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Long-term results of a multidisciplinary medication optimization program for older adults including primary care and hospital team
No full textInternational audienc
How do I treat dMMR/MSI gastro-oesophageal adenocarcinoma in 2025? A position paper from the EORTC-GITCG gastro-esophageal task force
No full textInternational audienceIn less than a decade, immune checkpoint inhibitors (ICIs) have transformed the management of mismatch repair-deficient (dMMR) and microsatellite instability-high (MSI) cancers. However, beyond colorectal cancer (CRC), much of the evidence is mostly derived from non-randomized phase II studies or post-hoc analyses of broader clinical trials. dMMR/MSI tumours represent a specific subgroup of gastro-esophageal adenocarcinomas (GEA), accounting for approximately 9 % of cases, with a higher prevalence in early-stage compared to advanced-stage disease and older female patients. These tumours are predominantly sporadic, often linked to MLH1 promoter methylation, and rarely exhibit HER2 overexpression/ERBB2 amplification or other oncogenic drivers. The treatment landscape for early stage dMMR/MSI GEA is likely to change substantially soon, as ICIs have shown high pathological complete response (pCR) rates in small phase II trials, raising questions on optimisation of neoadjuvant therapy, and paving the way for organ preservation. The standard of treatment for untreated patients with advanced dMMR/MSI GEA is chemotherapy + ICI irrespectively of PDL-1 status. However, the role of chemotherapy-free regimen consisting of CTLA-4 plus PD-1 inhibitors remains undetermined. This review addresses these and other emerging questions, offering expert opinions and insights into the future therapeutic landscape for dMMR/MSI GEA
Description de la posture et des vibrations transmises aux doigts du musicien lors de la pratique de la guitare électrique
No full textPerformance sportive et musicale : geste, contrôle, perception; GSAM - Acoustique Musicale: GAP - Voix et ParoleNational audienceLa compréhension de la pratique musicale est essentielle tant dans des objectifs de facture instrumentale que d’apprentissage du geste ou encore de perception musicale. Dans ce cadre, de nombreuses études se sont intéressées à l’instrument et au son rayonné puis perçu par le musicien et l’auditoire. Relativement peu d’études se sont centrées sur le musicien dans son ensemble afin d’approcher ses stratégies d’organisation posturale et gestuelle en fonction de la partition mais aussi des retours acoustiques et vibrotactiles de l’instrument. La présente étude vise à initier cette démarche dans le cadre de la pratique de la guitare électrique. Cinq guitaristes ont été invités à jouer une gamme à trois tempi différents. Un ensemble de signaux biomécaniques et vibratoires ont été collectés de manière synchrone lors de chaque essai. En particulier, un système de capture optoélectronique du mouvement couplé à deux plateformes de force et un ensemble d’électrodes électromyographiques de surface ont permis de mesurer la cinématique du corps complet ainsi que les efforts appliqués au sol simultanément à l’activation des principaux muscles fléchisseurs et extenseurs du coude, du poignet et des doigts. Par ailleurs, la réponse vibratoire en plusieurs points de l’instrument ainsi que les signaux vibratoires transmis à la main gauche du musicien ont été collectés à l’aide d’accéléromètres. L’analyse de la base de données ainsi obtenue permettra dans un premier temps de proposer une description pluridisciplinaire de la pratique de la guitare électrique. Dans un second temps, l’effet du tempo, notamment sur la stabilité posturale et le contrôle du musicien, sera abordé
Resilience and 'miracle' in times of crisis in Borno : the case of Kwaya Kusar local government area in Nigeria
No full textColloque Méga-Tchad, Nice, FRA, 30-/10/2025 - 16/06/2017My fieldwork on the group that would later be called Boko Haram began in 2005 along the Niger-Nigeria border and continued in Maiduguri, Yola, Damaturu, Kano, Diffa, Bosso, Maine-Soroa, N'Djamena and Baga Sola. It has led me to develop a sociological and political analysis of the insurgency, together with a mapping of the situation.¹ The impact of the Boko Haram insurgency has not been uniform across time and space. Following skirmishes in Kanama along the Niger border, and then in the Mandara Mountains of Cameroon in 2003-2004, a small group of jihadists called the ?Nigerian Taliban' first joined..
