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Selective reflection Casimir-Polder spectroscopy in vapor cells: The influence of the thermal velocity distribution
No full textInternational audienc
Les « doubles suivis » comme situations frontières [synthèse du rapport de recherche]: Pratiques professionnelles et différenciations sociales des jeunes suivis par l'ASE et la PJJ
No full textEvidence Use at the Regional Health Agency of Ile‐de‐France: Analysis of Practices, Obstacles, and Needs
No full textInternational audienceABSTRACT Professionals and decision‐makers in regional or local administrations often face time and resource constraints that hinder evidence‐based decision‐making. This article examines the practices, obstacles, and needs relating to evidence use within the Regional Health Agency of Ile‐de‐France, a decentralized agency of the French Ministry of Health and Access to Care. We used a mixed‐methods action research approach, including an online questionnaire completed by 60 agents. In addition, we conducted 27 semi‐structured interviews with certain staff members. We also conducted an exploratory group interview with three documentalists. The results of the structural equation models show that agents' skills in accessing evidence, institutional support and being a project leader were correlated with evidence use in decision‐making 89% ( p = 0.009), 35% ( p < 0.001), and 48% ( p = 0.031) respectively. Respondents reported having skills in identifying and accessing experiential (84.1%, p = 0.007), contextual (84.8%, p = 0.002), and scientific (73.6%, p = 0.486) knowledge. In addition, 79.5% ( p = 0.274) of respondents stated they felt competent in assessing the reliability and relevance of evidence to inform their decision‐making. Although the quantitative results show that respondents generally declared moderate to moderately high levels of competence in accessing and assessing the quality and reliability of evidence, the qualitative analysis highlights partial discrepancies. Several agents mentioned lacking the necessary skills to access and evaluate evidence effectively. This discrepancy can be explained by several factors, including a subjective overestimation of respondents' ‘competence’ in the closed‐ended questionnaires, resulting in an overall positive self‐perception, as well as obstacles to identifying and accessing scientific knowledge (language barrier), difficulties in accessing paid scientific journals, lack of time on the part of agents, and work overload. These findings highlight a disconnect between agents' perceived competence and actual capabilities in accessing and evaluating evidence. It is therefore essential to go beyond simple self‐reported measurement by using mixed‐method approaches to understand better the complexity of the factors that influence the use of evidence in decision‐making in public health agencies. Building an evidence ecosystem in decentralized organizations could lead to better‐informed policies, reduced social inequality in health, and improved resource allocation.Resumen: Los profesionales y responsables de la toma de decisiones en las administraciones regionales o locales a menudo se enfrentan a limitaciones de tiempo y recursos que dificultan la toma de decisiones basada en la evidencia. Este artículo examina las prácticas, los obstáculos y las necesidades relacionadas con el uso de la evidencia en la Agencia Regional de Salud de Île‐de‐France, un organismo descentralizado del Ministerio de Salud y Acceso a la Atención de Francia. Se empleó un enfoque de investigación‐acción con métodos mixtos, que incluyó un cuestionario en línea completado por 60 agentes. Además, se realizaron 27 entrevistas semiestructuradas con algunos miembros del personal. También se realizó una entrevista grupal exploratoria con tres documentalistas. Los resultados mostraron que las variables relacionadas con el acceso a la evidencia —específicamente, las habilidades para identificar el conocimiento experiencial (p = 0,007) y el conocimiento contextual (p = 0,002)— se asociaron significativamente con el uso de la evidencia en la toma de decisiones. El uso de la evidencia también se correlacionó con el cargo desempeñado (48%, p = 0,031), el apoyo institucional (35%, p < 0,001) y las habilidades de acceso a datos (89%, p = 0,009). Se identificaron varios obstáculos para el uso de datos, y en especial del conocimiento científico. Estos incluyen la falta de competencias para acceder y evaluar la fiabilidad y la relevancia del conocimiento científico; el desconocimiento del inglés (idioma predominante en la investigación); la escasa visibilidad de los recursos disponibles (bases de datos, suscripciones a revistas, etc.); la falta de tiempo; la sobrecarga de trabajo; y la falta de cultura organizacional y apoyo. La creación de un ecosistema de evidencia en organizaciones descentralizadas podría generar políticas mejor fundamentadas, contribuyendo así a la reducción de la desigualdad social en salud y a una mejor asignación de recursos
OPTIMAL HAMILTON-TYPE GRADIENT ESTIMATES FOR THE HEAT EQUATION ON NONCOMPACT MANIFOLDS
No full textWe derive localized and global noncompact versions of Hamilton's gradient estimate for positive solutions to the heat equation on Riemannian manifolds with Ricci curvature bounded below. Our estimates are essentially optimal and significantly improve on all previous estimates of this type. As applications, we derive a new and sharp, space only, local pseudo-Harnack inequality, as well as estimates of the spatial modulus of continuity of solutions
