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Lycées agricoles : quelle place pour les filles ?
No full textInternational audienceCet article examine la présence croissante des filles dans l'enseignement agricole français, tout en soulignant les persistantes ségrégations de genre. Malgré une parité dans les effectifs globaux, les filles se concentrent majoritairement dans la filière des services aux personnes, héritière des écoles ménagères agricoles. Les formations agricoles proprement dites restent dominées par les garçons, avec des disparités marquées selon les spécialités. Des obstacles classiques persistent pour l'intégration des filles dans les filières majoritairement investies par les garçons, comme la difficulté à trouver des stages. Les actions menées pour favoriser la mixité, bien qu'existantes, ont un effet limité sur les ségrégations de genre, notamment car elles interviennent tardivement dans le parcours d'orientation. L'article met en lumière les complexités du renouvellement générationnel dans l'agriculture française, où les représentations et les résistances structurelles continuent de façonner les choix de carrière et les opportunités des jeunes, en particulier des filles
PIM2 inhibition promotes MCL1 dependency in plasma cells involving integrated stress response-driven NOXA expression
No full textInternational audienceOur study explores the complex dynamics of the integrated stress response (ISR) axis, highlighting PIM2 kinase’s critical role and its interaction with the BCL2 protein family, uncovering key mechanisms of cell survival and tumor progression. Elevated PIM2 expression, a marker of various cancers, often correlates with disease aggressiveness. Using a model of normal and malignant plasma cells, we show that inhibiting PIM2 kinase inhibits phosphorylated BAD production and activates ISR-mediated NOXA expression. This shift towards MCL1 dependence underscores the synergy achieved through combined PIM/MCL1 inhibition, driven largely by ISR-mediated NOXA expression. In mouse xenograft models, dual targeting of PIM2 and MCL1 effectively controls tumor growth-a response reversed by ISR-specific inhibition and upregulation of genes linked to tumor cell dissemination. This work elucidates the molecular intricacies of PIM2 inhibition and its implications for cancer therapy, especially in tumors with elevated PIM2 expression
Beyond Seizures: Psychiatric comorbidities in children with epilepsy
No full textInternational audienceAbstractPurposeChildren with epilepsy are at an increased risk of developing psychiatric comorbidities, which exacerbate the overall disease burden. However, these disorders are often underreported in developing countries. This study, conducted in a developing country, aims to evaluate the frequency of psychiatric disorders and associated factors in a large cohort of children with epilepsy.MethodsThis study is part of a large, ongoing prospective study on a cohort of children with epilepsy in Lebanon. Children were recruited at the onset of their seizures between March 2010 and May 2016 and were followed for periods ranging from 2 to 12 years. The medical records of 598 children with new-onset seizures were analyzed throughout their follow-up period to identify the presence of any psychiatric disorders. Psychiatric disorders were classified as internalizing or externalizing disorders based on DSM-5 criteria and were considered present if the child had been referred and diagnosed by a pediatric psychiatrist, therapist, or neurologist, or if the medical record provided clear evidence of the child taking medication for a psychiatric disorder. Multivariable logistic regression was used to identify factors associated with psychiatric disorders.ResultsOf the 598 children with new onset seizures, 75 (12.5 %) were diagnosed with a psychiatric disorder, with 30 (5.0 %) having an internalizing disorder and 47 (7.9 %) having an externalizing disorder. Externalizing psychiatric disorders were most commonly reported children with developmental epileptic encephalopathies (18.2 %) compared to other epilepsy groups. Intellectual and developmental delay was the most important factor associated with externalizing disorders (OR 3.36, 95 %CI 1.48–7.62, p = 0.004). In contrast, the frequency of internalizing disorders didn’t differ across epilepsy groups. The most significant factors associated with the occurrence of internalizing psychiatric comorbidity were the failure of at least two antiseizure medications (OR 3.25, 95 % CI 1.37–7.71, p = 0.007) and an older age at seizure onset (> 10 years vs. < 2 years, OR 6.86, 95 % CI 1.49–31.57, p = 0.013).ConclusionThe prevalence of diagnosed psychiatric comorbidities in children with epilepsy in this study was lower than previously reported in developed countries. This may indicate potential underreporting of psychiatric disorders in Lebanon, where local practices may prioritize epilepsy management over mental health. This study highlights the need for systematic psychiatric screening during routine clinic visits, particularly for children with intellectual or developmental delays and those with poor seizure control
Multiphoton imaging via spectro-temporally tailored femtosecond pulses for dynamically reconfigurable excitation and multimodal analysis of biological samples
No full textInternational audienc
PHYSICIANS UNDERESTIMATED CARDIOVASCULAR RISK AND OVERESTIMATED CONTROL OF BLOOD PRESSURE IN PATIENTS WITH HYPERTENSION: A SUBANALYSIS OF THE SNAPSHOT STUDY IN EUROPE
