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Évaluation globale standardisée systématique des rhumatismes inflammatoires chroniques : intérêts et limites
No full textInternational audienceIntroduction: National and international recommendations call for an annual standardized systematic holistic review in the management of chronic inflammatory rheumatism (CIR). This includes an assessment of disease activity and severity, as well as patient education on the disease, knowledge of pharmacological and non-pharmacological treatments, adherence to treatment and screening for comorbidities. Our study aims to recall the definition of a holistic review (HR), to present the evidence of their effectiveness and to give an overview of HR practices in France. Methods: A literature review was conducted in the Pubmed database to identify randomized controlled trials (RCTs) or meta-analyses reporting the efficacy of a multidisciplinary intervention in ICR or other chronic diseases. Two online surveys were sent to all rheumatology departments in France and to a sample of independent rheumatologists, with 34 and 19 questions respectively. These questionnaires were used to determine the profile of the responding center/rheumatologist, the existence of an HR and the obstacles or facilitators to its implementation. Results: Literature search yielded 872 articles, 24 of which were finally included: 16 RCTs and 8 meta-analyses. Only 3 articles concerned ICRs, including one meta-analysis of 10 RCTs in rheumatoid arthritis (RA). Of these 3 studies, 2 RCTs in systemic lupus and systemic sclerosis showed a favorable impact of a multidisciplinary approach on SLEDAI and grip strength and mouth opening respectively, while the meta-analysis in RA showed no benefit on disability or disease activity. The questionnaire was answered by 72 centers and 186 rheumatologists. A third of the centers had already implemented a HR during a day hospitalization. Seventy percent of centers estimated that they managed more than 10 patients per month, devoting an average of 35 minutes of rheumatologist time and 90 minutes of cumulative time for all other healthcare professionals (HCPs) involved in the program. Most of the HCPs involved were nurses (92%), dieticians (56%) and physiotherapists (56%). The main obstacles to setting up a HR were the lack of paramedical resources, lack of economic value and lack of support from treating rheumatologists, while patient motivation was seen as a facilitating factor. Conclusion: Although HR is recommended, there is little evidence of its effectiveness in ICR. Only 36% of responding centers have implemented such a program. This survey helps to identify the obstacles and facilitators, and to find solutions for extending this practice.Introduction > Les recommandations nationales et internationales proposent la réalisation d'une évaluation globale systématique standardisée (EGSS) annuelle dans la prise en charge desrhumatismes inflammatoires chroniques (RIC). Celle-ci comprend une évaluation de l'activité et la sévérité de la maladie, mais aussi l'éducation du patient sur la maladie, les connaissances destraitements pharmacologiques et non-pharmacologiques, l'adhésion aux traitements et le dépistage des comorbidités. L'objectif de cette mise au point est de rappeler la définition d'une EGSS, de présenter les preuves de leur efficacité et de faire un état des lieux des pratiques d'une EGSS en France à partir d'une enquête adressée à 72 services de rhumatologie et 186 rhumatologues libéraux. Méthodes > Une revue de la littérature a été menée dans la base de données Pubmed afind'identifier les essais contrôlés randomisés (ECR) ou les méta-analyses rapportant l'efficacité d'une intervention pluridisciplinaire dans les RIC ou dans d'autres maladies chroniques. Deux enquêtes en ligne ont été adressées à tous les services de rhumatologie en France et à un échantillon de rhumatologues libéraux comprenant respectivement 34 et 19 questions. Ces questionnaires permettaient de déterminer le profil du centre/rhumatologue répondeur, l'existence d'une EGSS et les freins ou les éléments facilitateurs à sa mise en place. Résultats > La recherche bibliographique a identifié 872 articles dont 24 ont finalement été inclus :16 ECR et 8 méta-analyses. Seuls 3 articles concernaient les RIC dont une méta-analyse combinant 10 ECR et 2 études d'extension dans la polyarthrite rhumatoïde (PR). Parmi ces 3 études, 2 ECR dans le lupus systémique et la sclérodermie systémique ont montré un impact favorable d'une approche multidisciplinaire respectivement sur le SLEDAI et la force de préhension et l'ouverture buccale tandis que la méta-analyse dans la PR n'a pas démontré de bénéfice sur l'amélioration du handicap ou sur l'activité de la maladie. Une réponse au questionnaire a été obtenue pour 72 centres et 186 rhumatologues. Un tiers des centres avaient déjà mis en place une EGSS au cours d'une HDJ. Soixante-dix pour cent