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SLE patients with childhood-onset: A nation-wide population-based study
No full textInternational audienceSystemic lupus erythematosus (SLE) is a chronic autoimmune disease that typically affects women of childbearing age. Using a nationwide database, we aimed to assess the prevalence, main clinical features and outcomes of patients with childhood-onset SLE (cSLE). Data on all patients admitted to a French hospital between January 2011 and December 2020 with at least one ICD, 10th revision code for SLE were retrieved from the nationwide hospital medical information database. Individuals who developed systemic SLE before the age of 17 years were considered to have cSLE. Between 2011 and 2020, 36,791 unique SLE patients were hospitalised in France. Among them, 1030 individuals younger than 17 years (median [q1-q3] age 13.0 [11.0;15.0]) years, 81.9 % female) were identified as having cSLE. The prevalence of cSLE was 8.3 cases per 100,000 inhabitants. The main characteristics of cSLE did not differ by sex, except for a younger age of onset in boys. Older children have a higher incidence of lupus nephritis. Compared to adult-onset SLE, lupus nephritis and immune cytopenia were twice as frequent in cSLE. During a median follow-up of 7.1 [4.0-9.0] years, 539 (52.3 %) cSLE patients experienced at least one hospitalisation for an infection. A total of 6 patients (0.6 %) died. All of these deaths occurred during the hospitalisation in which the first lupus code was assigned. The prevalence of cSLE in France was 8.3 cases per 100,000 of the population. cSLE had a higher rate of renal nephritis and immune cytopenia than adult-onset SLE
Deep sternal wound infection after cardiac surgery: A combination of 2 distinct infection types, deep incisional surgical-site infection and mediastinitis: Results of a retrospective study
No full textInternational audienceIntroduction: Deep sternal wound infection after cardiac surgery remains a serious complication associated with a poor prognosis. Deep sternal wound infection is classified by the Centers for Disease Control and Prevention as deep incisional surgical site-infection and mediastinitis. This study aims to describe the incidence, perioperative characteristics, and outcomes of deep sternal wound infection on the basis of clinical presentations. Methods: This monocentric retrospective study included all consecutive patients who underwent cardiac surgery with cardiopulmonary bypass between 2006 and 2019 in a tertiary teaching hospital. The primary outcome was 90-day mortality, and the main secondary outcome was a landmark analysis of 90day mortality, excluding patients who died within the first 28 days. Results: Among the 14,850 patients included in this study, deep sternal wound infection occurred in 542 (3.6%) patients: 390 (72%) presented with deep incisional surgical site-infection and 152 (28%) presented mediastinitis. Patients with deep sternal wound infection had a lower 90-day survival than patients without deep sternal wound infection; in particular, patients with mediastinitis had the lowest survival rate compared to deep incisional surgical site-infectione and deep sternal wound infection efree patients (82% vs 94% vs 95%, respectively; both comparisons P < .001), and mediastinitis was an independent risk factor for 90-day mortality. No difference in 90-day survival was observed between patients without deep sternal wound infection and patients with deep incisional surgical site-infection (P ¼ .378). However, in the landmark analysis, both deep incisional surgical site-infection and mediastinitis were associated with lower survival compared with patients without deep sternal wound infection and were independent risk factors for mortality. Conclusion: Deep incisional surgical site-infection and mediastinitis exhibited distinct incidences, bacterial characteristics, and prognoses, with mediastinitis being associated with the poorest prognosis. However, when the competing risk of death was considered, deep incisional surgical-site infection diSSI also emerged as an independent risk factor for 90-day mortality
La renaissance de la recherche en Afrique : de la dépendance à l'intégration internationale
