Portail HAL de l'Université Picardie Jules Verne
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Cyclic exclusive enteral nutrition versus partial enteral nutrition to maintain long-term drug-free remission in paediatric Crohn's disease (CD-HOPE): an open-label, endpoint-blinded, randomised controlled trial
No full textInternational audienceBackgroundFor children with Crohn's disease, there is a marked demand for long-term nutritional treatment strategies to avoid the side-effects related to drug treatment. We aimed to investigate whether paediatric patients with Crohn's disease responding to nutritional induction therapy can be maintained in remission on dietary therapy without the use of medication or surgery.MethodsIn this open-label, endpoint-blinded, randomised controlled trial (CD-HOPE) done in 21 hospitals of the GETAID pédiatrique network in France, eligible patients were aged 6 years to younger than 18 years with Crohn's disease (newly diagnosed or relapsing after drug treatment) who had reached clinical remission (weighted Paediatric Crohn's Disease Activity Index [wPCDAI] ≤12·5) after induction therapy with 6–12 weeks of exclusive enteral nutrition (EEN; 100% of calories). Stratified by age (≤10 years or >10 years) and relapse status, patients were randomly assigned (1:1) using block randomisation to receive either cyclic EEN (C-EEN; 100% of daily caloric requirements) for 2 weeks every 8 weeks for at least six cycles or daily partial enteral nutrition (PEN; 25% of daily caloric requirements) for 52 weeks. Oral MODULEN IBD was used for both. Except for the 2-week intervals of EEN in the C-EEN group, food access was not restricted. The primary endpoint was relapse rate at 12 months. A relapse was defined as: (1) a wPCDAI score greater than 12·5 at two successive visits, or (2) a wPCDAI greater than 12·5 once and the need for Crohn's disease-related surgery, medication, or study exit, or (3) a wPCDAI score continuously greater than 12·5 since the last study visit, or (4) incomplete wPCDAI and moderate or severe Physician Global Assessment at any timepoint. Primary and safety analyses were performed on an intention-to-treat basis. This trial was registered on ClinicalTrials.gov (NCT02201693) and is complete.FindingsBetween Dec 12, 2014, and Sept 4, 2018 (last patient visit Oct 2, 2019), 112 patients were screened and 100 patients (70 boys and 30 girls) were randomly assigned to C-EEN (n=49) or PEN (n=51). Median age of participants was 12 years (IQR 11–13) in the C-EEN group and 13 years (11–14) in the PEN group. At 12 months, 24 (49%) of 49 patients had relapsed on C-EEN compared with 39 (76%) of 51 patients on PEN (adjusted odds ratio 0·29 [95% CI 0·13–0·70], p=0·0051). 19 adverse events occurred in 17 patients: four serious adverse events in four patients on PEN, not related to treatment, and 15 non-serious adverse events in 13 patients (nine in seven patients on C-EEN and six in six patients on PEN). The serious adverse events were all related to Crohn's disease relapse requiring hospitalisation for rescue therapy. Six adverse events were possibly related to study treatment: one patient in the C-EEN group reported transient vomiting and diarrhoea at the start of the first EEN cycle, one patient in the C-EEN group developed anorexia and, in the PEN group, four patients reported either weight loss, nausea, Crohn's disease relapse, or skin infection. No malignancy or death was reported in this study.InterpretationC-EEN was superior to PEN in maintaining clinical remission over 1 year in paediatric patients with Crohn's disease responding to EEN induction therapy. These findings suggest a new way to use nutritional therapy for maintaining drug-free long-term remission in patients with Crohn's disease who are responding to EEN induction therapy.FundingAssistance Publique-Hôpitaux de Paris and Nestlé Health Science
Public Attention to Gender Equality and Stock Market Returns
No full textInternational audienceWe examine the potential relationship between public attention to gender equality and returns on two U.S. gender‐diversity stock indices (the MSCI USA Women's Leadership and the Morningstar Women's Empowerment index) in comparison to their traditional counterparts (the MSCI USA and the Morningstar USA index) over the 2017–2022 period. We consider several measures of public attention to gender equality: (1) the U.S. daily Google Search Volume Index for different keywords related to gender equality, (2) the number of daily visits to specific Wikipedia pages devoted to gender equality, and (3) the daily number of news stories related to this phenomenon. We find a positive association between public attention to gender equality and returns on U.S. gender‐diversity stock indices. We attribute this result to an increasing investor preferences for owning stocks of companies that promote gender diversity in the workplace during periods of high public attention to gender equality. This finding, which is robust to a battery of alternative estimation methods and proxies, offers important managerial and public policy implications
A Recurrent Blood Culture–Negative Endocarditis Revealing Whipple’s Disease
