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Standardized Outcomes for Randomized Controlled Trials Targeting Early Interventions in Patients With Moderate-to-Severe Traumatic Brain Injury: Protocol for the Development of a Core Outcome Set
No full textInternational audienceWith more than 60 million new cases around the world each year, traumatic brain injury (TBI) causes substantial mortality and morbidity. Managing TBI is a major human, social, and economic concern. In the last 20 years, there has been an increase in clinical trials in neurocritical care, leading mostly to negative results. The evaluation of neurological outcomes, predominantly as primary outcomes, using clinical scales (Glasgow Outcome Scale) has limitations that could explain these results. Moreover, patient-centered outcomes are seldom reported despite their recognized clinical relevance. : The aim of this project is to establish a core outcome set (COS) for patients with moderate-to-severe TBI in randomized control trials in neurocritical care research. This study will follow five distinct steps: (1) systematic review to identify outcomes that have been reported in trials; (2) semistructured interviews with patients and their families to identify their priorities after TBI and explore potential patient-centered outcomes; (3) health care stakeholder focus groups with clinicians, researchers, and policy makers to describe potential outcomes; (4) an eDelphi survey with stakeholder groups to make a list of previously identified core outcomes; and (5) a consensus workshop to establish a COS for moderate-to-severe TBI clinical trials. : The systematic review was published in August 2024. Regarding Step 2, 30 semistructured interviews of patients and relatives were performed from July 2021 to December 2023, and analyses were completed in October 2024. Step 3 is currently under development, and Step 4 is planned for the end of 2025. Step 5 is expected to occur during fall/winter 2026. Conclusions: Establishing a COS, to be consistently measured and reported in TBI trials in neurocritical care will ensure rigorous reporting, avoid bias, and improve the integrity, transparency, and usability of clinical research. The French context of the study is the main limitation, but we are seeking international collaboration on the project. The results of each step of the project will be disseminated through abstracts, publications, and patient associations. Establishing a COS, to be consistently measured and reported in TBI trials in neurocritical care will ensure rigorous reporting, avoid bias, and improve the integrity, transparency, and usability of clinical research. The French context of the study is the main limitation, but we are seeking international collaboration on the project. The results of each step of the project will be disseminated through abstracts, publications, and patient associations. DERR1-10.2196/54525
Forecasting extreme trajectories using seminorm representations
No full textFor (X t ) a two-sided α-stable moving average, this paper studies the conditional distribution of future paths given a piece of observed trajectory when the process is far from its central values. Under this framework, vectors of the form X t = (X t-m , . . . , X t , X t+1 , . . . , X t+h ), m ≥ 0, h ≥ 1, are multivariate αstable and the dependence between the past and future components is encoded in their spectral measures.A new representation of stable random vectors on unit cylinders sets {s ∈ R m+h+1 : ∥s∥ = 1} for ∥ • ∥ an adequate seminorm is proposed to describe the tail behaviour of vectors X t when only the first m + 1 components are assumed to be observed and large in norm. Not all stable vectors admit such a representation and (X t ) will have to be "anticipative enough" for X t to admit one. The conditional distribution of future paths can then be explicitly derived using the regularly varying tails property of stable vectors and has a natural interpretation in terms of pattern identification. Through Monte Carlo simulations we develop procedures to forecast crash probabilities and crash dates and demonstrate their finite sample performances. As an empirical illustration, we estimate probabilities and reversal dates of El Niño and La Niña occurrences.</div
Rebuts dans l’espace méditerranéen: Flux, pratiques et contestations
