by his son, Félix Tshisekedi . Five months before the 2018 general election , the UDPS and three other opposition parties made a joint statement calling for

16512-594: Was shaped by its coexistence for over half a millennium beside the native Celtic Gaulish language , which did not go extinct until the late sixth century, long after the fall of the Western Roman Empire . The population remained 90% indigenous in origin; the Romanizing class were the local native elite (not Roman settlers), whose children learned Latin in Roman schools. At the time of the collapse of

16641-570: Was the language they use the most at home rose from 67% at the 2007 census to 74% at the 2017 census. In Wallis and Futuna, the percentage of the population who reported that French was the language they use the most at home rose from 10% at the 2008 census to 13% at the 2018 census. According to a demographic projection led by the Université Laval and the Réseau Démographie de l'Agence universitaire de la Francophonie ,

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