HAL-Paris 13
Not a member yet
33893 research outputs found
Sort by
Dietary consumption trajectory profiles over time of French adults from the NutriNet-Santé cohort (2014-2022): Multicriteria analysis of sustainability
No full textInternational audienceDietary patterns significantly impact climate change and morbidity, making transitions to sustainable diets urgent. Few studies explore repeated dietary measures collected over several years or variations across distinct consumer profiles characterized by sociodemographic and dietary patterns.Objective: Our study aims to identify dietary trajectory profiles in French adults (2014-2022), assessing environmental, nutritional, and health outcomes.Methods: Consumption data from 17,187 NutriNet-Santé cohort participants (52% women, average age 48y, SD = 16) were collected via food frequency questionnaires in 2014 (weighted to the French Census), 2018, and 2022. Dietary trajectory profiles were modeled using Group-based multi-trajectory modeling based on principal component analysis of energy-adjusted consumption data. Associations with environmental (greenhouse gas (GHG) emissions) and nutritional (adherence to French dietary guidelines, diet quality index) dimensions were assessed via multivariable mixed models. Health impacts were evaluated as Disability-Adjusted Life Years (DALYs)avoided, using the Comparative Risk Assessment approach.Results: Six dietary trajectory profiles (P) with distinct starting diets and evolutions were identified. P0 had average intakes, while P1 and P5 were meat-focused, with P5 showing the highest animal consumption. P3 and P4 leaned plant-based, with P4 maintaining high fish and plant intakes, and P3 increasing ruminant meat. P2 initially high in salty or sweet fatty foods, shifted significantly toward plant-based diets. Over time, GHG emissions decreased (-5% to -14%), diet quality (PNNS-GS2 score) improved (+12% to +174%), and health risks declined in four profiles due to reduced red meat and higher whole grains/fruits but increased for P4 and P5 due to processed meat.Conclusion: These profiles reflect diverse population segments with distinct dietary profiles and degrees of sustainability improvements. However, significant advancements remain limited, highlighting the need for further research on economic, psychological, and cultural factors to guide sustainable changes.</p
L'adolescence dans l'oeuvre de S. Freud: les lettres à Fliess. Névroses de l'adolescence et théorie de l'après-coup
No full textInternational audienc
La reconfiguration du rôle du communicant public au prisme des dispositifs participatifs
No full textInternational audienceIn a context marked by a desire on the part of the State and its institutions to strengthen citizen involvement in public life, the public communicator is emerging as a crucial player in the deployment of participatory mechanisms. The aim of this article is to examine how the role of the public communicator operating within institutions is being enriched, and how it interacts with the role of the public communicator operating outside these institutions, embodied by the consultants-technicians. To this end, we study the issues of promotion, collaboration and training that structure the profession of public communicator in the mobilization of new participatory tools.Dans un contexte marqué par une volonté de l'État et de ses institutions de renforcer l'engagement des citoyens dans la vie publique, le communicant public s'impose comme un acteur crucial dans le déploiement des dispositifs participatifs. Ainsi, cet article vise à étudier l'enrichissement du rôle du communicant public opérant au sein des institutions et ses interactions avec celui opérant à l'extérieur de ces institutions, incarné par les consultants-techniciens. Pour cela, nous étudions les enjeux de promotion, de collaboration puis de formation qui structurent le métier de communicant public dans la mobilisation des nouveaux outils participatifs
Deeper insight into speech characteristics of patients at ultra-high risk using classification and explainability models
No full textInternational audienceIntroduction: Peculiar use of language and even language deficits are one of the well-known signs of schizophrenia. Different language features analyzed using natural language processing and machine learning have been reported to differentiate patients at ultra-high risk for psychosis. However, it has not always been explained how, and to what extent, those linguistic markers allow the distinction of patients. This study aims to find relevant linguistic markers for classifying patients at ultra-high risk and explain how the detected markers contribute to the classification.Methods: The first consultations with a psychiatrist of 68 patients (15 not-at-risk patients, 45 at-risk patients, and 8 patients with first episode psychosis) were recorded, transcribed verbatim, and annotated for analyses using natural language processing. A gradient-boosted decision tree algorithm was tested to evaluate its potential to correctly classify three categories of patients and find relevant linguistic markers at the level of lexical richness, semantic coherence, speech disfluency, and syntactic complexity. The Synthetic Minority Oversampling Technique was used to handle imbalanced data, and the SHapley Additive exPlanations (SHAP) values were computed to measure feature importance and each feature’s contributions to the classification.Results: The model yielded good performance, that is, 0.82 accuracy, 0.82 F2-score, 0.85 precision, 0.82 recall, and 0.86 ROC–AUC score, with four linguistic variables that concern weak coherence, the use of “I,” and filled pauses. Discussion The findings in this study suggest that weak coherence play a key role in classification. No significant differences in the use of “I” and filled pauses were found between groups using a statistical test, but an explainability model showed its different contributions. The contribution of each linguistic feature to the classification by patient group provided deeper insight into linguistic manifestations of each patient group and their subtle differences, which could help better analyze and understand patients’ language behaviors
La prise en charge orthodontique des enfants porteurs de maladie rares et handicaps : et si on ne s'interdisait rien ?
