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Le cachet de la poste et les recours administratifs
No full textInternational audienceTirant les conséquences de sa décision de section du 13 mai 2024, Mme Caire-Tetauru, le Conseil d’État étend aux recours administratifs la prise en compte de la date d’expédition des requêtes pour le calcul du délai de recours. La décision uniformise les règles de computation des délais et participe de la simplification du contentieux administratif, sur lequel elle aura une portée d’autant plus grande que les recours administratifs expédiés par voie postale sont encore assez nombreux
Motor complications and postural abnormalities interplay in Parkinson's disease
No full textInternational audienceBackground: Postural abnormalities (PA) and motor complications (MCs, including motor fluctuations - MFs- and levodopa-induced dyskinesia - LIDs) are hallmark of Parkinson's disease (PD) progression, yet their relationship remains poorly understood.Objective: To investigate the association between PA and MCs, motor symptoms, and non-motor symptoms (NMS) in patients with PD, and to assess whether PA influences the development of MCs over time.Methods: Data of the prospective NS-Park cohort (27 French PD Expert Centers) were analysed. PA was defined by a score ≥2 on item 3.13 of the MDS-UPDRS-III. Associations between PA and MCs, as well as with other motor symptoms and NMS, were assessed using logistic regression models. We used interval censoring survival models to assess the associations between PA at inclusion and the incidence of MCs. Analyses were adjusted for sex, age, disease duration, dopaminergic dose, and disease severity.Results: Among 13,037 included PD patients (58.7 % male, median age at diagnosis 61 years), 724 (5.6 %) presented with PA. Patients with PA had longer disease duration, higher disease severity, and higher dopaminergic treatment. PA exhibited a higher prevalence of troublesome MFs (OR: 5.96; 95 % CI: 4.25-8.32) and LIDs (OR: 2.81; 95 % CI: 1.79-4.30), while associations with milder MCs were inconsistent. However, PA was not significantly associated with the development of MCs during follow-up.Conclusions: PA are associated with more frequent severe MCs, and a higher burden of motor and NMS, making patient care particularly challenging
Refusing to have children in a world in crisis: analysis of ecological justifications for not becoming parents
No full textInternational audienceThe issue of childfreedom for ecological reasons is increasingly being discussed in the media and scientific circles. While some studies analyze how environmental concerns influence fecundity intentions, others question the legitimacy of ecological reasons for choosing to be childfree (Veaux & Roux, 2023). In France, although INED (Bouchet-Valat & Toulemon, 2025) shows a correlation between climate concerns and a decline in the number of desired children, there are still no precise figures to quantify this phenomenon. In the USA, in 2020, 14.3% of adults without children cited climate change as a “major reason” for this choice. In my qualitative corpus of 50 childfree, 90% mention the environment as a reason for not having children.This choice is based on a deep environmental awareness ranging from the degradation of ecosystems to the climate crisis and the increasing scarcity of natural resources. This decision is often motivated by intergenerational altruism: it is not so much a refusal to have children for oneself as a concern for the future generations and the preservation of life.The childfree discourse also fits into a (neo-)Malthusian logic linked to debates on overpopulation. Although this notion is scientifically controversial, it is often incorporated in a cautious and nuanced way into childfree views. Some go so far as to identify with antinatalist movements or even advocate for the voluntary extinction of humanity.Also, childfree people question consumerist lifestyles, considering that overconsumption and overproduction have a greater impact on the environment than birth rates themselves. The everyday practices of childfree people reflect a desire for ecological consistency: adopting vegetarian or vegan diets, engaging in animal causes, consuming locally (short supply chains, bulk stores), frequent use of second-hand markets, attention to natural and fossil resources, and selectice sorting of household waste
Approche compréhensive en école primaire : intermétiers et besoins formatifs pour soutenir l’autorégulation des enfants.
