Portail HAL de l'Université Picardie Jules Verne
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Sociodemographic impact on smart cities IoT adoption in China
No full textInternational audienceDigital disruption is one of the most important social megatrends that deeply impact recent and future economic activities. IoT has contributed to the development of Chinese smart cities in recent years. Building on the authors' prior study (Boustani, Xu, & Xu, 2022), which established the mediating role of blockchain adoption between IoT and continuous usage intention, this study investigates how sociodemographic variables moderate these relationships. The authors use Partial Least Squares Structural Equation Modeling (PLS-SEM) and Partial Least Squares Multi-Group Analysis (PLS-MGA) with the SmartPLS software, analyzing a dataset comprising over a thousand samples in China. The authors' findings demonstrate that age positively moderates the blockchain adoption-continuous usage intention relationship, IoT knowledge positively moderates the citizen empowerment-IoT relationship, while frequency of IoT use negatively moderates the social influence-IoT relationship. These results extend UTAUT theory by revealing boundary conditions of technology adoption in smart cities
The Dynamic Landscape of the Coagulome of Metastatic Malignant Melanoma
No full textInternational audienceThe local expression of coagulation-related genes defines the tumor coagulome. The tumor coagulome plays a pivotal role in cancer-associated thrombosis (CAT) and hemostatic complications, such as venous thromboembolism (VTE), which are frequent in patients with advanced/metastatic cancer. Genomic analyses of human tumors, such as skin cutaneous melanoma (SKCM), have unveiled the complexity of the metastatic trajectories. However, no study to date has focused on the metastatic coagulome along these trajectories. Using bulk-tumor and single-cell analyses of primary SKCM, metastastic samples and circulating tumor cells (CTCs), we explored the coagulome of SKCM along metastatic progression. We identified consistent changes in the coagulome of SKCM metastases compared to primary tumors and observed metastatic site specificity. Compared to other metastatic sites, lung metastases of SKCM had a specific coagulome with a higher expression of F3, encoding Tissue Factor. Single-cell analyses were used to chart the inter- and intra-tumor heterogeneity and characterize the metastatic coagulome of SKCM. We found that a subpopulation of CTCs from SKCM expressed high levels of platelet genes, suggesting the contribution of CTC–platelet interactions to the CTC coagulome. These findings highlight the dynamic properties of the metastatic coagulome and its link to cancer progression
Serrin's overdetermined problems on epigraphs
No full textIn this work we establish some rigidity results for Serrin's overdetermined problem \begin{equation*} \left\{ \begin{array}{cll} - \Delta u=f(u) & \text{in}& \Omega,\newline u > 0& \text{in} & \Omega,\newline u=0 & \text{on} & \partial \Omega,\newline \dfrac{\partial u}{\partial \eta} = \mathfrak{c} = const. & \text{on} & \partial \Omega, \end{array} \right. \end{equation*} when is an epigraph (not necessarily globally Lipschitz-continuous) and is a classical solution, possibly unbounded. In broad terms, our main results prove that must be an affine half-space and must be one-dimensional, provided the epigraph is bounded from below. These results hold when is of Allen-Cahn type and or, alternatively, when is locally Lipschitz-continuous (with no restriction on the sign of ) and . These results partially answer a question raised by Berestycki, Caffarelli and Nirenberg in [1]. Finally, when f(0) <0, we also prove a new monotonicity result, valid in any dimension
Off-label use of biologics in urticarial vasculitis: a European retrospective cohort study
No full textInternational audienceObjectives Urticarial vasculitis (UV) is characterized by atypical urticarial lesions and leukocytoclastic vasculitis, sometimes with extracutaneous manifestations. First-line treatment is based on colchicine, hydroxychloroquine, dapsone or low-dose glucocorticoids. In refractory forms, the use of biologics has been anecdotally described as potentially effective. We aimed to describe the efficacy and safety of biologics in patients with UV. Methods We conducted a retrospective European multicentre study including patients with hypocomplementemic or normocomplementemic UV who received at least one biologic, including anti-CD20, anti-IgE and/or IL1-targeted therapy, from 2008 to 2021. We analyzed clinical and biological characteristics as well as efficacy and safety of the biologics. Results Forty-one patients receiving 52 therapeutic sequences were analyzed, including rituximab in 23, IL1-targeted therapy in 16 and anti-IgE in 13 cases. UV was hypocomplementemic in 24 (59%) cases. Biologics were used in median in 5th line of treatment, in combination with glucocorticoids in 75%. After a median follow-up of 25 (IQR 12–43) months, the cutaneous response was complete in 40%, partial in 37% and inadequate in 23%. Glucocorticoid discontinuation was achieved in 34% of patients. Serious adverse events, mainly infectious, were observed in 7 (17%) patients. Conclusion Biologics are an effective and rather well-tolerated treatment option for UV that are refractory to conventional therapies
