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Arc Blanc: A Real-Time Ocean Simulator
No full textInternational audienceThe oceans cover the vast majority of the Earth. Therefore, their simulation has many scientific, industrial and military interests, including computer graphics domain. By fully exploiting the multi-threading power of GPU and CPU, current state-of-the-art tools can achieve real-time ocean simulation, even if it is sometimes needed to reduce the physical realism for large scenes. Although most of the building blocks for implementing an ocean simulator are described in the literature, a clear explanation of how they interconnect is lacking. Hence, this paper proposes to bring all these components together, detailing all their interactions, in a comprehensive and fully described real-time framework that simulates the free ocean surface and the coupling between solids and fluid. This article also presents several improvements to enhance the physical realism of our model. The two main ones are: calculating the real-time velocity of ocean fluids at any depth; computing the input of the solid to fluid coupling algorithm
Comparative efficacy of different techniques for colonic endoscopic submucosal dissection: A network meta-analysis of randomized controlled trials
No full textInternational audienc
Étude sociologique et photographique sur les personnels funéraires V.D. (Visage Découvert)
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Efficacy and safety of mechanical thrombectomy in distal medium middle cerebral artery occlusion ischemic stroke patients on low-dose aspirin
No full textInternational audienceBackground: Acute ischemic stroke (AIS) from distal medium vessel occlusion (DMVO) presents unique treatment challenges. Mechanical thrombectomy (MT) is emerging as a viable option for these patients, yet the role of pre-stroke aspirin treatment is unclear. This study evaluates the impact of pre-stroke low-dose aspirin on outcomes in DMVO patients undergoing MT. Methods: We conducted a multinational, multicenter, propensity score-weighted analysis within the Multicenter Analysis of primary Distal medium vessel occlusions: effect of Mechanical Thrombectomy (MAD-MT) registry. Patients with AIS due to DMVO, treated with MT, were included. We compared outcomes between patients on pre-stroke low-dose aspirin (75–100 mg) and those not on antiplatelet therapy. The primary outcome was functional independence at 90 days (modified Rankin Scale (mRS), 0–2). Secondary outcomes included excellent functional outcome at 90 days (mRS, 0–1), mortality, and day 1 post-MT National Institutes of Health Stroke Scale (NIHSS) score. Safety outcomes focused on hemorrhagic complications, including symptomatic intracerebral hemorrhage (sICH). Results: Among 1354 patients, 150 were on pre-stroke low-dose aspirin. After applying inverse probability of treatment weighting (IPTW), aspirin use was associated with significantly better functional outcomes (mRS, 0–2: odds ratio (OR) = 1.89, 95% confidence interval (CI) = 1.14 to 3.12) and lower 90-day mortality (OR = 0.56, 95% CI = 0.32 to 1.00). The aspirin group had lower NIHSS scores on day 1 (β = −1.5, 95% CI = −2.8 to −0.27). The sICH rate was not significantly different between the groups (OR = 0.92, 95% CI = 0.60 to 1.43). Conclusions: Pre-stroke low-dose aspirin was associated with improved functional outcomes and reduced mortality in patients with DMVO undergoing MT, without a significant increase in sICH. These findings suggest that low-dose aspirin may be safe and associated with more frequent excellent outcomes for this patient population. Further prospective studies are needed to validate these results and assess long-term outcomes
Transvenous Approach for the Treatment of Cerebral Arteriovenous Malformations: A Randomized Comparison With Transarterial Embolization
No full textInternational audienceBACKGROUND: Transvenous embolization (TVE) is a new treatment of brain arteriovenous malformations (AVMs). The safety and efficacy of TVE have not been compared with transarterial embolization (TAE). The primary hypothesis of this trial was that TVE would increase the proportion of AVM occlusion from 40% to 80%. METHODS: The TATAM (Transvenous Approach for the Treatment of Cerebral AVMs) was an investigator-initiated, multicenter, prospective, phase 2, open-label, controlled randomized trial comparing TVE versus TAE alone (1:1). Patients with symptomatic or asymptomatic AVMs considered curable with 2 endovascular sessions were reviewed by a case selection committee. Participating centers were experienced (>20 cases) or proctored by experts. The primary outcome was complete occlusion of the AVM, confirmed by catheter angiography at 3 to 6 months. There was no blinding. Primary analyses were intent-to-treat. RESULTS: From May 2019 to April 2023, 77 patients were recruited in 7 French and 2 Canadian centers. After exclusions, results from 69 patients were analyzed; 35 were allocated TVE and 34 TAE. The mean age of participants was 43.3 years; 29 of 69 (42%) were female. There were 2 crossovers. The primary outcome was reached in 29 of 35 patients with TVE (83% [95% CI, 67%–92%]) compared with 20 of 34 patients allocated TAE (59% [95% CI, 42%–74%]; P =0.036). Poor outcomes (modified Rankin Scale score >2 at 3–6 months) occurred in 7 of 35 patients with TVE (20% [95% CI, 10%–36%]) and 9 of 34 patients with TAE (27% [95% CI, 15%–43%]; P =0.513) and related serious adverse events in 12 of 35 patients with TVE (34% [95% CI, 21%–51%]) and 14 of 34 patients with TAE (41% [95% CI, 26%–58%]; P =0.624). CONCLUSIONS: TVE was more effective than TAE in terms of angiographic results at 3 to 6 months. Morbidity was similar but high for both groups. More studies are needed to determine the role of curative embolization in managing patients with brain AVM. REGISTRATION: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT03691870
Predictive models of clinical outcome of endovascular treatment for anterior circulation stroke using machine learning
No full textInternational audienceBackground and purpose: Mechanical Thrombectomy (MT) has recently become the standard of care for anterior circulation stroke with large vessel occlusion, but predictive factors of successful MT are still not clearly defined. To tailor treatment individually for each patient, the aim of this study was to evaluate the performances of Machine Learning to predict clinical outcome (mRS) at 3 months after MT. Material and methods: From the ETIS French prospective multicenter registry, data from patients who underwent MT for anterior circulation stroke with large vessel occlusion between January 2018 and December 2020 were extracted. Three machine learning models (Support Vector Machine, Random Forest and XGBoost) have been trained with clinical, biological and brain imaging data available in emergency conditions from the cohort of patients treated from 2018 to 2019. Models' performances to predict good outcome (3-months mRS <3) were evaluated on patients treated in 2020. Performances were evaluated with AUC, accuracy, sensitivity and specificity, then ROC curves AUC were compared with the best performing model. Results: 4297 patients were included, 1737 (40 %) with good outcome and 2560 (60 %) with bad outcome were used to train models and 599 patients treated in 2020 were used to evaluate their performances. The best model was obtained with XGBoost: AUC = 0.77, accuracy = 69.3 % but no statistically significant difference existed between models. Conclusion:Our study shows satisfying performances of machine learning to predict clinical outcome after MT using data easily available at initial diagnosis and before the decision to treat.</div
Using of the 2D materials signature for thermal Raman measurements of power devices
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Prevalence of restless leg syndrome and associated comorbidities in a sub-saharan African general population: results from the Benin Society and Sleep (BeSAS) study
No full textInternational audiencePurpose: To assess the prevalence of Restless Leg Syndrome (RLS) and associated comorbidities among adults in rural and urban areas of Benin, a Sub-Saharan country, where limited data exists on its burden and clinical relevance.Methods: A cross-sectional population-based study was conducted in Benin. RLS was identified using the standardized International Restless Legs Questionnaire. Demographic data and lifestyle data (alcohol consumption, smoking) were self-reported by participants, while precise anthropometric measurements (height, weight, BMI) and clinical parameters (blood pressure, blood glucose) were obtained using standardized protocols to assess nutritional status and detect hypertension and diabetes. Sleep quality was evaluated using three validated instruments: the Pittsburgh Sleep Quality Index, the Epworth Sleepiness Scale, and the Insomnia Severity Index. Data were collected through face-to-face interviews conducted by trained personnel using KoBoToolbox software on digital tablets. Logistic regression models were used to determine the relationship between RLS and associated comorbidities.Results: Among 2,909 participants (58.7% urban, mean age 44.7 years, 61.2% female), RLS prevalence was 5.0% [95% CI: 4.3-5.9], with higher rates in rural (9.4%) versus urban areas (1.9%). Prevalence increased with age (1.7% in 25-34 years to 12.5% in ≥ 65 years) and was higher in females (5.9%) than males (3.5%). RLS showed significant associations with hypertension (adjusted odds ratio [aOR] = 1.56, 95% CI: 1.04-2.35, p = 0.03) and poor sleep quality (aOR = 3.07, 95% CI: 2.07-4.57, p < 0.001).Conclusion: RLS shows notable prevalence in Benin with rural-urban disparities and significant associations with hypertension and poor sleep quality, highlighting the need for further research in sub-Saharan populations
Sur les routes de la sociologie. Épisode 8 avec Thibaut Besozzi, un sociologue chez les sans-abris [Podcast]
No full text[Podcast] Réalisation : Joachim Benet Rivière et Vonnick Ribéraud / Montage et mixage : Vonnick Ribérau