No full textInternational audienceBackground: Blood culture-negative infective endocarditis (BCNIE) represents a diagnostic and therapeutic challenge. The main reasons for negative blood cultures are prior antibiotic exposure, fungal infection, or infection with fastidious bacteria.Case summary: Here, we describe the case of a 61-year-old patient with recurrent BCNIE initially diagnosed as rheumatoid arthritis but ultimately diagnosed as Whipple's endocarditis.Discussion: Whipple's disease is a rare, chronic, multisystemic infection that may relapse if diagnosis is delayed. Whipple's endocarditis is often misdiagnosed, and its treatment remains empirical. This case shows all the typical features, with misdiagnosis causing a delay in identifying the underlying cause of BCNIE and leading to relapse before the initiation of appropriate treatment.Take-home messages: In the presence of BCNIE, Whipple's disease should always be considered as a potential underlying cause. Prolonged antibiotic therapy appears to reduce the risk of relapse, although close clinical monitoring is recommended as relapses have been reported
Low-latency online estimation of human upper-limb pose and kinematics from a single 360 camera
No full textInternational audienceWe present a fully online framework for streaminghuman upper-limb kinematics estimation from a single 360camera. Incoming frames are processed sequentially throughvertical-boundary-aware tracking, pseudo-perspective rendering,and Neural Localizer Fields to estimate a sparse set of 3Danatomical landmarks in real time. These landmarks are mappedto an OpenSim-compatible biomechanical model, with jointangles computed on the fly via an online inverse kinematicssolver. The system achieves end-to-end latencies as low as22.9 ms on a high-performance setup. Evaluated in a single-participant scenario involving an initial T-pose calibration andrepeated object displacement toward the camera, it demonstratesrobust performance under moderate self-occlusion and sphericaldistortion. While tested in a constrained setting, its modular, real-time design makes it a promising candidate for human–robotinteraction and other motion analysis applications, enablingminimal, markerless, and anatomically interpretable upper-limbtracking from omnidirectional vision
Artificial Intelligence in Rheumatology: From Algorithms to Clinical Impact in Osteoporosis and Chronic Inflammatory Rheumatic Diseases
No full textInternational audienceBackground: Artificial intelligence (AI) is transforming medicine by supporting data-driven diagnosis, prognosis, and personalized care. In rheumatology, AI applications are rapidly expanding in imaging, disease monitoring, and therapeutic decision support. This review aimed to summarize current evidence on AI in osteoporosis and chronic inflammatory rheumatic diseases, with a focus on methodological robustness and clinical applicability. Methods: A narrative review was conducted following SANRA criteria. PubMed and the Cochrane Library were systematically searched for studies published between January 2015 and July 2025 using MeSH terms and free-text keywords related to AI, osteoporosis, and inflammatory rheumatic diseases. A total of 323 articles were included. Results: Machine learning and deep learning models show strong performance in osteoporosis for predicting bone mineral density (BMD), bone loss, and fractures. In chronic inflammatory rheumatic diseases, AI improves imaging interpretation, particularly for sacroiliitis. AI tools also demonstrate potential for predicting disease risk and activity, diagnostic support and treatment response. Hybrid models combining imaging, clinical, and biological data appear particularly promising. However, most studies rely on retrospective single-center datasets, with limited external validation, suboptimal explainability, and scarce evidence of real-world implementation. Conclusions: AI holds significant promise for advancing diagnosis and personalized management in osteoporosis and rheumatic diseases. However, major challenges persist, including heterogeneous data quality, inconsistent methodological reporting, limited clinical validation, and barriers to integration into routine practice. Bridging the gap between algorithmic performance and clinical impact will require prospective studies, robust validation frameworks, and strategies to build trust among clinicians and patients
Investigating the impact of an occupational therapy approach on occupational participation and engagement of people with disabilities in the Lebanese labor market: A single-case experimental design
No full textInternational audienceIntroduction: Work inclusion of people with disabilities (PWD) is a pivotal area of occupational therapy (OT). National and international legislation underlines the rights and duties of PWD concerning workplace inclusion. Despite legal frameworks promoting PWD rights in employment, significant barriers exist. Few studies have explored OT interventions in this context. This research aims to assess the impact of an OT-based job coaching intervention on PWDs’ participation and engagement in the Lebanese labor market. Method: Using an ABABA design, the study involved 27 sessions applying job coaching principles within an OT framework. Three employed individuals with disabilities, facing workplace challenges, participated. Baseline data included task execution speed and errors. Occupational participation and engagement were measured using the Model of Human Occupation Screening Tool. Results: OT-based job coaching effectively enhanced PWD’s participation and engagement, reducing task errors and execution time, thereby addressing some occupational challenges. Conclusion: Based on the outcomes of this study, integrating job coaching with OT approach may improve job performance for PWD. Future research should replicate these findings on a larger scale to validate their applicability in Lebanon and globally
