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Overall Survival After Allogeneic Transplantation in Advanced Cutaneous T-Cell Lymphomas (CUTALLO): A Propensity Score–Matched Controlled Prospective Study
No full textInternational audienceCutaneous T-cell lymphomas (CTCLs) are rare, usually refractory, and sometimes fatal diseases. Patients presenting with advanced-stage CTCL usually exhibit poor long-term survival outcomes. Only very few treatments have improved progression-free survival (PFS) in advanced CTCL, and no treatment has increased overall survival (OS). In 2023, the results of the CUTALLO trial supported the hypothesis that hematopoietic stem-cell transplantation (HSCT) was associated with significantly longer PFS as compared with standard-of-care treatment among advanced-stage patients although HSCT did not significantly affect OS. We provide herein the final OS data pertaining to the same patient population after a longer median follow-up of 38.9 months. Of the 99 patients included in the analysis, 55 (56%) were assigned to the HSCT group, whereas 44 (44%) were allocated to the non-HSCT group. The updated survival analysis reported that 16 of 55 patients (29%) in the HSCT group and 22 of 44 patients (50%) in the non-HSCT group died. The median OS was not reached in the HSCT group and 51.5 months (95% CI, 26.9 to 51.5) in the non-HSCT group (hazard ratio, 0.40 [95% CI, 0.20 to 0.80]). Compared with the standard of care for advanced CTCL, after extended follow-up, allogeneic HSCT was associated with significantly longer OS. ClinicalTrials.gov NCT02520908
Buzzy bees: Improving the monitoring of pollinator activity in sunflower fields with continuous acoustic recording and deep learning
No full textAnimal pollination is involved in the reproduction of 90 % of flowering plants. Approximately 70% of crops at global scale rely on pollinators, and growing concerns about insect decline highlight the need for effective monitoring of their activity. Traditional monitoring methods are often time-consuming and destructive. Technological advances now allow the development of passive techniques, such as computer vision and acoustic recording, combined with machine learning. These methods offer improved spatial and temporal coverage for biodiversity monitoring. Passive acoustic monitoring is particularly promising for tracking pollinators but remains underutilized and often relies on outdated machine learning approaches. Recently, deep learning methods—originally designed for image analysis—have begun to be applied to spectrograms of acoustic monitoring of various taxa, including flying insects. In this study, we propose a method for quantifying pollinator activity in sunflower fields based on the automatic detection of wingbeat sounds. We tested both a random forest and a deep learning algorithm using a new open-access software tool for acoustic biodiversity monitoring, TadariDeep. Our results show that deep learning outperforms random forest algorithms in classifying pollinator flight sounds. Comparisons with a standard visual observation protocol confirm the validity of the acoustic approach. Moreover, acoustic monitoring provides a more continuous and accurate assessment of pollinator activity than visual methods. Therefore, combining passive acoustic monitoring with deep learning presents a reliable way to assess pollinator activity at broad spatial and temporal scales. Nonetheless, further refinement is needed to improve species-level identification
Vers une meilleure gestion de la douleur des mammifères et poissons destinés à la consommation humaine – Partie 1 : Concepts, mécanismes, causes, détection
No full textInternational audienceThis article addresses scientific knowledge on pain in livestockspecies intended for human consumption. Pain is an unpleasant sensory and emotional experience associated with or resembling that associated with actual or potential tissue damage. It has three components: sensory, emotional and cognitive. The mechanisms of pain are similar in most species: elaboration, transmission, integration. Throughout their lives, farm animals are confronted with various contexts that can generate pain, with a significant impact on their production and economic performances, as well as on their health and welfare. Pain caused by some farming practices is predictable and its management can be anticipated, unlike accidents or diseases whose occurrence is not or hardly predictable. When in pain, farm animals change their behaviour and physiological response. To detect it, we can mobilize observations focusing on the animals (e.g. posture, facial expression, reaction to palpation, etc.) but also on the way they interact with their physical environment (activities, locomotion, space