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Molecular landscape of respiratory infection: A large-scale, multi-centre blood transcriptome dataset
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Management of women with abnormal cervical cytology: Update of French guidelines after the implementation of HPV screening
No full textInternational audienceObjectiveTo update the French national cancer institute (INCa) guidelines for the management of women with abnormal cervical cytology.MethodsIn 2016, INCa published guidelines for the management of women with abnormal cervical cytology. In 2019, however, the national authority for Health (HAS) recommended that the test for human papillomavirus be used to screen for cervical cancer in women over 30. It therefore became necessary to update the initial management and follow-up of women who had a positive test followed by abnormal reflex cytology findings. We used modified Delphi methods. The 3 members of the organizing committee revised each decision tree and then presented them to 35 experts over 2 rounds, to obtain their agreement about their validity and clarity.ResultsThis formalized consensus of experts allowed the creation of 17 decision trees instead of 15 previously: 13 on the diagnosis management of abnormal cytology, stratified by age, and 4 by therapeutic indications in abnormal histology. The median agreement scores were 89 % (interquartile range 81 %–97 %).ConclusionThese 17 decision trees present different situations encountered by various health professionals and guide them, depending on their specialties, in providing initial or follow-up management or delegating care
Fuzzy Logic Control of a 6-Phase Axial Flux Permanent Magnet Synchronous Generator in Faulty Modes
No full textInternational audienceThis paper deals with the Fuzzy Logic Control (FLC) of a 6-phase axial flux permanent magnet synchronous generator (6P-AFPMSG) aiming to increase the reliability under healthy and faulty conditions, including stator phase or converter leg openings. The FLC, associated to the Field Oriented Control (FOC), has been chosen for its simplicity and its well-known robustness against plant parameters variations. Indeed, due to the loss of stator phases, a classical controller, such as PI regulator, is no more suitable since large electromagnetic extracted power ripples appear. Experimental results show that the proposed robust association of FLC with FOC applied to the 6P-AFPMSG to regulate dq currents presents very interesting performances by minimizing extracted power ripples during both healthy and faulty operations (loss of 2 phases)
Baseline quantitative ECG parameters do not fully predict class 1 antiarrhythmic effect in Brugada patient: Drug-induced ECG changes in Brugada patients
No full textInternational audienceBackground: Drug challenge is useful to identify patients with Brugada syndrome (BS) without spontaneous ECG type 1 pattern. Effect of class I antiarrhythmic challenge is difficult to anticipate and potentially associated with complications.Objective: Assess the response to class I antiarrhythmic challenge.Methods: We included patients from the French multicenter MUTAVIT registry with a drug induced BS. Using digitized ECG, we automatically quantified 12‑lead ECG parameters on lead V1-V3.Results: Among 157 patients (72 % males, mean age 43 ± 13 years), baseline ECG did not show a type 2 or 3 BS pattern in 58 %. Drug infusion induced a QRS prolongation from 96 ± 20 to 117 ± 25 ms and an increase of ST amplitude from 107 ± 82 to 345 ± 231 μV (lead V2). Amplitude of drug-challenge effect was associated with homogeneous response across groups (with and without baseline BS pattern). Baseline ST elevation correlated with a pronounced response to the induction test (on V1: r = 0.697 (0.568; 0.792), p < 0.001, R2 = 0.486). Conversely, on-drug QRS duration was poorly correlated with baseline QRS duration (on V2: r = 0.215 (0.0527; 0.366), p < 0.05, R2 = 0.046). SCN5A variant carriers had longer QRS duration at baseline but not during drug challenge. Male patients had prolonged baseline QRS and baseline and post-induction ST amplitude.Conclusion: Amplitude of sodium blockade effect on ST elevation was correlated with baseline ST amplitude but dugs effect on QRS duration was only slightly correlated with baseline QRS duration. Presence of (likely) pathogenic SCN5A variant was associated with different baseline ECG characteristics and response to sodium channel blockade