No full textLa recherche doit contribuer à anticiper les enjeux de développement durable. Toutefois, la plupart des pays africains ne disposent pas de systèmes de recherche suffisamment solides pour relever ce défi. Restée longtemps dépendante de la « science coloniale », la recherche y a connu un essor au lendemain des indépendances. Cette période a été suivie par celle des politiques d’ajustement structurel, qui ont généralement conduit au sous-financement et à la marginalisation du secteur. Aujourd’hui, les moyens dédiés à la recherche en Afrique sont largement concentrés sur la recherche pour le développement et sur des disciplines comme les sciences médicales et agricoles. Cette situation est le fruit de l’héritage colonial et des politiques de développement. Elle est aussi la résultante des choix des États, qui privilégient l’enseignement supérieur à la recherche. Si cette recherche pour le développement répond à un besoin des sociétés, elle reste liée à l’assistance technique et à la recherche appliquée, au détriment de la recherche fondamentale, marginalisée. Dépendent de standards qui valorisent peu la recherche pour le développement, les carrières des scientifiques africains s’en ressentent. On voit émerger, d’une part, une forme de dualisme entre les chercheurs et institutions connectés (et dépendants) des réseaux et financements internationaux et ceux qui en restent en marge, et d’autre part, un dualisme entre universités et institutions de recherche « pour le développement ». Prenant appui sur le cas des pays sahéliens, ce chapitre illustre bien cette situation. Au Sahel, la production de recherche est limitée, malgré une tendance à la hausse depuis les années 2000. Le Sénégal, qui héberge depuis l’époque coloniale d’importantes institutions de recherche, se singularise et affiche une production de recherche plus importante et plus diversifiée, tout en gardant des liens institutionnels structurants avec des organismes étrangers
Usefulness of the GeneXpert MTB/RIF Ct for predicting tuberculosis infectiousness
No full textInternational audienceIntroduction: The GeneXpert® MTB/RIF test is faster and more sensitive than smear microscopy (SM) for the diagnosis of pulmonary tuberculosis (pTB). We evaluated the contribution of the Ct ("Cycle threshold") of the GeneXpert MTB/RIF test to estimate infectiousness.Methods: We performed a multicenter retrospective analysis of patients with pTB confirmed by positivity of culture and GeneXpert. The median Ct was calculated on Day 0 (D0). We studied the following correlations: between the Ct and SM on D0, Ct and Time-To-Detection (TTD) of the culture in liquid medium on D0 and then the correlation between the Ct on D0 and the culture on D15, Month 1 (M1), and M2.Results: A total of 426 patients were included. SM was negative for 130 (30.6 %) patients. The global median Ct was 20.1. The Ct was significantly correlated with the SM grade at diagnosis (Xpert MTB/RIF or Xpert MTB/RIF Ultra, r = -0.77, p<0.001 and r = -0.69, p<0.0001, respectively). D0 Ct was significantly correlated with TTD (r = 0.71, p<0.0001 and r = 0.71, p<0.0001, respectively) and with a positive culture only on D15 (p<0.0001 and p<0.0001, respectively).Conclusion: The Ct value correlated well with the smear grade and with the bacillary load at diagnosis. Smear microscopy is less sensitive for estimating the risk of transmission. The GeneXpert test (and its Ct) could therefore replace smear microscopy for diagnosis but also for estimating the infectiousness of patients, particularly in low-resource countries where smear and culture are poorly available
Déclaration au 10ème Forum multipartite sur la Science, la Technologie et l’Innovation: Déclaration au 10ème Forum multipartite sur la Science, la Technologie et l’InnovationOrganisation des Nations Unies - ECOSOC, les 06 - 08 mai 2025par Oleg CURBATOV, Vice-président, Représentant permanent à l’UNESCO et à l’ONUMaître de Conférences habilité à diriger des recherches – Université Sorbonne Paris Nord
No full textThe International Association of University Professors and Lecturers (IAUPL), a non-governmental organization endowed with a general consultative status in ECOSOC, is delighted to participate once again in the Multi-stakeholder Forum on Science, Technology and Innovation, which is meeting today to examine global cooperation in Science, Technology and Innovation, with a view to providing guidance for a sustainable future.International audienceQuantum technology is poised to revolutionize various sectors, including drug innovation. Advances in this field are already making significant contributions to society. For example, neuro-technologies coupled with quantum technologies are expected to yield results in understanding human consciousness and acting upon it.We are continuing to celebrate the International Year of Quantum Technologies, a year to reflect on the profound implications of quantum science. Quantum sciences operate in different physical relativities and require an understanding of technologies, uses, human behavior and also ethics, from an alternative point of view, with a different perspective from that offered by classical physics. Many initiatives have seen the light of day during these years. The Pact for the Future and its annex, the Global Digital Compact, were conceived at a time applications of AI and other emergent technologies were coming out, but without