use, etc.) and social environment (proximity, social interactions, synchronization).Cet article propose de dresser un état des lieux des connaissances scientifiques sur la douleur chez les animaux de production destinés à la consommation humaine. La douleur est « une expérience sensitive et émotionnelle désagréable associée ou ressemblant à celle associée à une atteinte tissulaire réelle ou potentielle ». Elle comporte trois composantes : sensitive, émotionnelle et cognitive. Les mécanismes de la douleur sont similaires chez la plupart des espèces : transduction, transmission, intégration. Tout au long de leur vie, les animaux de production sont confrontés à divers contextes pouvant générer de la douleur, avec un impact important sur leurs performances zootechniques, économiques, sur leur santé et sur leur bien-être. La douleur provoquée par certaines interventions en élevage est prévisible et sa prise en charge peut être anticipée, à l’inverse des accidents ou des maladies dont la survenue n’est pas ou peu prévisible. Les animaux manifestent la douleur en modifiant leurs comportements et leurs réponses physiologiques. Pour la détecter, on peut mobiliser l’observation centrée sur les animaux (posture, expression faciale, réaction à la palpation…) mais aussi sur la manière dont ils interagissent avec leur environnement physique (activités, locomotion, utilisation de l’espace…) et social (proximité, interactions, synchronisation)
Cronotopias do vivido: tempos e espaços que tecem os relatos de vida de mulheres
No full textInternational audienc
Impact de l’usage d’un manuel sur l’enseignement de la relation de parallélisme à l’école primaire
No full textInternational audienceIn previous research, we developed a framework for a didactic analysis of mathematics textbooks in the field of geometry at primary school. As a continuation of this work, the present study investigates the possibility of establishing a link between an analysis of a textbook’s “intrinsic quality” and the effects observed on its use by a teacher when conducting learning activities focused on the concept of parallelism in Year 4 (students aged 9–10). We reveal the numerous adaptations of the textbook's suggestions made by the teacher of the class studied. Our analyses also show that the expertise of a teacher using a textbook of "low didactic quality" may not be sufficient to detect and compensate for the failings of this textbook.Lors de recherches antérieures, nous avons élaboré une grille d’analyse didactique de manuels scolaires en mathématiques dans le domaine de la géométrie à l’école primaire. Dans le prolongement de ces travaux, la présente étude porte sur la possibilité d'une mise en lien entre l’analyse de la « qualité intrinsèque » d’un manuel et les effets constatés dans son utilisation par un enseignant pour conduire des situations d’apprentissage portant sur la relation de parallélisme en CM1 (élèves de 9-10 ans). Nous révélons les nombreuses adaptations des propositions du manuel réalisées par l’enseignant de la classe étudiée. Nos analyses mettent également en évidence que l’expertise d’un enseignant utilisateur d’un manuel de « faible qualité didactique » peut se révéler insuffisante pour déceler et compenser les manques de ce manuel
Silex : une campagne de mesures aéroportées pour l’étude des feux de forêt
No full textNational audienc
Oral anticoagulant reversal and mortality in trauma patients: a multicentre propensity score–matched cohort study
No full textInternational audienceBackground: Oral anticoagulant (OAC) therapy increases bleeding risk but its impact on trauma outcomes and the benefit of reversal remains uncertain. This study aimed to evaluate 1/the effect of preinjury OAC therapy on trauma mortality and 2/the protective role of OAC reversal and its associated thrombotic risk.Methods: We conducted an observational study using a prospective multicenter trauma registry between January 2012 and December 2023. OAC-treated patients were matched with non-OAC-treated patients using a propensity score. Univariable and multivariable logistic regressions assessed associations between OAC therapy and day 1 and day 7 mortality. The effect of guideline-concordant OAC reversal was evaluated. Thrombotic complications were recorded.Findings: Of the 27,426 trauma patients, 3% were OAC-treated. They were older, had more comorbidities, and experienced higher mortality. After matching (n = 2196), OAC therapy remained independently associated with increased mortality (day 1: OR 2·21, 95% CI [1·41-3·43]; day 7: OR 2·06, [1·41-3·00]), with greater risk from vitamin K antagonists (VKA) than direct oral anticoagulants (DOAC). Guideline-concordant OAC reversal, achieved only in 21% of cases, independently reduced mortality at day 1 (OR 