des centres estimaient prendre en charge > 10 patients par mois en y consacrant en moyenne 35 minutes de temps-rhumatologue et 90 minutes de temps cumulé pour tous les autres professionnels de santé (PDS) participants au programme. Les PDS impliqués étaient majoritairement l'infirmier (92 %), le diététicien (56 %) et le kinésithérapeute (56 %). Les principaux freins à la mise en place d'une EGSS étaient l'absence de ressources paramédicales suffisantes, le manque de valorisation économique et l'absence d'adhésion des rhumatologues traitants tandis que la motivation des patients ressortait plutôt comme un élément facilitateur.Conclusion > Bien que la réalisation d'une EGSS soit recommandée par les sociétés savantes, les preuves de leur efficacité dans les RIC sont minces. De plus, seuls 36 % des centres répondeurs ont mis en place un tel programme. Cette enquête permet de soulever les freins et les éléments facilitateurs afin de trouver des solutions pour étendre cette pratique
Impact of farming practices on soil microbial biomass: An international synthesis
No full textInternational audienceAgricultural intensification during the 20th century has profoundly altered soil ecosystems, underscoring the urgent need for sustainable practices enhancing soil quality. Soil microbial biomass is a key indicator of soil quality, reflecting both biological and ecosystem resilience. However, existing studies often focus on specific practices or regions, limiting their applicability to diverse farming systems. This study synthesizes data from 280 scientific publications selected through the Web of Science database, covering a wide geographical range, to evaluate the effects of the main agronomic levers, i.e. tillage, fertilization, crop rotation diversity including inter-cropping, and pesticide use on soil microbial biomass. Statistical analyses revealed that soil microbial biomass is generally promoted by organic fertilization (+64 % to +76 %), reduced tillage (+32 % to +41 %) and increased crop diversity (+10 % to +47 %), while mineral fertilization shows more modest effects (+7 % to +35 %). These results comply with the “carrying capacity” and “ecological habitat” concepts for soil microorganisms: farming practices affect soil microbial biomass either directly through resources availability or survival, and indirectly by changing the soil physical and chemical properties, i.e. habitat properties and growth conditions. By integrating findings from this extensive dataset, this work significantly expands the current understandings of how agricultural practices influence soil microbial biomass. It emphasizes the operational potential of soil microbial biomass as a practical, unifying indicator for assessing the impact of farming strategies on soil quality. Moreover, this study provides actionable insights to support sustainable land management and aligns international soil monitoring initiatives, including the European Directive on soil monitoring and resilience and its national implementations
Ambivalences de l'action littéraire féministe : de la reconnaissance au soin, au risque de l'agression
No full textNational audienceAu cours des années 1969-1985, en France mais aussi au Québec et dans d’autres pays de la francophonie, le mouvement des femmes, comme la lutte pour les droits des personnes homosexuelles, trouvent dans la littérature un terrain d’exercice singulier. Les pensées et pratiques de l’engagement littéraire d’héritage existentialiste s’y renouvellent, donnant lieu à d’inédites théories politiques de la littérature. Leur trait interpellatif est particulièrement renforcé : les autrices interpellent leurs lectrices et lecteurs pour les pousser à une prise de conscience ou à une révolte ; elles s'adressent les unes aux autres dans une démarche de recherche de reconnaissance littéraire et politique. Cela implique un risque spécifique de l’écriture féministe, à la fois en raison de la nature de ce qu’elle dénonce et en raison du public auquel elle s’adresse : comment, en discutant de l’expérience intime de la violence, s'engager sans risquer d'aller trop loin, et de blesser ? Comment assumer de “dévoiler“ pour dénoncer le patriarcat, si c'est prendre le risque de mettre à nu ses victimes ? Quelles ressources sont mobilisées pour prendre soin du lectorat, lorsque le risque de l'agression est inhérent à la démarche d'écriture elle-même
A modeling framework for biodiversity assessment in renewable energy development: A case study on European bats and wind turbines