Machine learning to detect recent recreational drug use in intensive cardiac care units
No full textInternational audienceBackground: Although recreational drug use is a strong risk factor for acute cardiovascular events, systematic testing is currently not performed in patients admitted to intensive cardiac care units, with a risk of underdetection. To address this issue, machine learning methods could assist in the detection of recreational drug use.Aims: To investigate the accuracy of a machine learning model using clinical, biological and echocardiographic data for detecting recreational drug use in patients admitted to intensive cardiac care units.Methods: From 07 to 22 April 2021, systematic screening for all traditional recreational drugs (cannabis, opioids, cocaine, amphetamines, 3,4-methylenedioxymethamphetamine) was performed by urinary testing in all consecutive patients admitted to intensive cardiac care units in 39 French centres. The primary outcome was recreational drug detection by urinary testing. The framework involved automated variable selection by eXtreme Gradient Boosting (XGBoost) and model building with multiple algorithms, using 31 centres as the derivation cohort and eight other centres as the validation cohort.Results: Among the 1499 patients undergoing urinary testing for drugs (mean age 63±15 years; 70% male), 161 (11%) tested positive (cannabis: 9.1%; opioids: 2.1%; cocaine: 1.7%; amphetamines: 0.7%; 3,4-methylenedioxymethamphetamine: 0.6%). Of these, only 57% had reported drug use. Using nine variables, the best machine learning model (random forest) showed good performance in the derivation cohort (area under the receiver operating characteristic curve=0.82) and in the validation cohort (area under the receiver operating characteristic curve=0.76).Conclusions: In a large intensive cardiac care unit cohort, a comprehensive machine learning model exhibited good performance in detecting recreational drug use, and provided valuable insights into the relationships between clinical variables and drug use through explainable machine learning techniques
Lieux du possible, lieux du virtuel
No full textInternational audienceIn this article, we examine the role of place in the virtual, the tension between concrete place (site)and virtual. Our starting point is the role Deleuze gives to place in Différence et répétition :place can be found in the space between “possible” and “virtual”, as Deleuze defines them.The next step is to explore in greater detail the notion of place, not the place of representationon screen, but the concrete site of experience: the theater room (in general). The aim is toconfront the Deleuzian perspective with this thickness of place through a traditional film –inthe sense that it is not an installation or an interactive film– and then to sketch out a reflectionto grasp the relationship between place and virtuality with regard to what we call “virtualimages” (webfilm, virtual reality experience).Dans cet article, nous étudions la part du lieu dans le virtuel, la tension entre lieu concret etvirtuel. Nous partons de la place que Deleuze donne au lieu dans Différence et répétition : le lieupeut se loger dans l’espace qui existe entre « possible » et « virtuel », tels que Deleuze les définit.Il s’agit ensuite d’explorer plus en détail la notion de lieu, non pas le lieu de la représentationà l’écran, mais le lieu concret de l’expérience : la salle (en général). Il s’agit de confronter la pers-pective deleuzienne à cette épaisseur du lieu à travers un film traditionnel – au sens où ce n’estpas une installation ou un film interactif - puis d’esquisser une réflexion pour saisir la relationentre lieu et virtuel à propos de ce qu’on appelle des « images virtuelles » (webfilm, expériencede réalité virtuelle)
Situations de vulnérabilités et persévérance dans les études : paroles d'étudiants
No full textInternational audienc
Identification of gene–sun exposure interactions of GWAS-identified variants in perceived facial aging progression
No full textInternational audienceSkin aging is characterized by observable major changes in the composition and organization of the skin, including the appearance of wrinkles, tissue sagging, dryness, and pigmentary disorders. While both environmental and genetic factors contribute to these changes, their interaction remains underexplored. Perceived age is a biomarker of health and strongly related to facial skin aging features. Thus, we conducted a gene-environment interaction analysis on the perceived facial aging progression phenotype in 226 women, focusing on sun exposure as the environmental factor.Methods. We assessed perceived age in 226 women at two time points, 12 years apart, allowing defining a perceived facial aging progression as phenotype. We applied a two-step gene-environment interaction approach. First, a genome-wide association study (GWAS) was performed to identify SNP effects on the perceived facial aging progression, selecting those with a p -value <5 × 10 −3 . In the second step, we used GEM software to test interactions between the 7,464 selected SNP and sun exposure.Result. The GWAS identified four significant SNP associated with perceived facial aging progression, located in the CGGBP1 , PGM5-AS1 , and CSMD1 genes. The CGGBP1 gene is involved in DNA damage/repair, telomere and mRNA metabolism; PGM5-AS1 is an antisense RNA regulating PGM5 , a component of adherens-type cell junctions; CSMD1 is involved in complement regulation and cell migration. In the second step, we tested 7,464 SNP for interactions with sun exposure in perceived facial aging progression, identifying a significant interaction signal in the VANGL1 gene. The VANGL1 gene contributes to the structural organization of the plasma membrane and has been identified as a key gene for cutaneous function and was expressed during keratinization.Discussion. This study revealed four relevant genetic associations with skin aging and one significant G × E interaction. These findings support the known link between telomere shortening/protection and aging, and suggesting a potential role for keratinization in the context of facial aging and sun exposure, though further validation in larger cohorts is necessary. The findings could help to develop new approaches for facial aging prevention and treatment and to better understand molecular mechanisms of aging
L ∞ -error estimates for solutions of the Helmholtz equation with truncated index in a fold caustic model
No full textThis note considers the error estimates for the solutions of high-frequency Helmholtz equations, that is, waves refracted by a surface, in the domain when the indices of refraction coincide. We derive error estimates in terms of the wave number k > 0 for truncated indexes of refraction, thereby adapting the physical meaning of the wave equations through the use of Airy functions and their derivatives.</div