nevertheless providing a detailed definition of these technologies, such as quantum technologies, for example. The university researchers at IAUPL are convinced that the conception of an additional document to the Pact for the Future Global Digital Compact would be essential in the next few years to come in order to give direction to quantum technologies.However, it is not a question of multiplying complementary instruments, but rather of creating an original document, in the spirit of technological and societal convergence, which could be called the “Convergent Pact for Quantum Technologies of the Future”, where each component and each person will find their place for a sustainable and responsible development of Humanity
Low-coercivity behavior and biomedical potential of cube-like and rounded hematite (α-Fe2O3) nanoparticles: Insights from hydrothermal synthesis
No full textInternational audienceUnderstanding the shape-dependent magnetic properties of hematite (α-Fe2O3) nanoparticles is essential for advancing their biomedical and nanotechnological applications. We synthesized cube-like and rounded hematite nanoparticles using a controlled hydrothermal synthesis method by varying ethanol/water ratios, enabling precise morphological tuning. While the Morin transition temperature (TM) (225–231 K) and coercivity below TM (≈180 Oe) remain largely shape-independent, coercivity above TM exhibits significant shape dependence. Cube-like hematite nanoparticles display ultra-low coercivity (HC = 21 Oe) due to defect-minimized planar surfaces, whereas rounded hematite nanoparticles exhibit higher coercivity (HC = 306 Oe) due to defect-rich curved surfaces and atomic misalignments. MRI relaxivity measurements reveal that rounded hematite nanoparticles enhance transverse relaxivity (5.70 ± 0.17 mM[Fe]-1s−1), while cube-like hematite nanoparticles show higher longitudinal relaxivity (0.0075 mM[Fe]-1s−1), demonstrating morphology-dependent MRI contrast efficiency. With low cytotoxicity and high biocompatibility, the synthesized hematite nanoparticles show promise for biomedical applications, particularly in targeted imaging and magnetic nanodevice development
Positionnement et éléments de cadrage préalable pour aborder les transitions numérique et écologique
No full textInternational audienceThis text provides a preliminary framework for tackling digital and ecological transitions. After contextualizing the now central issue of global warming and highlighting the need for transitions, the authors identify and put into perspective the emergence of this notion and the rationales that impede transition(s). Paradoxically, despite a number of similarities in the processes and names used, the logics underlying digital transition and ecological transition are at odds with each other, between an optical illusion and a semantic hold-up. The digital transition is an oxymoron because the widespread digitalization of society does not encourage restraint. Is using this vocabulary anything more than a tactic to divert attention from digital growth that is already in the pipeline?El texto ofrece un marco preliminar para abordar las transiciones digital y ecológica. Tras contextualizar la cuestión, ahora central, del calentamiento global y destacar la necesidad de hacer un llamamiento a las transiciones, los autores se proponen identificar y poner en perspectiva la génesis de esta noción y la naturaleza de las lógicas en juego que obstaculizan la(s) transición(es). Lo paradójico es que, a pesar de algunas similitudes en el proceso y en las denominaciones utilizadas, ambas lógicas están enfrentadas, entre una ilusión óptica y un bloqueo semántico. La transición digital es un oxímoron porque la digitalización generalizada de la sociedad no favorece el imperativo de sobriedad. ¿La exhibición no sería una táctica de distracción para desviar la atención de lo que ya está en marcha en términos de crecimiento digital?Le texte apporte un cadrage préalable pour aborder les transitions numérique et écologique. Après avoir contextualisé la problématique devenue centrale du réchauffement climatique et fait ressortir la nécessité d’en appeler aux transitions, les auteurs s’emploient à identifier et mettre en perspective la genèse de cette notion et la nature des logiques à l’œuvre qui entrave la(es) transition(s). Le paradoxe est qu’en dépit d’un certain nombre de similitudes dans le processus et les appellations, tout oppose ces deux logiques entre illusion d’optique et hold-up sémantique. La transition numérique est un oxymore car la numérisation généralisée de la société ne favorise pas l'impératif de sobriété. L’affichage ne permettrait-il pas une diversion pour détourner l’attention de ce qui se prépare dès à présent en matière de croissance du numérique