No full textCe numéro 37 des Cahiers d’EMAM est le prolongement, l’élargissement, mais aussi l’enrichissement d’une réflexion initiée lors du panel « Rebuts, récupération et réparation : usages et pratiques économiques dans les villes arabes », qui s’est tenu à l’occasion du 5e Congrès du GIS Moyen-Orient et Mondes musulmans, en juillet 2023. Les lecteurs·trices pourront y découvrir sept articles de chercheur·euses géographes, sociologues et anthropologues, mais aussi trois longs résumés de thèses rédigés spécifiquement pour cette publication [Joëlle Abou Issa, Ines Naimi, Diane Robert]. Toutes ces contributions ont pour point commun d’appréhender les rebuts comme une entrée privilégiée pour saisir les enjeux socio-économiques, politiques et environnementaux qui témoignent des inégalités et des injustices qui structurent les sociétés de la région.Une partie de ces contributions s’intéresse à la structuration de ces économies du déchet, aux mondes sociaux de la récupération et du recyclage, aux réseaux d’acteurs qui les animent, et aux espaces urbains dans lesquels elles s’inscrivent et qu’elles contribuent à reconfigurer. D’autres contributions montrent comment les économies du rebut participent à façonner des subjectivités politiques émergentes et situées, en mettant l’accent sur les injustices environnementales et sociales liées aux déchets et à leurs effets nuisibles, voire toxiques. Elles révèlent ainsi comment la circulation de ces matières et leur gestion politique, souvent délétère, affectent les milieux de vie locaux et suscitent des formes de mobilisation, de dénonciation, voire de contestation, autour des inégalités et des violences environnementales que produisent ces circulations et politiques.Enfin, les conflits de ces dernières décennies qui ont marqué la région moyen-orientale (Irak, Syrie, Liban, Yémen et, bien sûr, Gaza) ont laissé ruines, pollutions toxiques, munitions non explosées et innombrables déchets de toutes sortes. Si les violences sociales et environnementales héritées de ces « rebuts de guerre » ne sont pas abordées dans ce Cahier, elles nous obligent, en tant que chercheur·euses, à les intégrer à nos réflexions futures
Contemporary management of patients with native mitral regurgitation in heart valve centres
No full textInternational audienceBackground: Despite a key role in the latest guidelines, the screening process of patients with mitral regurgitation (MR) referred to Heart Valve Centres (HVCs) remains unexplored.Aims: To investigate characteristics, management and outcomes of patients with native MR referred to HVCs.Methods: Between January 2017 and May 2021, all patients with MR referred to seven French HVCs for medico-surgical evaluation were included. Individual management was left to the local interdisciplinary HVC. Patients eligible to mitral valve (MV) intervention were compared with those deemed ineligible and left on medical therapy. The primary endpoint was 2-year all-cause mortality.Results: After exclusion for treatment refusal or non-MV surgery, a total of 823 patients were analysed: 662 eligible versus 161 ineligible to MV intervention. Among the 662 eligible patients, 382 (57.7%) underwent transcatheter edge-to-edge repair, 215 (32.5%) MV surgery, 40 (6.0%) transcatheter MV replacement and 25 (3.8%) were either on the waiting list at the end of follow-up (n=12) or had died before intervention (n=13). Ineligible patients had higher surgical risk scores (median EuroSCORE II 4.2% vs. 3.3%; P=0.003; median Society of Thoracic Surgeons mortality risk score 4.3% vs. 3.5%; P=0.023) and more advanced left ventricular (LV) impairment (mean LV ejection fraction 49.7% vs. 56.6%; P<0.001). At 2years, all-cause mortality was significantly higher in ineligible versus eligible patients (36.3% vs. 18.0%; P<0.0001). After multivariable adjustment, HVC-defined eligibility for MV intervention was associated with lower 2-year mortality (hazard ratio: 0.54, 95% confidence interval: 0.35-0.84; P=0.006).Conclusion: HVC interdisciplinary evaluation of severe native MR results in MV intervention in most cases. Eligibility for MV intervention was associated with lower risk of 2-year mortality
Enquêter à distance : une voie pour gérer la charge émotionnelle face aux récits de violences en terrain d’enquête ?
No full textInternational audienc
Nature d’une décision sur le départ volontaire, CJUE, 1er août 2025, aff. C-636/23 et C-637/23, Al Hoceima et Boghni
No full textInternational audienceUne décision sur le départ volontaire n’est pas une simple mesure d’exécution d’une décision de retour. Une décision sur l’octroi d’un délai de départ volontaire doit être susceptible de recour
Transports-Autorités de contrôle de sûreté, CJUE, 10 juill. 2025, aff. C-783/23, Liège Airport Security SA
No full textInternational audienceLes États ne sont pas tenus de confier à une seule autorité nationale toutes les responsabilités en matière de sûreté de l’aviation civile. La coordination et la surveillance de la mise en œuvre des normes de base commune doivent relever de l’autorité de contrôle désigné
Immigration - Aide à l’entrée irrégulière et responsabilité familiale , CJUE Grde. Ch., 3juin 2025, aff. C-460/23, Kinsa
No full textInternational audienceLe comportement d’une personne qui fait entrer irrégulièrement sur le territoire d’un État membre des mineurs ressortissants de pays tiers qui l’accompagnent et à l’égard desquels elle exerce la garde effective ne saurait relever de l’infraction générale d’aide à l’entrée irrégulière. Les droits de l’enfant et le régime de l’asile commandent la définition de l’incrimination d’aide à l’entrée irrégulièr