Biohybrid microstructured hydrogels obtained via in situ extracellular matrix deposition and decellularization using supercritical CO<sub>2</sub>
No full textInternational audienceIn recent decades, our understanding of biomaterials has shifted from seeing them simply as physical supports for cells or drug delivery platforms to recognizing their active and dynamic role in tissue repair, guided by their physicochemical, mechanical, and biological properties. Biologically derived materials such as the decellularized extracellular matrix (dECM) offer the advantage of replicating the biomolecular cellular environment and have been proposed for tissue regeneration. However, their use as scaffolds is hindered by poor mechanical properties and limited tunability of physical features. Herein, we fabricated a bioinspired hybrid hydrogel by integrating a chemically cross-linked microporous polysaccharide scaffold with native ECM directly secreted by cells. First, the scaffold synthesis and culture conditions were optimized to enhance ECM deposition by fibroblasts. To obtain an acellular scaffold, decellularization using supercritical CO2 was performed and compared to a conventional method, demonstrating its superiority in ensuring efficient decellularization while preserving an enriched ECM lining the surface of the pores and preventing scaffold damage. The biohybrid hydrogel was characterized by a very low amount of DNA (<5 ng DNA mg −1 ) and a network of highly interconnected pores covered by an abundant ECM including collagen I, collagen IV, fibronectin, elastin and laminin. This work presents a new versatile strategy that can be adapted to various tissues to engineer biomimetic microstructured materials overcoming the limitations associated with polymer-based and dECM-based strategies when used independently
Enhancing mechanical behavior of complex compositional alloy thin films by defect and interface engineering
No full textInternational audienc
National expert consensus on the management of antibiotic prophylaxis in surgical patients with a penicillin allergy label based on the Delphi method
No full textInternational audienceBackground: Patients with a penicillin allergy label have an increased risk of surgical site infection. Although a decision tree was published in 2019 to define which patients could benefit from direct cephalosporin use in the perioperative setting, this strategy remains unvalidated. This consensus statement aimed to adapt it based on an expert consensus to cover persisting caveats and to adapt it to an environment with poor allergist resources.Methods: Perioperative antibiotic prophylaxis and allergy experts were invited to participate. The Delphi method was implemented using an online-secured network. The panellists were given 3 weeks to answer each round. A consensus was reached if more than 75% of the experts rated the item ≥ 7 and if less than 25% rated the item ≤ 3.Results: Sixteen experts participated. A high level of agreement was obtained after four rounds, defining four categories of the index reaction: unknown, not compatible, or compatible with an immediate or delayed hypersensitivity reaction. Twelve items were defined to stratify the risk of true penicillin allergy according to the index reaction history. The experts agreed that patients with high-risk reactions could benefit from either an allergy work-up or beta-lactam alternatives use. Those at low risk could benefit from direct cephalosporin administration.Conclusions: This resulted in an adapted decision tree to promote cephalosporin prescription in patients with penicillin allergy labels. It will be used in a stepped-wedge prospective multicentric randomized study to assess its applicability and acceptability to promote first- and second-generation cephalosporin administration in the perioperative period
The impact of anti-inflammatory drugs on facial odontogenic cellulitis in children: a cross-sectional study in France
No full textInternational audienceAbstract Objective Dental caries is defined by the WHO as a multifactorial non-communicable disease. If left untreated, it can progress to abscesses and then head and neck odontogenic cellulitis. It requires immediate, appropriate, and interdisciplinary treatment. The aim of this study was to draw up an epidemiological profile of these children treated at the Lille University Hospital in northern France and to study the impact of self-medication of anti-inflammatory drugs. Materials and Methods A single-centre retrospective, cross-sectional study was conducted on children with odontogenic cellulitis admitted to the paediatric emergency department of the Lille University Hospital between March 2013 and December 2021. Results 15.3% of the 636 children included had taken nonsteroidal anti-inflammatory drugs before going to the emergency department. The frequency of pain and trismus was higher in children who had taken nonsteroidal anti-inflammatory drugs than in those who had not. Frequency of hospitalisation was higher in children who had not taken nonsteroidal anti-inflammatory drugs than for those who had (70% vs. 57%, respectively; p < 0.05). Inversely, the mean length of stay was longer for children who had taken nonsteroidal anti-inflammatory drugs than in those who had not (1.1 vs. 0.8 days, respectively; p < 0.05). Conclusion This first French epidemiological study on odontogenic cellulitis in children underlines the need to develop multidisciplinary prevention and patient education
