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Project OPV4COM - Organic photovoltaics for sustainable indoor IoT by simultaneous energy harvesting and optical wireless data reception
No full textNational audienc
La progression dynamique de l’Hypertension et de Diabete en Répu-blique Démocratique du Congo de 2019 to 2023
No full textInternational audienceIntroduction : La République Démocratique du Congo (RDC) ne dispose pas de données surla prévalence nationale de l'hypertension artérielle (HTA) ou de diabète (type I et II combinés)pour faciliter la prise de décisions fondées sur des données probantes, malgré l'hypothèsed'une transition épidémiologique dans les pays à revenu faible et intermédiaire. L'objectif decette étude était d'estimer une approximation de la prévalence de l'HTA et de diabète.Methodologie : Cette étude a utilisé les données hebdomadaires de routine relatives à l'HTAet au diabète du Système National d'Information Sanitaire (SNIS), couvrant la période 2019-2023. Les données ont fait l'objet d'une évaluation de la qualité et d'ajustements à l'aide desméthodes standardisées avant d'être analysées. Des analyses d'équité ont été réalisées auxniveaux national et infranational. Des courbes et des cartes épidémiologiques ont été produitespour analyser les tendances de la prévalence de l'HTA et de diabète chez les adultes âgés de18 ans et plus. L'autorisation d'utiliser les données a été obtenue auprès de l'autorité derégulation. Résultats : En cinq ans, la prévalence de l'HTA est passée de 13,23% (IC95% :13,22-13,24) à 15,23% (IC95% : 15,22-15,24) (+15,1% d'augmentation relative), et celle dediabète de 2,73% (IC95% : 2,72-2,74) à 3,345% (IC95% : 3,34-3,35) (+16,3% d'augmentationrelative), avec des variations observées d'une province à l'autre. Conclusion : En RDC, l'HTAet le diabète progressent rapidement. Les services de soins de santé primaires et préventifset les interventions de santé publique doivent donner la priorité à ces maladies
De la recherche participative à la recherche création : Variations autour d’une barque
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Construire la logistique urbaine durable : une ethnographie de l'écosystème urbaine
No full textThis dissertation examines the challenges and opportunities of achieving sustainability in city logistics, employing the concepts of wicked problems and urban ecosystems. Drawing on insights from industries where sustainability was addressed through technical solutions, this study offers a critical examination of the systemic, social, and environmental complexities of city logistics as a pivotal urban sub-ecosystem and a central aspect of urban sustainability. It draws attention to issues such as emissions, safety concerns, and the conditions of gig-economy workers, critiquing profit-driven approaches that ignore the interdependencies of urban systems. In contrast, the proposal put forth is that collaborative governance, which encourages the formation of local partnerships, should be the means by which sustainability is addressed at the city level. The research employs interpretive epistemology and ethnographic methods to facilitate a more profound comprehension of city logistics as situated within local social contexts. The thesis demonstrates that sustainable city logistics requires not only technical innovations but also adaptive, collective governance that engages urban stakeholders in decision-making processes. It highlights the necessity of transitioning from centralized, technocratic solutions to adaptive, collective governance that prioritizes adaptability and resilience. This thesis not only enhances understanding of urban logistics but also contributes to supply chain management by proposing a comprehensive approach to complex, systemic sustainability challenges that integrates social and environmental dimensions.Cette thèse examine les défis et les opportunités de la logistique urbaine durable, la conceptualisant comme un problème pernicieux inhérent à son contexte local : l'écosystème urbain. Cette étude propose un examen critique des complexités systémiques, sociales et environnementales de la logistique urbaine en tant que sous-écosystème urbain et aspect central de la durabilité urbaine. Elle attire l'attention sur des questions telles que les émissions, ou les conditions des travailleurs de l'économie de plateforme, et critique les approches axées sur le profit qui ignorent les interdépendances des sous-écosystèmes urbains. Au contraire, elle propose que la gouvernance collaborative, qui encourage la formation de partenariats locaux, soit le moyen par lequel la durabilité devrait être abordée au niveau de la ville. La thèse s'ancre dans une épistémologie interprétative et une méthode ethnographique pour faciliter une compréhension plus profonde de la logistique urbaine telle qu'elle est située dans les contextes sociaux locaux. Elle démontre que la logistique urbaine durable nécessite non seulement des innovations techniques, mais aussi une gouvernance adaptative et collective qui implique les acteurs urbains dans les processus de prise de décision. Elle souligne la nécessité de passer de solutions centralisées et technocratiques à une gouvernance adaptative et collective qui donne la priorité à l'adaptabilité et à la résilience. Cette thèse n'améliore pas seulement la compréhension de la logistique urbaine, mais contribue également au domaine du supply chain management en proposant une approche holiste des défis complexes et systémiques de la durabilité, qui intègre les dimensions sociales et environnementales
L’alternance nuit-elle à la santé ? Le cas de la métallurgie néo-aquitaine.
