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Perinatal outcomes following <i>in‐utero</i> transfusion for hydrops fetalis associated with parvovirus B19 infection
No full textInternational audienceObjective Congenital parvovirus B19 (PB19) infection can lead to severe fetal anemia and hydrops fetalis, necessitating in‐utero transfusion (IUT) as a life‐saving intervention. This study aimed to identify risk factors associated with unfavorable perinatal outcome following IUT in hydropic fetuses with PB19 infection, with the goal of optimizing transfusion strategies and improving fetal survival. Methods A retrospective, multicenter, international cohort study was conducted across nine specialized fetal medicine centers in France, Belgium and the Czech Republic. This study included pregnant women with a fetus diagnosed with hydrops due to PB19 infection that underwent at least one IUT for severe fetal anemia between January 2014 and May 2024. Clinical, demographic and procedural data were analyzed. The primary outcome was to identify maternal, fetal, obstetric or IUT‐related risk factors associated with adverse fetal or neonatal outcome, defined by a composite criterion of unfavorable outcome that included perinatal mortality and/or severe and persistent fetal anomalies, including severe fetal brain injury at follow‐up. Statistical analysis was conducted using logistic regression models to assess potential risk factors. Results Of the 84 eligible cases, 78 pregnancies were included in the final analysis. The rate of perinatal survival without severe brain injury was 59.0% (46/78), while 41.0% (32/78) of cases had an unfavorable outcome, including 20 (25.6%) cases of stillbirth, nine (11.5%) cases of termination of pregnancy, one (1.3%) case of continuation of pregnancy despite severe prenatal neurological findings and two (2.6%) cases of neonatal death. Notably, a higher fetal hemoglobin (Hb) level (> 9.3 g/dL) after the first or second IUT was significantly associated with a reduced risk of unfavorable outcome (adjusted odds ratio (aOR), 0.6 (95% CI, 0.4–0.8)). A femur length Z‐score of < −2 was associated with unfavorable outcome (aOR, 5.4 (95% CI, 1.3–27.0)). Transplacental vs transamniotic funicular puncture was not significantly associated with perinatal survival. Conclusions IUT remains a cornerstone intervention for managing severe fetal anemia caused by PB19 infection; however, rates of perinatal loss continue to be substantial, especially in the presence of severe hydrops. Achieving higher post‐transfusion Hb levels appears to be an important factor in improving survival outcomes for hydropic fetuses with PB19 infection. © 2026 International Society of Ultrasound in Obstetrics and Gynecology
Non-invasive ventilation: interpretation of ventilator supplied data
No full textInternational audienceBackground The increasing number of patients treated by long-term non-invasive ventilation (NIV) challenges the capacity of specialised centres to perform in-hospital follow-up evaluations and requires, therefore, from the clinician a thorough and critical appraisal of the information provided by ventilator software as an important component of follow-up assessment. A systematic approach of the information is required along with a knowledge of the limitations in the reliability of some parameters and the variability in modes of reporting, which may be confusing. Methods This review reports the summary of observations made by a multinational group of experts in this field (SomnoNIV) over several years, and the relevant items from the medical literature. Results We suggest a framework for a systematic approach of items provided by ventilator software, as well as a discussion of the different modes of reporting physiological variables according to manufacturers and pitfalls associated with some variables. An extensive iconography is included to illustrate and explicit the presentation of respiratory events occurring under NIV (impact of leaks, different patient-ventilator asynchronies, impact of inappropriate settings). Conclusion The analysis of the detailed tracings provided by the ventilator, and, importantly, the knowledge that these signals are modified and processed by the ventilator software and are not raw data, is important for the understanding of patient-ventilator interaction
Balanoposthitis due to Klebsiella aerogenes in men who have sex with men
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Idealized modeling of stratospheric aerosol injection deployment scenarios with two non-cooperative actors