Cardiogenic shock in patients with active onco-hematological malignancies: A multicenter retrospective study
No full textInternational audienceOnco-hematological (OH) patients face significant cardiovascular risks due to malignancy and drug toxicity. Data are limited on the characteristics and outcomes of OH patients with cardiogenic shock (CS) in intensive care units (ICUs)
APPROXIMATING USER-PREFERRED ABDUCTIVE EXPLANATIONS VIA SUPERMODULAR OPTIMIZATION: APPLICATION TO TREE-BASED CLASSIFIERS
No full textFormal explainability is an emerging field that aims to provide mathematically grounded explanations for the predictions of machine learning models. Among the most prominent forms of formal explanations are abductive explanations, which identify minimal subsets of features sufficient to justify a prediction. Despite their conciseness and interpretability, the exponential number of possible abductive explanations can make the computation of a single one uninformative, as more relevant alternatives may exist. To address this, recent approaches propose incorporating an explainee model that encodes user preferences, thereby enabling the generation of preferred abductive explanations. However, computing such preferred explanations remains computationally intractable, even for interpretable models like decision trees. In this work, we propose a novel approximation framework for efficiently computing preferred abductive explanations. We first formulate the problem as a supermodular optimization task and then introduce a greedy algorithm with provable approximation guarantees. Our approach allows the generation of high-quality explanations in polynomial time, significantly reducing the computational cost compared to exact methods. Unlike agnostic explanation techniques such as LIME and SHAP, our method preserves the formal guarantees of abductive reasoning while scaling to large instances. Experimental results on diverse datasets using decision trees and random forests demonstrate that our algorithm produces explanations that are both close to optimal and orders of magnitude faster than SAT-based exact methods. This makes our approach particularly well-suited to resource-constrained environments where traditional solvers are impractical.</div
Boosting mechanical properties of metallic thin films through advanced nanoengineered design strategies
No full textInternational audienceThe current trend toward miniaturization in devices components in key technologies such as microelectronics, energy production, sensors and wear protection requires the development of high-performance thin films with superior mechanical properties combining mutually excluding mechanical properties such as high yield strength and ductility. Achieving such performance, relies on leveraging microstructure-induced mechanical properties, requiring the precise control of film’s microstructure, atomic composition, grain size and thickness based on nanoengineering design concepts. Here, I will present recent results for several class of advanced thin film materials including nanostructured metallic glasses (ZrCu, ZrCuAl)[1, 2] high entropy alloys (CoCuCrFeNi) and nanolaminates (fully amorphous, amorphous/crystalline)[3, 4], highlighting how the control of the microstructure affect the and micro-scale mechanical behavior and enable ultimate mechanical properties.Among the main results, I will show the fabrication of fully amorphous Zr24Cu76/Zr61Cu39 nanolaminates by magnetron sputtering with controlled nanoscale periodicity (Λ, down to 5 nm), local chemistry and glass-glass interfaces [3]. I will show how the shear band instability can be mitigated when Λ ≤ 50 nm, reaching remarkably large elastic/plastic deformation (16%) and yield strength (~2GPa) by micro-pillar compression [3]. Then, I will present the potential of Pulsed Laser Deposition (PLD) as a novel technique to synthetize nanostructured cluster-assembled ZrCu and CoCuCrFeNi films, reaching ultimate yield strength (>3 GPa) and ductility (>6 %) for ZrCu. Finally, I will focus on the synthesis of crystal/glass ultrafine nanolaminates by PLD[4] in which ∼4 nm Al (crystalline) separate 6 and 9 nm-thick Zr50Cu50 metallic glass nanolayers, showing high yield strength (3.4 GPa) in combination with enhanced elastoplastic deformation (>6%, in compression), while managing to effectively block the percolation of shear bands even at >15% deformation[4].Overall, I will show how fine microstructural control in metallic thin films is an effective strategy to tailor their deformation behavior and boosting their mechanical properties with potential for industrial applications. [1] M. Ghidelli et al., Acta Mater. 213 (2021) 116955.[2] C. Poltronieri et al., Acta Mater. 258 (2023) 119226.[3] A. Brognara et al., Small Struct. (2024) 2400011.[4] F. Bignoli et al., ACS Appl. Mater. Inter. 16(27) (2024) 35686-35696