No full textInternational audienceCombining renewable energy planning and biodiversity conservation is urgently needed to address the interconnected climate change and biodiversity loss crisis and meet the United Nation's Sustainable Development Goals 7, 13, and 15. However, in many countries such as France, current strategies to limit the negative effects of renewable energy on biodiversity still hold major limitations during the planning process that could be overcome with modeling approaches. Here we propose a new modeling-based framework which aims to determine potential threats posed by projects to biodiversity. By capitalizing on large-scale standardized citizen science biodiversity data to create biodiversity benchmarks, this approach aims to better inform the Ecological Impact Assessment (EIA) process at different stages pre-and post-project construction. We demonstrate the practical application of the framework using bats and onshore wind energy development in France as a case study. We reveal that current approaches in renewable energy planning in France failed to identify sites of biodiversity significance with >90 % of wind turbines approved for construction to be placed in sites of high significance for bats. The risks posed by future wind turbines to bats concern all taxa (all protected in the EU), including species with higher collision risks. We highlight how the proposed modeling-based framework could contribute to a more objective evaluation of pre-and post-construction impacts on biodiversity and become a prevalent component of the EIA process. Its implementation could promote a more biodiversity-friendly approach to renewable energy planning, aligning with the Global Biodiversity Framework's target of halting biodiversity loss by 2030.</div
A DNA sensor based on CbAgo effector protein and on a dual electrochemical signal amplification strategy for B19 parvovirus detection
No full textInternational audienceHuman parvovirus B19 is a prevalent childhood infectious virus that poses a great challenge to public health, so the detection of B19V is of great importance. In this study, a DNA sensor based on CbAgo, a Cas effector, and a dual electrochemical signal amplification strategy was developed by using a novel nanocomposite MnO2/CMK-3/g-C3N4/AgNPs for initial signal amplification, with CMK being an ordered mesoporous carbon nanomaterial. Single-walled carbon nanotubes (SWCNTs) were used as electrocatalytic probes for secondary signal amplification to detect B19 DNA. The detection process begins with polymerase chain reaction (PCR) amplification using the B19V infectious clone plasmid (pB19-M20) as a template and NS1-F/R as primers, followed by specific cleavage of B19 DNA based on the programmable cutting sites of CbAgo effector protein. This study enriches the application of Argonaute proteins in sensing and introduces a novel method to detect B19V. Under optimized conditions, the biosensor can detect B19 DNA in the range of 10−15–10−10 M, with a detection limit (LOD) of 0.2 fM. The results indicate that the developed DNA sensor holds promise for reliable and sensitive detection of B19 DNA in human serum
On curve-flat Lipschitz functions and their linearizations
No full text37 pagesInternational audienceWe show that several operator ideals coincide when intersected with the class of linearizations of Lipschitz maps. In particular, we show that the linearization of a Lipschitz map is Dunford-Pettis if and only if it is Radon-Nikod\'ym if and only if it does not fix any copy of . We also identify and study the corresponding metric property of , which is a natural extension of the curve-flatness introduced in [arXiv:2103.09370]. Further, we show that is compact if and only if it does not fix any copy of
Nose-to-brain delivery of DHA-loaded nanoemulsions: A promising approach against Alzheimer’s disease
No full textInternational audienceReduced docosahexaenoic acid (DHA) concentrations seem to be associated with an increased risk of Alzheimer's disease (AD), and DHA accretion to the brain across the blood-brain-barrier (BBB) can be modulated by various factors. Therefore, there is an urgent need to identify an efficient and non-invasive method to ensure brain DHA enrichment. In the present study, a safe and stable DHA-enriched nanoemulsion, designed to protect DHA against oxidation, was designed and administered intranasally in a transgenic mouse model of AD, the J20 mice.Intranasal treatment with nanoformulated DHA significantly improved well-being and working spatial memory in six-months-old J20 mice. These behavioral effects were associated with a reduction of amyloid deposition, oxidative stress, and neuroinflammation in brain tissues, which may be partially due to DHA-induced inactivation of the pleiotropic kinase GSK3β.In conclusion, intranasal DHA administration exhibited strong therapeutic effects and disease-modifying benefits in the J20 AD model. Given that DHA has already shown safety and tolerability in healthy human subjects, our results further support the need for clinical trials to assess the potential of this approach in Alzheimer's patients.</p
Le sanctuaire du dieu Cobannus / Couan, commune de Saint-Aubin-des-Chaumes (Nièvre). Opération de fouille programmée pluriannuelle (2024-2026). Rapport de première année - 2024