Antibiotic susceptibility according to age of clinical strains from hospital respiratory samples: A nationwide study
No full textInternational audienceObjectives: This study evaluated the microbiological distribution and sensitivity of clinical strains from respiratory samples of inpatients to the antibiotics usually recommended for treatment of lower respiratory tract infection (LRTI).Methods: Using the French SPARES (Surveillance et Prévention de l'AntibioRésistance en Etablissement de Santé) database, we recorded all respiratory microbiological samples collected in 2022 in 409 hospitals located in all regions of France. The distribution of main bacterial species and their resistance to the most frequently prescribed antibiotics for LRTI were compared by age group (18-64 years, 65-79 years, ≥ 80 years).Results: Among 48,721 strains, 47.7 % were isolated from patients aged 18-64 years, 37.9 % aged 65-79 years, and 14.4 % aged ≥ 80 years. Enterobacteriaceae (30.1 %, 36.0 % and 35.1 %, respectively) and Pseudomonas aeruginosa (19.0 %, 25.0 % and 27.1 %) were the most prevalent pathogens, especially in older patients. Conversely, Haemophilus influenzae (14.5 %, 10.7 % and 8.7 %) and Streptococcus pneumoniae (8.3 %, 5.6 % and 3.4 %) were rare in older age. Overall antibiotic resistance increased with age across all classes: in increasing order of resistance, levofloxacin (9.2 %, 11.1 % and 13.2 %), piperacillin-tazobactam (14.5 %, 16.8 % and 17.4 %), cefotaxime (27.4 %, 34.3 % and 39.5 %), doxycycline (28.2 %, 37.4 % and 39.5 %), cotrimoxazole (32.1 %, 38.5 % and 40.2 %), and amoxicillin-clavulanate (37.2 %, 46.0 % and 51.4 %, p < 0.05 for all comparisons). More than half of the strains were resistant to amoxicillin and erythromycin.Conclusions: In this large nationwide database of respiratory samples, older age was associated with a high prevalence of Enterobacteriaceae and P. aeruginosa and beta-lactam resistance, a finding challenging current LRTI probabilistic treatment. Conversely, H. influenzae and S. pneumoniae were rarely observed in patients over 80 years of age
Surface-Tension-Induced Phase Transitions in Freestanding Ferroelectric Thin Films
No full textInternational audienceThe control of ferroelectric topological phases in ultrathin films is central to the development of next-generation nanoelectronic devices. While epitaxial strain is widely used to tune polarization states, its applicability is inherently limited to substrate-bound systems. Here, we show that surface tension becomes a key mechanical factor in freestanding ferroelectric films, governing phase stability and the emergence of topological polarization textures. Using a thermodynamic free energy framework, we show that surface tension induces effective compressive stress in freestanding films, strongly influencing both uniform and topological polarization states. Surface tension also drives large-scale morphological instabilities, reshaping phase behavior in the ferroelectric regime. Our results reveal surface tension as a robust, substrate-independent mechanism for engineering polarization states in freestanding films, creating new opportunities for flexible, strain-free ferroelectric devices
A Narrative Review of Heavy Metals and Sperm Quality: The Interplay with Antioxidant Imbalance and Reactive Oxygen Species
No full textInternational audienceReproductive infertility is characterized by the inability to achieve pregnancy after a year or more of unprotected sexual intercourse. This review highlights the significant impact of exposure to both types of heavy metals (essential and non-essential) on the reproductive performance of various species, particularly humans. Heavy metals present a high atomic density and weight, including lead, mercury, cadmium, nickel, chromium, and arsenic, and are delivered into the environment through natural and human activities, posing a threat to ecological systems and human reproductive health. These heavy metals have the potential for bioaccumulation and can adversely affect male fertility and sperm quality due to their role in disrupting endocrine functions, altering hormone levels responsible for sperm production, and inducing oxidative stress. The elevated production of reactive oxygen species (ROS) exceeds the capability of antioxidants and can lead to the alteration of sperm quality. Seminal fluid contains antioxidants like vitamin C, vitamin E, zinc, and selenium to counteract the impacts of ROS and also to preserve the sperm function. This review aims also to explore the impact of heavy metals on sperm quality and their relationship with antioxidant imbalance and ROS. The exposure to heavy metals whether through occupational or environmental means increases the production of ROS and therefore leads to an imbalance of antioxidants production. All these factors have no doubt an impact on male reproductive health