Subcutaneous defibrillator therapy in women
No full textInternational audienceIntroduction While the subcutaneous implantable cardioverter defibrillator (S-ICD) is now an established strategy to prevent sudden cardiac death, the specificities and outcomes associated with the use of this device in women have never been assessed so far.Objective The present study aimed to provide contemporary real-world data on S-ICD use and outcomes in women.Method We used data from the HONEST cohort, a nationwide study including all patients implanted with a S-ICD between 2012 and 2019 in France. Sex-specific outcomes were acceded using a weighting propensity score analysis.Results A total of 1148 women (47.3 ± 15.6 years), accounting for 23.3% of the whole cohort (n = 4924), were enrolled. Indication of implantation was primary prevention in 57.6% (vs. 65.1% in men) and secondary prevention in 42.4% (vs. 34.9% in men; P < 0.009). Coronary artery disease was the most frequent underlying heart disease (38.9% vs. 56.5% in men) and electrical heart disorders were more common in women (26.4% vs. 20.5%; P < 0.001). During a mean follow up of 4.22 ± 2.18 years, women did not have a higher risk of overall complications (aHR 0.95; 95%CI 0.89–1.01; P = 0.065), and of surgical reintervention (aHR 0.95, 95%CI 0.89–1.02, P = 0.094) (Fig. 1). Re-intervention due to pacing need occurred similarly in both sexes (2.4% vs. 2.8%; P = 0.434). Conversely, the risk of inappropriate (aHR 0.81; 95% 0.71–0.91; P < 0.001) and appropriate shocks (aHR 0.91; 95%CI 0.82–1.00; P = 0.045) was lower in women. Finally, there was no difference in risk of death between genders (aHR 1.00; 95%CI 0.97–1.02; P = 0.790).Conclusion This nationwide multicenter cohort study of S-ICD patients showed significant sex-related differences in patient characteristics and outcomes, with a lower risk of appropriate and inappropriate shocks in women as compared with men
Biochemical Insights into Specialized Plant Metabolites: Advancing Cosmeceutical Applications for Skin Benefits
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Revisiting the Place of Surgical Portal Decompression for Adults with Noncirrhotic Portal Hypertension due to Chronic Extrahepatic Portal Vein Obstruction: A Scoping Review
No full textInternational audienceBackgroundLiver cirrhosis accounts for more than 90% of portal hypertension cases, and the other cases are due to noncirrhotic portal hypertension (NCPH). Variceal bleeding is the most life-threatening complication of portal hypertension and its primary treatment is medical according to the Baveno VII guidelines. This review discusses the evidence on surgical portal decompression for adult patients with NCPH secondary to chronic extrahepatic portal vein obstruction (EHPVO).MethodsThis is a scoping review of the evidence for the feasibility and effectiveness of surgical portal decompression in adults with NCPH secondary to EHPVO.ResultsThis scoping review yielded 17 studies, including a total of 110 patients. Patient age(s) ranged from 19 to 68 years, with the majority undergoing nonphysiological (i.e., portosystemic shunts) shunts (N=84, 76.4%), mostly for variceal bleeding refractory to medical and endoscopic treatments. Physiological shunts (i.e., Rex shunts) had a potential advantage over nonphysiological shunts in postoperative rebleeding (5% vs. 10%) and hepatic encephalopathy rates (0% vs. 13%). Conversely, nonphysiological shunts had a potential advantage over physiological shunts in postoperative shunt thrombosis (8% vs. 22%).DiscussionThis scoping review reported that surgical portal decompression is feasible in adults with NCPH due to EHPVO with favorable outcomes and long-term patency
Aspect et évolution des lésions péri-kystiques dans les pneumopathies interstitielles diffuses fibrosantes à ANCA
