HAL Université de Tours
Not a member yet
55851 research outputs found
Sort by
Universality of discontinuous bifurcations in collisionless dynamics
No full textInternational audienceWe investigate the universality in collisionless nonlinear dynamics of a codimension-two bifurcation where two eigenvalues collide at the origin, and two lines of continuous bifurcation and discontinuous jump meet. Through linear analysis and direct numerical simulations, we show that this bifurcation does occur, both for two-dimensional shear flows and for repulsive systems mimicking plasmas
Evolution of Cognitive and Socio-Emotional Skills in an older Woman with Autism Spectrum Disorders and Severe Intellectual Disability Receiving Individualized Support Based on the CHIPPS Program: A Clinical Case Report
No full textInternational audienceOlder adults with autism spectrum disorders (ASD) and severe intellectual disability (ID) require constant and regularly updated relational, social, and healthy support. This paper presents the evolution of cognitive and socio-emotional abilities in a 69-year-old female patient with this dual diagnosis (associated with epilepsy) who benefited from a personalized psycho-educative program.The program, which includes cognitive and social remediation sessions and daily individual coaching to promote personal autonomy, was implemented daily for two years (15 hours per week). Cognitive and socio-emotional development was assessed using the Social Cognitive Evaluation Battery adapted for Adults (SCEB-A) at intervention commencement (Time 1) and completion (Time 2; 24 months).An increase in abilities was noted in all cognitive and socio-emotional domains.Older individuals with ASD, severe ID, and epilepsy can make progress in cognitive and socio-emotional functioning through the regular application of a psycho-educative program. However, this study is limited due to the inclusion of a single participant, and thus, the results cannot be generalized to older adults with ASD and severe ID
Patients and relatives’ point of view on the choice of outcomes for a randomized-controlled trial in moderate-to-severe Traumatic Brain Injury
No full textInternational audienc
Data science for insurance fraud detection: a review
No full textInternational audienceThe chapter 'Data Science for Insurance Fraud Detection: A Review' delves into the application of data science and machine learning techniques to combat insurance fraud. It begins by discussing the significance of insurance fraud and its impact on the industry, followed by an overview of the historical development of fraud detection methods. The chapter then categorizes fraud detection techniques into unsupervised, supervised, and social network learning approaches, each with its unique advantages and challenges. Notably, the text emphasizes the importance of cost-sensitive learning to address the rarity and high cost of fraudulent claims effectively. The chapter also includes an empirical illustration, demonstrating the superior performance of advanced machine learning models compared to traditional econometric methods in both statistical and financial terms. Throughout, the text highlights the evolving nature of fraud and the need for adaptive, real-time fraud detection systems. This comprehensive review offers valuable insights for professionals seeking to enhance their fraud detection strategies, making it a must-read for those in the insurance and risk management sectors
Femmes et pouvoir au Grand Siècle : de la société ecclésiastique à la société mondaine et littéraire
No full textInternational audienc
Automated DWI-FLAIR mismatch assessment in stroke using DWI only
No full textInternational audienceIn Acute Ischemic Stroke (AIS), mismatch between Diffusion-Weighted Imaging (DWI) and Fluid-Attenuated Inversion-Recovery (FLAIR) helps identify patients who can benefit from thrombolysis when stroke onset time is unknown (15% of AIS). However, visual assessment has suboptimal observer agreement. Our study aims to develop and validate a Deep-Learning model for predicting DWI-FLAIR mismatch using solely DWI data. This retrospective study included AIS patients from ETIS registry (derivation cohort, 2018-2024) and WAKE-UP trial (validation cohort, 2012-2017). DWI-FLAIR mismatch was rated visually. We trained a model to predict manually-labeled FLAIR visible areas (FVA) matching the DWI lesion on baseline and early follow-up MRIs, using only DWI as input. FVA-index was defined as the volume of predicted regions. Area under the ROC curve (AUC) and optimal FVA-index cutoff to predict DWI-FLAIR mismatch in the derivation cohort were computed. Validation was performed using baseline MRIs of