No full textTable ronde V : Les produits de l’alternance. Ce que l’alternance fait aux apprentis (2) — Animation : Sophie Orange (CENS, Université de Nantes)International audienceWork-study training has become a key model for youth professionalization, designed to facilitate their integration into the labor market. In 2024, nearly one million young people in France are engaged in apprenticeships or vocational high school programs. However, this pedagogical model balances skill acquisition with significant exposure to occupational risks.This research examines the social and institutional mechanisms that make young apprentices particularly vulnerable to workplace risks, based on a field study conducted in the metal industry in Nouvelle-Aquitaine. The findings reveal that apprentices and vocational high school students face more precarious and hazardous working conditions than salaried workers of the same age. Indeed, 46% of apprentices in industrial boilermaking reported having had an accident in the past 12 months, a rate 4.4 times higher than the average for 15- to 24-year-olds.The analysis highlights three structural contradictions in the work-study model: A fragmented approach to occupational health and safety training, with uneven knowledge transmission between training centers and workplaces (Rollin, 2024). Pressure to secure employment, which leads young workers to accept hazardous and demanding conditions, similar to those of temporary workers (Thébaud-Mony, 2008). A hybrid status that limits their protection, making it difficult to recognize workplace accidents and occupational illnesses.These findings suggest that work-study training itself generates risks due to the lack of comprehensive occupational safety education. Given this reality, this study calls for a critical reassessment of the responsibilities of key stakeholders (companies, educational institutions, policymakers) to strengthen protections for young workers in training.L’alternance est aujourd’hui un modèle central de professionnalisation des jeunes, visant à faciliter leur insertion sur le marché du travail. En 2024, près d’un million de jeunes sont concernés en France, à travers l’apprentissage ou la formation en lycée professionnel. Toutefois, ce modèle pédagogique repose sur un équilibre fragile entre acquisition de compétences et exposition aux risques professionnels.Cette recherche interroge les mécanismes sociaux et institutionnels qui rendent les jeunes alternants particulièrement vulnérables face aux risques du travail, en s’appuyant sur une enquête menée dans le secteur de la métallurgie en Nouvelle-Aquitaine. Les résultats montrent que les apprentis et lycéens professionnels sont confrontés à des conditions de travail plus précaires et accidentogènes que les jeunes salariés du même âge. En effet, 46 % des apprentis en chaudronnerie industrielle déclarent avoir eu un accident au cours des 12 derniers mois, soit un taux 4,4 fois supérieur à la moyenne des 15-24 ans.L’analyse met en évidence trois contradictions structurelles du modèle de l’alternance : Un apprentissage fragmenté de la santé au travail, avec une transmission inégale des savoirs entre les centres de formation et les entreprises (Rollin, 2024). Une pression à l’employabilité qui conduit les jeunes à accepter des conditions de travail pénibles et risquées, similaires à celles des intérimaires (Thébaud-Mony, 2008). Un statut hybride qui limite leur protection, rendant difficile la reconnaissance des accidents et maladies professionnelles.Ces résultats soulignent que l’alternance, en tant que dispositif de formation, produit elle-même du risque en raison d’une prise en compte insuffisante de la prévention des dangers. Face à ce constat, cette étude invite à réinterroger les responsabilités des acteurs impliqués (entreprises, institutions éducatives, politiques publiques) afin de renforcer l’encadrement des jeunes en formation
Tous moyens ? Idées reçues sur les classes moyennes. Chapitre 11 - "Les classes moyennes ne peuvent plus se loger"
No full textNational audienceAprès avoir proposé une définition des classes moyennes, ce chapitre déconstruit l'idée reçue selon laquelle ces dernières ne peuvent plus se loger, en la complexifiant et en la relativisant fortement
Effect of temporary suspension of chronic immunosuppressive drugs on day-90 mortality and ICU-acquired infections among critically Ill patients with solid organ transplant: a retrospective multicenter study
No full textInternational audiencePurpose: Decision-making for management of immunosuppressive drugs in solid organ transplant patients admitted to the ICU remains controversial. This study aimed to evaluate the impact of a temporary suspension strategy (interruption of immunosuppressive drugs > 24h) on day-90 mortality and ICU-acquired infections.Methods: This multicenter observational retrospective study conducted in solid organ transplant patients admitted to nine ICUs used a Bayesian approach with priors based on a belief elicitation process conducted among a panel of experts.Results: Among 591 enrolled patients, suspension strategy was used in 34% of them, during a median period of 5 days [IQR: 3-10]. This approach was more common in patients admitted for sepsis (38%) or COVID-19 (49%) than for non-septic causes (24%) (p < 0.001). Overall, day-90 mortality reached 30%, and Bayesian analysis revealed substantial uncertainty with an OR at 1.13 (95% Credible Interval (CrI): 0.74-1.70), and a 15% probability of a beneficial effect. In the subgroup of patients with sepsis, OR was at 0.90 (95% CrI: 0.55-1.55), with a 50% probability of a beneficial effect. ICU-acquired infections occurred in 26% of patients. The suspension strategy indicated a potential benefit, both in the entire cohort, with a 73% probability of a beneficial effect [OR: 0.74 (95% CrI: 0.49-1.15)], and in the subgroup of sepsis patients with a 78% probability of beneficial effect [OR 0.70 (95% CrI, 0.42-1.16)].Conclusion: Temporary suspension of immunosuppressive drugs may reduce the risk of ICU-acquired infections, with a true uncertainty on day-90 mortality. Prospective studies are warranted to confirm these results