No full textInternational audienceThis code is the version of https://github.com/OB-IPSL/two-actor-SRM used in the article by Määttänen et al. (2025) in Environmental Science: Atmospheres of the Royal Society of Chemistry (A. Määttänen, F. Ravetta, J. Bureau, T. Lurton and O. Boucher, Environ. Sci.: Atmos., 2026, DOI: 10.1039/D5EA00022J. The article investigates solar radiation management scenarios of two non-cooperative actors deploying stratospheric aerosol injection (SAI) through idealized experiments. The repository includes the codes for a four-box Energy Balance Model capable of predicting hemispheric temperatures and monsoon precipitation and the coupled PI-controller. A short README is included
« Car tout desplaist fors estude et science » : arts et savoirs chez Eustache Deschamps
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Small in the heat, transparent in the bloom : copepod morphological responses in the California upwelling ecosystem
No full textInternational audienceCopepods are central to marine food webs as they link primary producers to higher trophic levels. This study used in situ images collected with an Underwater Vision Profiler during four cruises (2008, 2012, 2014 and 2016) in the California Current Ecosystem to investigate how copepod morphologies relate to environmental conditions. Consistent with Bergmann’s rule, our results indicate that smaller copepods were associated with warmer environments. Copepods with more complex body shapes, owing to extended appendages, were observed in waters with higher fluorescence and diatom concentrations. Finally, more transparent copepods were found in shallower waters with higher fluorescence, potentially suggesting predatory avoidance of darker copepods found deeper in the water column. These findings support the power of imaging-based functional trait-based approaches to link zooplankton morphological variability with environmental gradients, enhancing our understanding of zooplankton dynamics in productive upwelling systems
The Yang-Mills measure on compact surfaces as a universal scaling limit of lattice gauge models
No full textIn this article, we study the 2-dimensional Yang-Mills measure on compact surfaces from a unified continuum and discrete perspective. We construct the Yang-Mills measure as a random distributional 1-form on surfaces of arbitrary genus equipped with an arbitrary smooth area form, using geometric tools based on zero-area bands and cylindrical resolutions. This yields a canonical bulk-singular decomposition of the measure, reflecting the topology of the surface.We prove a universality theorem stating that the continuum Yang-Mills measure arises as the scaling limit of a wide class of lattice gauge theories, including Wilson, Manton, and Villain actions, on any compact surface. We study the convergence in natural spaces of distributions with anisotropic regularity. As further consequences, we obtain a new intrinsic construction of the Yang-Mills measure, independent of the previous constructions in the literature, and prove the convergence of correlation functions and Segal amplitudes on all compact surfaces.Dans cet article, nous étudions la mesure de Yang–Mills bidimensionnelle sur les surfaces compactes selon une approche unifiée, à la fois continue et discrète. Nous construisons la mesure de Yang–Mills comme une 1-forme aléatoire distributionnelle sur des surfaces de genre arbitraire, munies d’une forme de surface lisse quelconque, en utilisant des outils géométriques basés sur les bandes de surface de surface nulle et les résolutions cylindriques. Cette démarche conduit à une décomposition canonique de la mesure en parties régulière et singulière, reflétant la topologie de la surface. Nous démontrons un théorème d’universalité établissant que la mesure de Yang–Mills du continuum apparaît comme la limite d’échelle d’une large classe de théories de jauge sur réseau, incluant les actions de Wilson, Manton et Villain, sur toute surface compacte. Nous étudions la convergence dans des espaces naturels de distributions à régularité anisotrope. Ainsi, nous obtenons une nouvelle construction intrinsèque de la mesure de Yang–Mills, indépendante des approches précédentes de la littérature, et nous prouvons la convergence des fonctions de corrélation et des amplitudes de Segal sur toutes les surfaces compactes
Investigation of the lithium extraction mechanism from LiNi0.6Mn0.2Co0.2O2 by using operando neutron diffraction in an all-solid-state battery