Ethnicity affects relapse-free survival in immune-mediated thrombotic thrombocytopenic purpura
No full textInternational audienceImmune-mediated thrombotic thrombocytopenic purpura (iTTP) is caused by a severe, antibody-mediated deficiency of ADAMTS13 (A Disintegrin And Metalloproteinase with ThromboSpondin-1 motifs, 13th member) activity. The B-cell depleting agent rituximab is effective in restoring ADAMTS13 activity and therefore preventing relapses. However, the risk of relapse appears heterogeneous among patients, although the underlying causes are elusive. Preliminary reports suggested that African ancestry could be associated with decreased relapse-free survival (RFS). Data from the registry of the French National Thrombotic Microangiopathy Reference Center were used to further address the role of ethnicity on response and RFS after rituximab administration in the acute as well as in the preemptive setting. A total of 790 patients (134 patients of African ancestry and 656 patients of European ancestry) were included in the study. Time from rituximab administration to ADAMTS13 recovery was comparable between the two cohorts. Patients of African ancestry had inferior 3-year combined RFS after the first rituximab-treated episode compared to patients of European ancestry (
Quality-driven divisive K-Means: A new clustering strategy for MALDI imaging data for a more precise and less biased characterization of complex biological tissues
No full textInternational audienceMatrix-Assisted Laser Desorption/Ionization Mass Spectrometry Imaging (MALDI-MSI) has become the foremost technique for molecular characterization of complex biological tissues, owing to its unparalleled sensitivity, broad molecular coverage, and high spatial resolution. While targeted analysis is traditionally dominated MALDI imaging workflows, the inherent limitations of hypothesis-driven approaches have fueled interest in untargeted strategies. Clustering, particularly k-means-based methods, has emerged as a powerful tool for exploring spectral datasets without predefined assumptions. However, conventional k-means struggles with heterogeneous spectral distributions, prompting the adoption of bisecting k-means in MALDI imaging. Despite its hierarchical structure, bisecting k-means introduces biases by arbitrarily merging or fragmenting clusters, potentially distorting biological interpretations. This study introduces Quality-Driven Divisive k-means, a novel clustering approach that retains the hierarchical nature of bisecting k-means while dynamically optimizing the number of clusters at each partitioning level. Using MALDI imaging of squamous cell carcinoma tissues from the tongue, we illustrate the potential of Quality-Driven Divisive k-means to provide a more faithful representation of molecular architectures, mitigating the distortions inherent to fixed binary partitioning. Our findings suggest that adaptive clustering methodologies could enhance spectroscopic imaging, paving the way for more accurate tissue characterization in biomedical and clinical research
Exploring processability limitations of commercial hard carbon for negative electrodes of Na-ion batteries
No full textInternational audienceOptimizing electrode manufacturing processes for sodium-ion batteries (SIBs) is crucial for enhancing their performance and commercial viability. This study systematically investigates the influence of critical electrode fabrication parameters, including solid content, mass loading, and calendering, on commercial hard carbon (HC) electrode properties. Slurries prepared with 35 % and 40 % solid content (SC) demonstrated distinct rheological behaviours, directly affecting electrode mechanical stability and processability. The slurry with SC-35 % provided a better balance between manageable viscosity and robust mechanical stability upon drying, whereas SC40 % slurry exhibited higher viscosity, particle agglomeration, and poorer electrode mechanical integrity. Calendering was studied at compression degrees of 10 %, 20 %, and 30 %, revealing limited effectiveness in reducing porosity due to the intrinsic mechanical properties of HC, whereas, higher compression degrees led to structural damage. Electrochemical studies conducted in half-cells (HC vs. Na) and full-cells (HC vs. Na3V2(PO4)3) clearly indicated better electrochemical performance at moderate calendering degrees (10-20 %), effectively balancing mechanical integrity and electrical conductivity. This comprehensive study results in a useful experimental database in academic literature, underscoring the importance of precise control over slurry formulation and calendering parameters to achieve structurally robust electrodes, thus significantly enhancing the practical performance of SIBs
Annotating Texture and Imitation Patterns in a Corpus of Slow Movements in Corelli’s Trio Sonatas
No full textInternational audienceThe Corelli trio sonatas are emblematic of the mid-Baroque period, characterized by their elegant melodies, intricate counterpoint, and systematic development of thematic material. Extending harmonic annotations from Hentschel et al. (2021), we provide a dataset with annotations of all 38 slow movements of the Sonate da chiesa Op. 1 (1681) and Op. 3 (1689), focusing on this Baroque writing style. The 7,000+ annotations describe the texture (homorhythmy, imitations, suspensions), further detailing thematic and imitation patterns, with other information such as rhythmic density. We provide audio synchronizations to a widely available recording and release the corpus for download as well as through the Dezrann platform