No full textInternational audienceIntroductionLes lésions péri-kystiques (LPK), à type de condensation ou verre dépoli au contact de lésion fibrosantes kystiques, ont été décrites sur le scanner dans les pneumopathies interstitielles diffuses (PID) fibrosantes à ANCA. L’objectif de l’étude était de décrire l’évolution des LPK en fonction de l’évolution clinique, selon les critères de progression de la fibrose pulmonaire, et du taux d’ANCA.MéthodesLes patients avec PID fibrosante et ANCA positifs ont été inclus dans 6 centres hospitaliers de l’inter-région Nord-Ouest. Les lésions péri-kystiques cibles étaient mesurées sur les scanners successifs, et leur évolution entre 2 scanners comparée à l’évolution clinique, à la présence de critères de progression de la fibrose pulmonaire, au score BVAS, et à la variation du taux d’ANCA.RésultatsTrente-quatre patients ont été inclus et 50 paires de scanners définissant les cas ont été analysées. À baseline, les LPK étaient présentes chez 24 patients. L’amélioration des LPK était associée à une amélioration clinique globale (p = 0,02, test de Fisher exact), à l’absence de critères de progression de la fibrose pulmonaire (p < 0,001), et à l’amélioration du taux d’ANCA (p < 0,001). L’amélioration des LPK n’était pas associée à celle du score du BVAS (p = 0,17).ConclusionL’évolution des LPK paraît intéressante pour l’évaluation de l’évolution de la PID fibrosante à ANCA
Role of Narrow Band Imaging in assessing bronchial mucosal hypervascularization in COVID-19 patients
No full textInternational audienceBackgroundSARS-CoV-2 virus which targets the lung vasculature is supposed to affect both pulmonary and bronchial arteries. This study evaluated the tracheobronchial vascularization density observed with narrow band imaging (NBI) in patients hospitalized for COVID-19 pneumonia. To determine if the observed changes were specific of COVID-19 patients, the procedure was also performed in non-COVID-19 patients.MethodsThirty patients included in this monocentric, prospective study underwent videobronchoscopy using both white light and NBI: 10 with a COVID-19 infection, 10 with a non-COVID-19 pulmonary infection and 10 with a peripheral pulmonary nodule. The tracheobronchial vascular density observed through NBI was rated by two blinded pneumologists at three levels (carina, right main bronchus and left main bronchus).ResultsWhen compared to the two other groups, a significant increase of the tracheobronchial vascularization was found in COVID-19 patients. The median tracheobronchial vascularization global score obtained with NBI (out of 15 points) was: 10 [9 – 13] in the COVID-19 group, 5 [4 – 10] in the non-COVID-19 group (p < 0.001) and 6 in the Nodule group [4 – 9] (p = 0.002). Using a weighted Cohen's Kappa coefficient, we observed a good agreement between the two raters for the evaluation of the tracheobronchial vascularization score (κ = 0.75 [0.65-0.83]); p < 0.001).ConclusionVideobronchoscopy with NBI in COVID-19 patients showed diffuse changes in tracheobronchial vascularization. We suggest that such bronchial hypervascularisation with dilated vessels contributes, at least in part, to the intrapulmonary right to left shunt that characterized the COVID-19 related Acute Vascular Distress Syndrome (AVDS)
French protocol for the diagnosis and management of giant cell arteritis
No full textInternational audienceGiant cell arteritis (GCA) is a large-vessel vasculitis that mainly affects women over fifty. GCA usually involves branches from the external carotid arteries, causing symptoms such as headaches, scalp tenderness, and jaw claudication. The most severe complication is ophthalmologic involvement, including acute anterior ischemic optic neuropathy and, less frequently, central retinal artery occlusion with a risk of permanent blindness. Approximately 40% of patients may have involvement of the aorta or its branches, which has a poor prognosis, although this is often asymptomatic at diagnosis. Diagnosis is largely based on imaging techniques such as FDG-PET combined with CT, CT angiography, or MRI angiography of the aorta and its branches. Polymyalgia rheumatica is associated with GCA in 30-50% of cases but may also occur independently. Treatment must be initiated urgently in the presence of ophthalmologic signs or when GCA is strongly suspected to prevent vision loss. The gold standard to confirm the diagnosis is temporal artery biopsy. However, Doppler ultrasound and vascular imaging are also reliable diagnostic techniques. Initially, high doses of corticosteroids like prednisone (40-80mg per day) are the mainstay of treatment. Tocilizumab can be discussed in combination with prednisone for corticosteroid sparing. Long-term management is essential, including monitoring for disease recurrence and corticosteroid-related side effects. General practitioners play a crucial role in early diagnosis, directing patients to specialized centres, and in managing ongoing treatment in collaboration with specialists. This collaboration is essential to address potential long-term complications such as cardiovascular events. They can occur five to ten years after the diagnosis of GCA even when the disease is no longer active, meaning that vigilant follow-up is required due to the patients' age and status