No full textInternational audienceAll‐Solid‐State Batteries (ASSBs) are promising emerging devices for meeting high‐energy demands and an in‐depth understanding of the reaction mechanisms occuring during their operation will help in their design for better performance. In this context, neutrons, with their high penetration depth and sensitivity to light elements such as lithium, provide a powerful tool for investigating the structural mechanisms occurring in bulk ASSBs, while the electrochemical operation of large batteries (required for neutron diffraction) remains a challenge. In this study, we demonstrate the reversible electrochemical Li + extraction/insertion within a 2.5 mm thick ASSB system comprising 140 mg of LiNi 0.6 Mn 0.2 Co 0.2 O 2 (NMC622) as the positive electrode material (238 mWh energy density), Li 5.4 PS 4.4 BrCl 0.6 (LPSClBr) as the solid electrolyte and Li 0.5 In as the negative electrode. Thanks to the use of the newly‐designed ILLBAT#5 electrochemical cell, we were able to perform operando neutron powder diffraction (NPD) of the system, which coupled with ex situ diffraction, allowed us to gain valuable insights into the structural evolution of NMC622 within the ASSB as well as to probe the structural stability of the Argyrodite solid electrolyte throughout the initial cycle. Herein, we report on the formation and the co‐existence of H1‐H2 phases in NMC622, attributed to system inhomogeneity
Les déterminants sociaux des troubles en santé mentale chez les professionnels de santé à distance du début de la pandémie de COVID-19
No full textThe COVID-19 pandemic represented an unprecedented challenge for healthcare systems and a major source of psychological vulnerability for healthcare professionals. In this context, this thesis is based on the longitudinal PsyCOVer study, which aims to examine the evolution of anxiety, depression, post-traumatic stress disorder (PTSD), and professional burnout, as well as the social, economic, relational, and organizational determinants that influence them, one and two years after the onset of the health crisis. The study is based on two survey waves conducted in 2021 and 2022 among various categories of healthcare workers, including physicians, nurses, nursing assistants, and other professionals working in hospitals or private practice. The results show a partial improvement in healthcare workers' mental health between 2021 and 2022: the prevalence of anxiety and depressive symptoms decreased, mainly among women, whereas PTSD and burnout persisted. These conditions are highly interdependent and tend to become chronic, suggesting shared mechanisms related to chronic stress and impaired emotional regulation. Baseline burnout appears to be a factor associated with the onset of depressive symptoms. Beyond working conditions and exposure to infection risk, the findings highlight the importance of socio-economic and relational factors in the pandemic context. Perceived financial deterioration, social isolation, and lack of support emerged as major vulnerabilities. These associations were particularly pronounced among women, reflecting gendered precariousness in certain professions (nurses, nursing assistants). Profession-related stigma also appeared as an aggravating factor, undermining healthcare workers' social capital and reinforcing a vicious cycle of psychological distress and isolation. Methodologically, PsyCOVer stands out as one of the few longitudinal French studies to have monitored healthcare workers' mental health after the acute phase of the pandemic. It provides an original contribution through the inclusion of diverse professions, including those in private practice, and the analysis of subjective determinants. This thesis offers valuable insights into the impact of the COVID-19 pandemic on healthcare workers' mental health in the context of a health crisis and offers concrete recommendations for public policies. It advocates for an integrated approach to healthcare workers' mental health during pandemics, addressing socio-economic determinants to reduce inequalities and anticipating and countering professional stigma that intensifies during crises. It also recommends strengthening social bonds within and beyond teams to combat isolation and implementing more systematic prevention and screening of mental health disorders, with special attention to the most vulnerable workers. Finally, it emphasizes the need for organizational changes that promote quality of work life and ensure faster and more equitable access to mental healthcare. Ultimately, this thesis underscores that healthcare workers' mental health is a central determinant of the quality and sustainability of healthcare systems. Lessons learned from the pandemic should guide preparedness for future health crises, to safeguard not only the well-being of professionals but also collective resilience.La pandémie de COVID-19 a constitué une crise sanitaire d'une ampleur inédite, fragilisant à la fois les systèmes de soins et la santé psychique des professionnels qui y travaillent. Dans ce contexte, cette thèse qui s'appuie sur l'enquête longitudinale PsyCOVer, vise à examiner l'évolution des troubles anxieux, dépressifs, de trouble de stress post-traumatique (TSPT) et de l'épuisement professionnel, ainsi que les déterminants sociaux, économiques, relationnels et organisationnels qui les influencent un an puis deux ans après le début de la crise sanitaire. L'étude repose sur deux vagues