Immune-mediated thrombotic thrombocytopenic purpura with systemic lupus erythematosus: clinical features and outcome
No full textInternational audienceObjective The association of immune-mediated thrombotic thrombocytopenic purpura (iTTP) and SLE was previously described, but patients with iTTP with coexistent SLE remain poorly characterised. Methods We compared the clinical presentation and the outcome of patients with iTTP with coexistent SLE (SLE-iTTP) to an age-sex matched cohort of patients with idiopathic iTTP without SLE. Results During the study period, 1409 patients with iTTP were recruited in our registry. Of these, 79 (6%) had a prior or concurrent diagnosis of SLE at the time of iTTP diagnosis, and 437 (31%) had detectable ANAs without other clinical features of SLE. When compared with idiopathic iTTP, patients with SLE-iTTP had more severe renal involvement, and cardiac involvement was more prevalent, whereas central nervous system involvement was less common. Patients with SLE-iTTP received more immunosuppressive agents. There was no difference in response categories during the acute phase. During follow-up, SLE-iTTP had superior ADAMTS13 relapse-free survival than idiopathic iTTP. Among patients with ANAs without other clinical features of SLE, 33 (8%) were diagnosed with SLE 27 months (IQR: 7–65 months) following iTTP diagnosis; 32 additional patients (7%) developed another systemic autoimmune disease. No patient from the idiopathic iTTP group developed clinical SLE during follow-up. Conclusion Patients with iTTP are prone to develop autoimmune features, and patients with SLE-iTTP have distinct clinical features and outcome. Relapse-free survival seems better in patients with SLE-iTTP, underscoring the need for tailored management strategies in this population, including a specific follow-up to assess early features suggestive of SLE. Trial registration number NCT00426686
Temporal Illumination Variation Compensation using Perpendicular Whisk-broom Hyperspectral Scans
No full textInternational audienceThis study introduces a novel method to mitigate temporal illumination variations in whisk-broom hyperspectral imaging under varying environmental illumination conditions. Whisk-broom hyperspectral imaging captures high resolution spectra pixel-by-pixel sequentially, a process susceptible to sunlight fluctuations over time, particularly when imaging cultural artifacts outdoors. Despite sunlight's broad spectrum, its variability over time can compromise the quality of hyperspectral images, affecting data analysis. Prior strategies suggested a supplementary single compensating vertical scan alongside the standard row-wise raster scan. However, this strategy fails when the additional single vertical scan is performed near or on a black frame. Building on this, our study proposes using two scans, one performed orthogonally to the traditional row-wise scan, to counteract illumination variations. Furthermore, we formulate the compensation problem in logarithmic space, exploiting the low-dimensional structure of the reflectance and illumination spectra. Using total variation penalization in the cost function enhances smoothness. Our method achieves robust compensation for changes in environmental illumination. We also demonstrate that we can use multiple columns from the column-wise scan without significantly decreasing the compensation quality while reducing acquisition time. We illustrate the application of our methods to hyperspectral images of stained-glass windows of the historic {Cathédrale Notre-Dame d'Amiens} in France
Towards The Fontaine-Mazur Conjecture for biquadratic extensions: an example
No full textInternational audienceWe prove that the Galois group of the maximal everywhere unramified pro-3-extension L of the biquadratic field has no infinite p-adic analytic pro-3 quotient. This answers negatively a question asked by Boston in his fundamental 1992 paper [4], in which it was observed that the Galois group of , if admitting such a quotient, may provide a counter example to the Fontaine-Mazur conjecture 1.1