the validation cohort. The derivation cohort included 3605 MRIs in 2922 patients and the validation cohort 844 MRIs in 844 patients. FVA-index demonstrated strong predictive value for DWI-FLAIR mismatch in baseline MRIs from the derivation (n = 2453, AUC = 0.85, 95%CI: 0.84-0.87) and validation cohort (n = 844, AUC = 0.86, 95%CI: 0.84-0.89). With an optimal FVA-index cutoff at 0.5, we obtained a kappa of 0.54 (95%CI: 0.48-0.59), 70% sensitivity (378/537, 95%CI: 66-74%) and 88% specificity (269/307, 95%CI: 83-91%) in the validation cohort. The model accurately predicts DWI-FLAIR mismatch in AIS patients with unknown stroke onset. It could aid readers when visual rating is challenging, or FLAIR unavailable
Association between mycophenolic acid treatment and infection with specific strains of Pneumocystis jirovecii in solid organ transplant recipients in France and Switzerland: a multicentre, retrospective, cross-sectional study
No full textInternational audienceBackground: Pneumocystis pneumonia (PCP) case clusters involving solid organ transplant (SOT) recipients have been reported worldwide. Mycophenolic acid, an immunosuppressant used to prevent rejection in SOT recipients that targets the inosine 5 ′ -monophosphate dehydrogenase (IMPDH) protein, has been hypothesised to exert selective pressure on Pneumocystis jirovecii, with the missense mutation G1020A (Ala261Thr) in the impdh gene a possible marker of such selective pressure. The aim of this study was to test the hypothesis that SOT recipients harbour P jirovecii with mutations in the impdh gene and are infected with specific P jirovecii strains.Methods: In this retrospective, multicentre, cross-sectional study of nationally representative, individual-level data, we included SOT recipients, regardless of the organ transplanted, involved or not in a PCP case cluster, and non-SOT recipients (control group) without mycophenolic acid exposure, diagnosed with PCP from 26 French and one Swiss secondary health-care centres. We included patients aged 18 years or older for whom archival P jirovecii DNA extracts were available in sufficient quantity and quality. P jirovecii specimens were characterised using a multilocus sequence typing method including impdh gene analysis. The primary outcome of this study was the detection of the G1020A (Ala261Thr) mutation in the impdh gene. A multivariable logistic regression was done to assess the relation between this mutation and the following variables retrieved from medical records: age, mycophenolic acid exposure at the time of PCP diagnosis, involvement in a PCP case cluster, PCP prophylaxis, and clinical outcome.Findings: 58 SOT recipients (44 treated with mycophenolic acid) and 59 non-SOT recipients (control group; not treated with mycophenolic acid) diagnosed with PCP between Jan 1, 2001, and Dec 31, 2021, were enrolled. The G1020A (Ala261Thr) mutation was detected in P jirovecii specimens from 40 (68⋅9%) SOT recipients (37 treated with mycophenolic acid) and in none of the P jirovecii specimens from the patients in the control group. The multivariable analysis showed that the allele characterised by the G1020A mutation was associated with mycophenolic acid exposure at the time of PCP diagnosis (adjusted odds ratio 73⋅61 [95% CI 17⋅41-455⋅70]; p<0⋅0001) and involvement in a PCP case cluster (12⋅77 [1⋅58-171⋅90]; p=0⋅029), whereas it was not associated with age, PCP prophylaxis, and clinical deterioration. A second missense mutation, G1020T (Ala261Ser) was identified in P jirovecii specimens from three SOT recipients (two treated with mycophenolic acid). Two specific multilocus genotypes (MLG-31 and MLG-34) of P jirovecii associated with Ala261Thr and Ala261Ser substitutions in IMPDH, respectively, were detected only in SOT recipients (38 patients with MLG-31 and three patients with MLG-34).Interpretation SOT recipients in this study were primarily infected with specific P jirovecii strains with mutations in the impdh gene, which might confer a selective advantage as both the G1020A (Ala261Thr) and G1020T (Ala261Ser) are associated with mycophenolic acid resistance in other fungi. Mycophenolic acid selective pressure might explain the maintenance and circulation of these P jirovecii strains within this patient population, and consequently their potential involvement in PCP case clusters
Les diplomaties euro-africaines au tournant des indépendances