Two-Dimensional Materials for Raman Thermometry on Power Electronic Devices
No full textInternational audienceRaman thermometry is a powerful technique for sub-microscale thermal measurements on semiconductor-based devices, provided that the active region remains accessible and is not obscured by metallization. Since pure metals do not exhibit Raman scattering, traditional Raman thermometry becomes ineffective in such cases. To overcome this limitation, we propose the use of atomically thin Two-Dimensional materials as local temperature sensors. These materials generate Raman spectra at the nanoscale, enabling highly precise absolute surface temperature measurements. In this study, we investigate the feasibility and effectiveness of this approach by applying it to power devices, including a calibrated gold resistor and an SiC Junction Barrier Schottky (JBS) diode. We assess the processing challenges and measurement reliability of 2D materials for thermal characterization. To validate our findings, we complement Raman thermometry with thermoreflectance measurements, which are well suited for metallized surfaces. For example, on the serpentine resistor, Raman thermometry applied to the 2D material yielded a thermal resistance of 22.099 °C/W, while thermoreflectance on the metallic surface measured 21.898 °C/W. This close agreement suggests good thermal conductance at the metal/2D material interface. The results demonstrate the potential of integrating 2D materials as effective nanoscale temperature probes, offering new insights into thermal management strategies for advanced electronic components. Additionally, thermal simulations are conducted to further analyze the thermal response of these devices under operational conditions. Furthermore, we investigate two 2D material integration methods, transfer and direct growth, and evaluate them through measured thermal resistances for the SiC JBS diode, highlighting the influence of the deposition technique on thermal performance
PATIENTS WITH UNCONTROLLED BP, DESPITE THREE OR MORE CLASSES OF ANTI-HYPERTENSIVE DRUGS HAVE MARKEDLY UNDERESTIMATED CARDIOVASCULAR RISK: A SUBANALYSIS OF THE SNAPSHOT EUROPE STUDY
No full textInternational audienceObjective:This subgroup analysis provides descriptive data on patients with blood pressure (BP) assessed as uncontrolled according to guidelines (SBP and/or DBP>140/90mmHg or >130/80mmHg depending on patient clinical profile), despite treatment with three or more antihypertensive classes.Design and method:SNAPSHOT is a cross-sectional, epidemiological, multicentre study, conducted in 9443 patients with hypertension from six European countries (Bulgaria, Croatia, Georgia, Romania, Serbia, and Spain). Investigators estimated BP and LDL-C control, and cardiovascular (CV) risk according to their clinical practice. Estimated CV risk categories were compared to the calculated CV risk based on SCORE2&2-OP.Results:This subanalysis included 3668 patients (66.7±9.9 years, 55.5% women). 86.4% were overweight/obese, and 16.7% were smokers. Dyslipidemia was present in 83.9% of patients, diabetes in 37.7%, while other comorbidities were present in 54.5%.At least one risk factor (male gender, age=>65years, BMI=>30 kg/m2, smoking), was reported in 94.0% of patients. Mean SBP/DBP were 145.5±16.4/85.9±9.4mmHg, 69.6% had SBP and/or DBP>140/90mmHg. Mean heart rate was 74.9±11.1bpm. All patients were uncontrolled for BP according to guidelines however 65.4% of patients were perceived as controlled by the investigators. Mean LDL-C was 119.3±45.9 mg/dL. Only 7.6% of patients were controlled for LDL-C according to guidelines whereas 53.1% were perceived controlled by the investigators.Patients were treated with a mean of 3.4±0.6 classes of drugs. A three-drug combination was used by 65.4% of patients. Most frequently used classes were: ACEIs+Diuretics+Beta-blockers (19.5%), ACEIs+CCBs+Diuretics (10.9%), ARBs+Diuretics+Beta-blockers (9.9%), and ACEIs+CCBs+Beta-blockers (7.1%). Four or more drugs were used by 34.6% of patients, with the most frequently used combination being ACEIs+CCBs+Diuretics+Beta-blockers (14.0%). Single pill combinations were used by 69.2% of patients.Estimated CV risk, compared to calculated CV risk, was: very high 26.9% vs. 90.6%; high 37.3% vs. 8.6%; and low-to-moderate 35.8% vs. 0.8%. Compared to guidelines, investigators estimated CV risk accurately in only 29.7% of patients, and underestimated in 69.2%.figure1Conclusions:Patients with uncontrolled BP, on three or more antihypertensive classes, had very-high cardiovascular risk, markedly underestimated by the investigators. The substantial gap in achieving optimal BP control in this subpopulation highlights the need for better assessment and management of hypertension, including treatment intensification