No full textInternational audienc
Adherence to the EAT-Lancet reference diet and risk of type 2 diabetes: results from the NutriNet-Santé cohort study
No full textInternational audienceIn 2019, the EAT-Lancet Commission proposed a planetary, healthy, and reference diet, designed to reduce the global health–environmental double burden of current dietary patterns. We aim to investigate the association between the EAT-Lancet reference diet and type 2 diabetes (T2D) risk. Methods This observational and prospective web-based study was conducted using data from 88 964 adults participating to the French NutriNet-Santé cohort 2009–22 (78.8% female; mean (SD) baseline age of participants was 43.8 (14.5) years). Dietary intakes were assessed at least by three repeated 24 hour-dietary records (mean = 6.3 (2.8)). The endpoint was incident T2D. The main exposure was the EAT-Lancet diet index (ELD-I) modeled as a continuous variable and sex-specific quintiles (Qs). Hazard ratios (HRs) and confidence intervals (CIs) were assessed by Cox proportional hazards models adjusted for potential confounders. The body mass index (BMI) role as a potential mediating factor in the relationship was also investigated. Results During follow-up (median = 8.79 years), 812 incident T2D cases occurred. The ELD-I ranged from −192 to 429 points with a median (interquartile range [IQR]) score of 42.8 (29.1) points. For each 25.7-point increase in ELD-I score (1SD), the risk of T2D is reduced by 11% (HR1SD: 0.89; 95% CI: 0.82–0.96; P = .003). The association studied was mediated up to 61% by BMI. Conclusions In this large cohort study, an increase in adherence to the EAT-Lancet reference diet was associated with a decreased risk of T2D beyond BMI. These results support previous findings and highlights the interest of the EAT-Lancet reference diet as a healthy and sustainable diet
Prospective association of the EAT-Lancet reference diet with body weight changes and incidence of overweight and obesity in a French cohort
No full textInternational audienceObesity has emerged as a significant public health issue globally. In response to the dual health and environmental challenges posed by dietary patterns, the EAT-Lancet Commission recommended a planetary health diet that promotes well-being. The present study aimed to investigate the association of the EAT-Lancet reference diet with body weight changes, incidences of overweight (Body Mass Index (BMI)≥25 kg/m²) and obesity (BMI≥30 kg/m²), in a large French cohort. Methods:The study analyzed data from 51,711 adults who participated in the French NutriNet-Santé cohort between 2009 and 2023. Exposure was measured by the level of adherence to the EAT-Lancet reference diet, evaluated through the EAT-Lancet Diet Index (ELD-I), categorized into sex-specific quintiles (Qs) and as a continuous variable. The relationship between ELD-I and changes in body weight (BW) was examined using multivariable linear mixed models. For the incidences of overweight and obesity, multivariable Cox proportional hazards models were employed.Findings: During follow-up (median=8•7y), 4,250 and 1,604 persons became overweight and obese, respectively. We observed an inverse association between the level of ELD-I and gain in BW (in kg) (β Q5 ×time=-0.18;95% CI:-0.20, -0.16; p<0•0001). Higher level of ELD-I was associated with lower risks of reaching overweight (HR Q5 compared with Q1 : 0•60; 95% CI:0•54, 0•66; p - trend <0•0001) and obesity status (HR Q5 compared with Q1 :0•54; 95% CI:0•45, 0•63; p -trend <0•0001) during follow-up. Conclusions:This comprehensive prospective observational study revealed that a stronger adherence to the EAT-Lancet reference diet is associated with a lower body weight and reduced risks of overweight and obesity. Promoting a sustainable plant-based diet seems to be an effective strategy for addressing the global public health challenge of obesity.</div
Evaluation of the nocebo effect after switching from etanercept or adalimumab originator to a biosimilar: a retrospective study of patients with inflammatory rheumatism
No full textInternational audienceAbstractObjectives: Despite significant savings with biosimilars, their negative perception can lead to the occurrence of a nocebo effect (NE), therefore we aimed to quantify the NE in inflammatory rheumatism after switching from adalimumab or etanercept originators to biosimilars.Methods: This retrospective study was conducted in 4 hospitals in Normandy, France between January 2018 and July 2022. The study included patients with rheumatoid arthritis or spondyloarthritis in remission under adalimumab or etanercept originators before switching to biosimilars. The occurrence of a NE was considered in patients who did not maintain biosimilars at 12 months and who presented a subjective adverse event (AE). A comparative analysis of the quantitative data collected before and after switching was performed. The AE that led to biosimilar discontinuation was identified. Additional analyses were performed to identify potential risk factors for the occurrence of a NE.Results: Among 183 patients included,13.1% presented a NE. Objective AEs were observed, including rheumatism reactivation (15.3%), intolerance (8.2%), infection (1.6%) and allergic reactions (0.5%). Morning stiffness duration was significantly different before and after the switch in the spondyloarthritis group (p=0.01). No risk factors were associated with the occurrence of a NE within the limits of the studied parameters.Conclusions: The occurrence of a NE after switching to a biosimilar remains acceptable. It appears less frequent when the switch is supervised by the practitioner rather than being systematic (up to 33% in some countries). A shared medical decision seems to be essential in a subset of patients, which remains to be defined
Assessing Abnormal Proximal Junctional Angles in Adult Spinal Deformity
No full textInternational audienceStudy design: Multicentric retrospective study of prospectively collected data.Objective: Based on normative data from a cohort of asymptomatic volunteers, this study sought to determine the rate of abnormal values of proximal junctional angles (PJA) in adult spinal deformity (ASD) surgery patients, and compare it with PJK rate. Summary of BackgroundData: Proximal junctional kyphosis (PJK) definition does not take the vertebral level into account. Methods: This study included 721 healthy volunteers and 824 ASD surgery patients with 2year postoperative follow-up. Normative values for each disc and vertebral body between T1 and T12 were analyzed, then normative values for PJA at each thoracic level were defined in the volunteer cohort as the mean±2 standard deviations. PJA abnormal values at the upper instrumented vertebra (UIV) were compared with Glattes' and Lovecchio's definitions for PJK in the ASD population at two years.</div