No full textEn 2024, la campagne de terrain a eu pour objectif l’exploration de la partie sud du complexe, en particulier du fossé délimitant l’espace sacré à l’époque gauloise et au début de l’époque romaine. Le temple maçonné, partiellement étudié en 2019, a été entièrement dégagé pour permettre l’examen des structures hydrauliques implantées dans la cella mais également les vestiges de sa spoliation à la fin du IVe siècle.Le secteur fouillé était très arasé par les labours, les structures les plus méridionales apparaissant à seulement une quinzaine de centimètres sous le couvert végétal. Les zones explorées sont toutefois représentatives des 10 phases d’aménagement successives du sanctuaire. Dans le détail, la branche est du fossé a révélé la présence d’un système de franchissement de la fin de La Tène D, sous les fondations de l’autel julio-claudien, ainsi qu’un système de porche ou de palissade sous le mur du péribole oriental. L’un des faits marquants de cette campagne est la fouille de la quasi-totalité du fossé sud. La dynamique de comblement est très différente de celle observée au nord, avec une absence de recurage et plutôt un remplissage naturel avant une obturation totale au Haut-Empire. Contrairement à ce qui avait été observé sur les flancs nord et est, aucune construction annexe n’est apparue en dehors d’une petite pièce contiguë au mur de péribole. Une voie a cependant été dégagée, permettant de contourner le complexe par le sud. Une fosse isolée à l’extérieur de l’espace sacré, tout au sud de la voie, a livré une céramique complète mais fragmentée portant un graffito, particulièrement notable, commémorant le don d’un fidèle à la divinité Cobannus.Malgré, une stratigraphie très limitée par l’érosion, ces travaux ont malgré tout permis d’obtenir un certain nombre de résultats, concernant l’évolution du site depuis sa fondation jusqu’à son abandon, son organisation interne ainsi que son programme décoratif. Retenons en particulier la mise en évidence des structures précoces (trous de poteau du bâtiment cultuel, système de pont, palissade), liées à la fondation du sanctuaire laténien et augusto-tibérien (phase 1 et 2). Le dernier état, daté de la seconde moitié du IVe siècle, se caractérise par des spoliations importantes, notamment au cœur de la cella où la structure profonde a été complètement démantelée, rendant sa restitution difficile, et comblée avec les ruines du temple qui n’ont pas été récupérées
Distributional regression with reject option
No full textSelective prediction, where a model has the option to abstain from making a decision, is crucial for machine learning applications in which mistakes are costly. In this work, we focus on distributional regression and introduce a framework that enables the model to abstain from estimation in situations of high uncertainty. We refer to this approach as distributional regression with reject option, inspired by similar concepts in classification and regression with reject option. We study the scenario where the rejection rate is fixed. We derive a closed-form expression for the optimal rule, which relies on thresholding the entropy function of the Continuous Ranked Probability Score (CRPS). We propose a semi-supervised estimation procedure for the optimal rule, using two datasets: the first, labeled, is used to estimate both the conditional distribution function and the entropy function of the CRPS, while the second, unlabeled, is employed to calibrate the desired rejection rate. Notably, the control of the rejection rate is distribution-free. Under mild conditions, we show that our procedure is asymptotically as effective as the optimal rule, both in terms of error rate and rejection rate. Additionally, we establish rates of convergence for our approach based on distributional k-nearest neighbor. A numerical analysis on real-world datasets demonstrates the strong performance of our procedur
A cometary Fluorescence Model for the ν3 Vibrational Band of Cyanogen
No full textInternational audienceCyanogen (C2N2) is suspected for a long time to be present in comets and to contribute to the creation of CN radical. So far no observations with ground-based facilities managed to detect this species but the Rosetta mission, thanks to in situ observations with the ROSINA mass spectrometer detected this species in the coma of 67P/Churyumov-Gerasimenko. To investigate its presence from infrared spectra in other comets, we developed a fluorescence model for the ν3 fundamental band. From new laboratory high-resolution infrared spectra of cyanogen, we analyzed the region of the ν3 band of C2N2, centered around 4.63 μm (2158 cm−1). In addition to line positions and intensities, molecular parameters for the ground and excited vibrational state were obtained. These parameters allowed us to develop a fluorescence model for cyanogen. Excitation rates of the ν3 band of cyanogen in cometary comae are presented. An attempt to detect cyanogen in a high-resolution spectrum of comet C/2022 E3 (ZTF) is discussed