No full textInternational audienceObjective:This pre-specified subgroup analysis aims to provide descriptive data on hypertensive patients with blood pressure (BP) estimated as controlled by the investigators, but not controlled according to guidelines (SBP and/or DBP>140/90mmHg or >130/80mmHg depending on patient clinical profile).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 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:4659 (49.3%) of SNAPSHOT Europe patients were included in this subanalysis: mean age of 65.2±10.7 years, 56.2% women, 81.6% overweight/obese, and 17.1% smokers. Duration of hypertension since diagnosis was 11.4 ±15.6 years. 54.3% of patients had office SBP and/or DBP >140/90 mmHg per protocol measurements. Selected risk factors for hypertension (male gender, age=>65years, BMI=>30 kg/m2, and smoking) were reported for: 38.8% (one risk), 39.0% (two), and 12.6% (three or more) of patients. Additional comorbidities were present in 44.3% of patients, including hypertensive left ventricular hypertrophy (33.3%), diabetes (30.4%), and chronic kidney disease (6.8%).Patients were treated with one drug (14.5%), a combination of two (34.1%), three (35.3%), and four or more drugs (16.2%). Single-pill combinations were used in 56.6% of patients. The most common classes used were ACEis (60.2%), diuretics (58.6%), beta-blockers (57.2%), CCBs (40.6%), ARBs (28.7%), and central antihypertensive drugs (7.7%).There was poor concordance between CV risk estimated by the investigators compared to CV risk calculated according to guidelines (low-to-moderate: 50.4% vs. 1.6%, high: 30.6% vs. 13.7%, and very high: 19.0% vs. 84.7%, Kappa test [95%CI]: 0.0235 [0.0155; 0.0316]).Compared with guideline recommendations, assessment of CV risk by investigators was accurate in only 22.9% of patients and underestimated in 75.8% of patients (Figure 2).figure1Conclusions:In this subgroup analysis, investigators tended to overestimate BP control and underestimate the CV risk in patients already treated with multiple antihypertensive classes. Context-specific interventions must be urgently developed and implemented to improve BP control and cardiovascular risk reduction in this population
Frequency Tunable Millimeter-Wave Patch Antenna Integrating Ferroelectric Capacitors
No full textInternational audienceWe present the design, realization and performance of a millimeter-wave patch antenna with frequency reconfiguration capabilities generated by integrating ferroelectric interdigitated tunable capacitors (FIDC). The tunable capacitors are based on Ba0.8Sr0.2TiO3 (BST) ferroelectric layers and exhibit very good and stable performances over the microwave and millimeter-wave bands, with a maximum tunability of 40% for a bias voltage of 100 V. The ferroelectric layers have been integrated in the slot-loop excitation circuit of the antenna and their Direct Current (DC) polarization allows a continuous frequency reconfiguration of the antenna around 30 GHz. An electrical model of the whole radiating device has been developed allowing extracting the range of capacitance values to be integrated into the excitation slot for an optimum frequency tuning. The fabricated antenna shows a variation of the operation frequency from 28.5 GHz to 34.95 GHz, corresponding to a frequency tuning of 22.6%. The antenna is very well matched all over the operating frequency band, with total efficiencies between 20% (0 V bias on FIDCs) and 65% (100 V bias)
Politique du logement, pouvoir des territoires et pouvoir sur les territoires. Luttes de définitions, d’usages et de mises en œuvre d’une réforme de la propriété justifiée par le « droit à la ville » et le ZAN
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Association between prefrontal cortex activation and gait parameters during single and dual-task walking in subacute stroke patients
No full textInternational audienceGait impairments are extensively reported in stroke patients. Despite the growing literature on reduced gait performances and increased prefrontal cortex (PFC) activation in stroke, the relationship between gait and PFC activation is still unclear. To explore this relationship further, we aimed to investigate the relationship between various spatiotemporal gait parameters and PFC activation during single and dual-task (DT) walking in subacute stroke individuals. Thirty-three patients walked 10 m for 30 s under two conditions, with and without a cognitive task (n-back test). PFC activation was evaluated with functional near-infrared spectroscopy (fNIRS). We assessed gait speed, double stance time, asymmetry of step length and swing time, and step length variability using an electronic walkway. Of the gait parameters examined, only gait speed in the DT condition appears to be associated with PFC activation (R2 = 0.220). In the multivariate regression analysis, the association between PFC activation and gait speed was no longer significant, with the Barthel score emerging as the only significant independent predictor (R2 = 0.383). These findings suggest that PFC activation could serve as a valuable complementary indicator alongside locomotor assessments during DT, but should be considered alongside relevant patients’ characteristics. Clinically, this approach may enhance the precision of identifying stroke patient profiles and help explore potential patient subgroups. However, further studies with larger samples are necessary to validate this hypothesis
EUS-Guided Gallbladder Drainage of Inoperable Malignant Distal Biliary Obstruction by Lumen-Apposing Metal Stent: Systematic Review and Meta-Analysis
No full textInternational audienceObjective: Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) has emerged as a promising alternative for biliary decompression in patients with malignant distal biliary obstruction (MDBO), used either as a first-line approach or after other interventions have failed. This study aimed to evaluate the aggregated efficacy and safety of EUS-GBD in this patient population. Methods: A comprehensive literature search was carried out across PubMed/Medline, Embase, and Cochrane databases up to 9 January 2024, to identify studies reporting outcomes of EUS-GBD in MDBO cases. The primary endpoint assessed was clinical success, while secondary endpoints included technical success and the incidence of adverse events (AEs). Pooled outcomes were calculated using a random-effects model and presented with 95% confidence intervals (CIs). Results: Seven studies encompassing a total of 193 patients were included in the analysis. The combined clinical success rate for EUS-GBD was 88.1% [95% CI: 78.9–94.9%], while the technical success rate was 99.2% [95% CI: 97.5–100%]. The overall AE rate was 13.7% [95% CI: 9.3–18.8%], with the majority being mild to moderate in severity; no fatal complications were reported. Subgroup analyses indicated that use of smaller lumen-apposing metal stents (LAMS) (<15 mm) was associated with slightly higher clinical success (93.3% [95% CI: 72.4–99.9%]) compared to larger stents (≥15 mm) (87.1% [95% CI: 78.8–93.5%]), and a marginally lower rate of AEs (12.3% [95% CI: 6.4–19.7%] vs. 15.2% [95% CI: 6.5–26.6%]). Conclusions: EUS-GBD demonstrates excellent technical performance, high clinical efficacy, and a manageable safety profile in patients with MDBO and a patent cystic duct