No full textInternational audienceComment passer d’un rapport impérial, fortement polarisé par une métropole, à des relations plus équilibrées, qui s’inscrivent dans un cadre associant des diplomaties bilatérales et multilatérales ? La question se pose aux États africains nouvellement indépendants. Croisant une histoire des relations internationales et une histoire sociale du politique, ce livre explore les reconfigurations des diplomaties euro-africaines, alors que le continent s’insère dans un système international dominé par les enjeux de Guerre froide et reconfiguré par l’arrivée des pays du Tiers-Monde.La boîte à outils de l’historien permet d’envisager cette vaste question de manière empirique. Fruit d’une collaboration entre les Archives diplomatiques et Nantes Université, l’ouvrage dresse un état des lieux des fonds diplomatiques français concernant l’Afrique au tournant des indépendances. Le dialogue entre archivistes et historiens met en lumière la richesse de ces archives et nourrit une réflexion méthodologique quant à leur interprétation.L’ouvrage examine la combinaison de continuités et de ruptures qui caractérise la décolonisation des relations entre Europe et Afrique. Aux Nations Unies, les États africains doivent prendre en compte les antagonismes de la Guerre froide, et tentent de renforcer leur place par des regroupements continentaux (panafricanisme) ou transcontinentaux (non-alignement, afro-asiatisme). L’ouvrage interroge aussi les notions d’aide et de développement – idéaux centraux de l’après-guerre – qui structurent les ambivalences des relations euro-africaines
Disability, recruitment and job retention: Identifying barriers and facilitators from the employers’ point of view
No full textInternational audienceBACKGROUND: Despite increased public awareness of the professional, integration of people with disabilities, they encounter more difficulties than their non-disabled counterparts in accessing employment. OBJECTIVE: The aim of this study was to gain a better understanding of the barriers and facilitators to hiring and retaining people with disabilities from the perspective of employers in the private and public sector in France. METHODS: This was a qualitative study using semi-structured interviews with forty-two employers from public structures or private companies. The Consolidated Criteria for Reporting Qualitative Research was used as a guideline to secure accurate and complete reporting of the study. RESULTS: Among barriers we found that 1. Stereotypes persist about disability, still associated with lower productivity and dangerous behaviour; 2. Disabilities were associated with costs that were considered too high; 3. Disabilities management was seen as an administrative burden. 4. The bumps of inclusion. We also highlighted facilitators such as 1. A public sector is a more favourable environment 2. Employer’s personal motivation to hire people with disabilities; 3. The support by Job Coaches was seen as a powerful facilitator. CONCLUSIONS: The decision to hire people with disabilities depends on many personal, societal and organisational factors. This study has contributed to a better understanding of their interrelationships and could be useful in developing more effective strategies for the inclusion of people with disabilities
Mind wandering and its relationship with sustained attention and executive functions in preschoolers
No full textInternational audienceMind wandering (MW) is a phenomenon that has been largely described in adults, during which thoughts do not stay on the current tasks or goals. Considering its negative impact on educational outcomes, measuring and understanding MW in children is essential. MW has been associated with attentional and executive performance in children above 8 years old. Given the huge changes in attention and executive functions organization before 6 years old, our study aimed at exploring how mind wandering interacts with these processes in preschoolers.Sixty children aged 4 to 6 years old were asked to evaluate their mind wandering propensity in the classroom using an adapted daydreaming questionnaire. They were also administered neuropsychological tests and questionnaires evaluating sustained attention, processing speed, cognitive flexibility, inhibition and a selection of individual traits.Preschoolers’ self-evaluation strongly correlated with their teacher’s evaluation, showing the feasibility of assessing MW in young children. The MW scores also correlated with the children’s performance in several tests assessing sustained attention, processing speed, cognitive flexibility and inhibition, as well as some individual traits. A latent variable modeling revealed that MW is best modeled by a latent factor independent from attention, speed and inhibition, but highly correlated with attention.Our results thus reveal the central role of attention in child development, suggesting that mind wandering in preschoolers could be linked to attention immaturity