No full textInternational audienc
A randomized phase III trial of structured tumour response surveillance and shared decision‐making for organ preservation in rectal cancer – PRODIGE 101‐ GRECCAR 20‐ EVAREC trial protocol
No full textInternational audienceAbstract Aim Standard management with chemoradiotherapy (CRT) or total neoadjuvant therapy (TNT) followed by total mesorectal excision (TME) reduces local recurrence but often is associated with significant long‐term functional impairment. Organ preservation (OP) has become a key therapeutic goal in rectal cancer to reduce surgery‐related morbidity without compromising oncological outcomes. Three main OP strategies have been developed: Watch and Wait (W&W) strategy, Local Excision (LE) and Contact X‐ray Brachytherapy (CXB), both applicable in patients showing a favourable tumour response after neoadjuvant therapy. The current challenge is defining the optimal timing and modalities for response assessment to accurately identify complete clinical response while balancing oncological control, functional outcomes and patient preferences. This trial evaluates whether a structured tumour response surveillance program combined with shared decision‐making (SDM) can safely increase OP rates. Methods GRECCAR 20 is a multicentre, randomized, open‐label, phase III trial enrolling patients with cT2‐T3N0‐1 rectal adenocarcinoma ≤ 8 cm from the anal verge and ≤ 4 cm in length, without involvement of the anal canal. Across the French GRECCAR and PRODIGE network, 270 patients will be recruited over 36 months. After neoadjuvant treatment (CRT or induction chemotherapy followed by CRT), participants are randomized to either a structured tumour response surveillance strategy with SDM over 8 to 24 weeks (experimental arm) or standard response assessment without SDM at 8 weeks (control arm). In the experimental arm (Arm A), reassessments at 2‐, 4‐ and 6‐month post‐treatment will guide management decisions—W&W, LE, CXB or TME—through a collaborative process between patient and clinician. In the control arm (Arm B), treatment decisions at 2 months will be made solely by the clinician, between LE or TME, based on clinical, endoscopic and radiological assessment. The primary outcome is the OP rate at 2 years. Secondary endpoints include disease‐free survival, TME‐free survival, functional outcomes, quality of life (QoL) and patient‐reported outcome measures (PROMs). Conclusion GRECCAR 20 is the first randomized trial to assess a structured tumour response surveillance program incorporating SDM in rectal cancer. By prioritizing patient values and QoL, this trial aims to improve OP rates without compromising oncological safety, potentially establishing a new standard of personalized, patient‐centred care
Determining the optimal operating conditions of SOFCs electrolytes based on evolution of their electronic transport number with temperature and oxygen partial pressure: A case study of the Ce0.9Gd0.1O2-δ electrolyte
No full textInternational audienceOptimizing the performance of Solid Oxide Fuel Cells (SOFCs) or Solid Oxide Electrolysis Cells (SOECs) necessitates a thorough understanding of the electrolytes' transport properties under the device's operating conditions, whether through experimental data or established transport laws. This study investigates the electrical properties of Gd-doped ceria as a potential electrolyte material for SOFC applications. The electrical behavior of Gd-doped ceria was analyzed over a broad range of oxygen partial pressures (from 10−36 to 1 bar) and temperatures (200 °C to 900 °C) to establish the Patterson diagram, i.e., the variation of the total electrical conductivity as a function of the oxygen partial pressure (on logarithmic scales) for various temperatures. Additionally, the average transport number of the Gd-doped ceria electrolyte was evaluated under varying oxygen partial pressure gradients and temperatures using a specific semi-permeation method and compared with data derived from the Patterson diagram. The results collected in this study indicate that the use of Gd-doped ceria as an SOFC electrolyte requires precise control of oxygen partial pressure (particularly below 10−24 bar at 600 °C) or the hydrogen-to-water ratio at the hydrogen electrode to prevent efficiency degradation of the electrochemical system and to determine optimal operating conditions.</p
Le camp de Rouillé: Nouvelles recherches, nouvelle histoire, de 1939 à nos jours
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The longitudinal association between anticholinergic burden and cognitive‐functional decline among older adults
No full textInternational audienceAims Long‐term use of medications with anticholinergic properties has been associated with cognitive and functional decline among older adults, yet these measures are typically assessed in isolation—potentially overlooking their interrelated nature. This study investigated the longitudinal association between anticholinergic burden and integrated cognitive‐functional measures in older adults. Methods Participants were drawn from S.AGES (France, 2009–2012). The total daily anticholinergic burden was assessed using the Anticholinergic Burden Scale (ACB) and the Anticholinergic and Sedative Burden Catalogue (ACSBC). We combined the Mini‐Mental State Examination (MMSE) with basic activities of daily living (BADLs), with instrumental activities of daily living (IADLs) or with both. Exploratory factor analyses (EFAs) and confirmatory factor analyses (CFAs) were conducted to explore dimensionality and model fit. The associations between the total burden and outcomes were estimated using generalized linear mixed models (GLMMs). Results Among 983 participants, a higher total daily ACB score was associated with poorer MMSE‐BADLs‐IADLs performance (OR = 1.25; 95% CI = [1.06–1.47]; p = 0.004) and MMSE‐IADLs (OR = 1.56; 95% CI = [1.30–1.88]; p < 0.001). Higher ACSBC scores showed similar associations with the MMSE‐BADLs‐IADLs (OR = 1.23; 95% CI = [1.08–1.40]; p < 0.001) and MMSE‐IADLs (OR = 1.40; 95% CI = [1.16–1.70]; p < 0.001). The three cognitive‐functional measures showed high internal consistency with comparative fit indexes (CFIs) of 0.9 and 0.95 and root mean squared error of approximations (RMSEAs) < 0.08, supporting a one‐factor model. Conclusions Our findings, based on combined measures in assessing cognitive‐functional decline in older adults, support incorporating anticholinergic burden assessment into routine care, particularly for patients aged ≥85 or those with CNS diseases and depression