0·10, 95% CI [0·03-0·31], p < 0·01) and day 7 (OR 0·51, 95% CI [0·22-0·97], p < 0·01). No significant association was found between reversal and thrombotic complications.Interpretation: Preinjury OAC therapy substantially increased trauma mortality, particularly with VKA. Guideline-concordant reversal was associated with reduced mortality in both VKA- and DOAC-treated patients without excess thrombotic risk but remains underused. These findings emphasise the urgent need for systematic implementation of reversal strategies in OAC-treated trauma patients.The Traumabase registry is funded by several Regional Health Agencies (Agences Régionales de Santé, ARS): ARS Île-de-France, ARS Occitanie, ARS Grand Est, ARS Hauts-de-France, and ARS Auvergne-Rhône-Alpes. The registry is also funded by the French Road Safety Observatory-Road Safety Delegation Service (Observatoire National Interministériel de la Sécurité Routière-Délégation à la Sécurité Routière)
Effect of Baseline Dialysis and Plasma Exchange on Renal Prognosis in Patients With Antineutrophil Cytoplasmic Autoantibody–Associated Vasculitis
No full textInternational audienceIntroduction: The identification of prognostic factors for renal failure in antineutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis (AAV) remains a challenge. The benefit of plasma exchange (PLEX) has been questioned, and the target population remains to be defined. We investigated the outcome of patients requiring renal replacement therapy (RRT) at baseline and factors associated with their prognosis at 1 year.Methods: This retrospective multicenter study evaluated the 1-year composite end point of death or end-stage kidney disease (ESKD) in patients with biopsy-proven renal AAV involvement.Results: Of the 394 patients included, 105 (26.6%) were on dialysis at baseline. Of these, 60 (57.1%) reached the composite end point compared with 29 patients (10.0%) who were not on RRT at baseline (P < 0.001). On multivariate analysis, age and sex were not associated with the composite outcome (P = 0.945 and P = 0.154, respectively); however, myeloperoxidase (MPO)-ANCA was (odds ratio [OR]: 3.60; 95% confidence interval [CI]: 1.79-7.60), as was a high baseline histologic renal risk score (OR: 1.29; 95% CI 1.17-1.44). The most strongly associated factor remained the need for dialysis at baseline (OR: 10.91; 95% CI: 5.52-22.70). Of the 91 patients surviving after requiring dialysis at baseline, 45 were weaned from RRT (49.5%) at 1 year, and PLEX was independently associated with a reduced risk of the composite outcome (OR: 0.23, 95% CI: 0.05-0.80).Conclusion: MPO-ANCA, need for dialysis, and high histological renal risk score at baseline were associated with the 1-year composite end point of death or ESKD. Almost half of the patients on dialysis at baseline were off dialysis at 1 year, with a better prognosis in those who had received PLEX
Impact of endometriosis on the progression of inflammatory bowel diseases: a multicenter retrospective study
No full textInternational audienceIntroduction: Women with endometriosis have a higher risk of developing inflammatory bowel diseases (IBD). This study aimed to better understanding the impact of endometriosis on the course of IBD. Methods: We conducted a retrospective cohort study in 18 French and Belgian IBD centers between June 2022 and March 2023. Any patient with both conditions was eligible for inclusion. They were randomly matched to 1 or 2 patients with IBD without endometriosis. The impact on IBD progression was assessed using a composite severity criterion including intestinal damage or need for bowel surgery. Results: Overall, 207 patients with both conditions (149 Crohn's disease (CD); 58 ulcerative colitis (UC)) were matched to 409 patients with IBD alone. The median follow-up duration for IBD was 10 years [5.75-17]. No difference was observed between the two groups regarding CD location, disease phenotype, and anoperineal involvement. Proctitis were more frequent in patients with UC and endometriosis. IBD patients with endometriosis were significantly less exposed to immunosuppressants (UC p<0.01; CD p<0.001) and biologics (UC p<0.01; CD p<0.001). CD patients with endometriosis had a less severe disease course compared to patients without endometriosis (HR=0.68; 95%CI 0.50-0.92; p=0.011). UC patients with endometriosis had not a significant different disease course compared to patients without endometriosis (HR=1.73; 95%CI 0.74-4.00; p=0.20). These results were similar in the subgroup of patients with endometriosis treated surgically. Conclusions: Endometriosis does not negatively influence the course of IBD, patients with CD even have a less severe progression. Patients were significantly less exposed to immunosuppressants and biologics