d'enquête menées en 2021 et 2022 auprès de différentes catégories de professionnels de santé, incluant médecins, infirmiers, aides-soignants et autres professionnels en exercice hospitalier ou libéral. Les résultats obtenus montrent une amélioration partielle de la santé mentale des soignants entre 2021 et 2022 : la prévalence des symptômes anxio-dépressifs diminue, principalement chez les femmes, mais le TSPT et l'épuisement professionnel persistent. Ces troubles et l'épuisement professionnel présentent une forte interdépendance et une tendance à la chronicisation, suggérant des mécanismes partagés liés au stress chronique et à l'altération de la régulation émotionnelle. L'épuisement professionnel initial apparait comme un facteur associé à la survenue de symptômes dépressifs. Au-delà des conditions de travail et de l'exposition au risque infectieux, les résultats de cette thèse soulignent l'importance des facteurs socio-économiques et relationnels dans ce contexte pandémique. La perception d'une dégradation financière, l'isolement social et l'absence de soutien constituent des vulnérabilités majeures. Ces associations sont particulièrement marquées chez les femmes, illustrant une précarisation genrée dans certaines professions (infirmières, aides-soignantes). La stigmatisation liée à la profession apparaît comme un facteur aggravant, fragilisant le capital social des soignants et alimentant un cercle vicieux de détresse psychologique et d'isolement. Sur le plan méthodologique, PsyCOVer se distingue comme l'une des rares enquêtes longitudinales françaises à avoir suivi la santé mentale des soignants après la phase aiguë de la pandémie. Elle apporte une contribution originale par l'intégration de professions variées, y compris en exercice libéral, et par l'analyse de déterminants subjectifs. Cette thèse offre des éclairages sur la santé mentale des soignants en contexte de crise sanitaire et propose des recommandations concrètes pour les politiques publiques. Elle plaide pour une approche intégrée de la santé mentale des soignants en période de pandémie visant à agir sur les déterminants socio-économiques afin de réduire les inégalités et à anticiper et contrer la stigmatisation professionnelle qui s'exacerbe en période de crise. Elle recommande également de renforcer les liens sociaux au sein et en dehors des équipes, afin de lutter contre l'isolement, et d'organiser une prévention et un dépistage plus systématiques des troubles psychiques, avec une attention spécifique portée aux soignants les plus vulnérables. Enfin, elle souligne la nécessité de changements organisationnels favorisant la qualité de vie au travail et un accès plus rapide et plus équitable aux soins en santé mentale. En définitive, cette thèse rappelle que la santé mentale des soignants constitue un déterminant central de la qualité et de la pérennité du système de soins. Les enseignements tirés de la pandémie doivent guider la préparation aux futures crises sanitaires, afin de préserver non seulement la santé des professionnels mais aussi la résilience collective
MASLD, MASH, and the CKM Spectrum: A Roadmap for Multi-Organ Clinical Trial Design
No full textInternational audienceCardiovascular, kidney, and metabolic (CKM) diseases and liver disease are not merely linked by shared risk factors but also frequently coexist as comorbidities with overlapping pathophysiology. Metabolic dysfunction-associated steatotic liver disease (MASLD) is highly prevalent in individuals with CKM disorders, and vice versa. The concomitant presence of these conditions amplifies the risk of both CKM and liver-related outcomes, raising the question of whether the CKM model should formally incorporate liver dysfunction. In this review, we detail the epidemiological and pathophysiological evidence that supports this expanded framework, highlighting the shared mechanisms of systemic inflammation, lipotoxicity, and fibrotic remodeling that unify these conditions. We then critically appraise the current landscape of selected heart failure, chronic kidney disease, and MASLD/metabolic dysfunction-associated steatohepatitis (MASH) trials, demonstrating how focus on single disease states with the exclusion of or insufficient data on the others has created knowledge gaps. Building on this, we provide a pragmatic outline for designing integrated multi-organ trials. We outline strategies for enriching trial populations, discuss the evidence and challenges for establishing non-invasive tests as surrogate endpoints to replace liver biopsy, and provide a framework for leveraging advanced biomarker and imaging sub-studies in CKM and MASLD/MASH trials. Finally, we advocate for a transition from isolated studies to patient-centered basket and platform trials that use master protocols to develop holistic therapies for these interconnected diseases.</div