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Exploring Factors Affecting Psychological Flexibility After Psychedelic Experiences
No full textInternational audienceNeurobiological effects and psychological models propose that psychedelics may promote psychological flexibility, suggesting a transdiagnostic effect by disrupting maladaptive patterns. The objective of this study was therefore to investigate the determinants of psychological flexibility change following a psychedelic use. This retrospective online survey included French individuals who had undergone a significant psychedelic experience. Participants were assessed for mystical experience intensity with the MEQ-30, and psychological flexibility via the AAQ-II, at three retrospective time points. Data analysis comprised descriptive statistics, correlation analysis, ANCOVA to evaluate the impact of psychedelic use variables on psychological flexibility, and linear regression to identify predictors of psychological flexibility changes. Data showed a positive correlation between mystical experience intensity and improvements in psychological flexibility, especially 1-month post-experience (p < .01), and during the 6 months before the survey (p < .01). Key predictors of changes in psychological flexibility included baseline AAQ-II scores, MEQ total scores and frequent psychedelic use, underlining the interaction between personal and experiential factors in determining therapeutic outcomes. In conclusion, this study highlights how the intensity of mystical experience and baseline psychological flexibility may be the key factors influencing changes in psychological flexibility post-psychedelic use, suggesting a potential therapeutic value
Besoins et attentes des médecins généralistes de la Somme pour la prise en charge palliative de leurs patients en ambulatoire dans la perspective de l'ouverture d'un hôpital de jour de médecine palliative
No full textIntroduction: Palliative care is a rapidly evolving field, at the heart of many ethical and societal debates. The 2024-2034 ten-years plan, aimed at strengthening the development of palliative care at national level, highlights several initiatives, including the creation of palliative day care hospitals. Such a project is currently ongoing in Somme department. The main objective of our study was to identify the needs and expectations of general physicians in the Somme regarding the palliative care of their outpatients, in anticipation of the opening of this palliative day care hospital. Materials and Methods: We conducted an observational, descriptive, quantitative, and crosssectional study using an anonymous digital questionnaire addressed to general physicians in Somme. Results: A total of 94 questionnaires were analyzed. 96.8% of respondents were in favor of opening a palliative care day hospital. The three main expectations were symptom management, easier access and care coordination. Discussion: This study highlights the positive reception and high expectations surrounding the opening of the future palliative day care hospital, in a context where the current provision of palliative care in Somme remains mixed. The results reveal a need for support in managing complex situations, along with a demand for easier access and improved care coordination. These expectations reflect the hope for a significant improvement in palliative care in the region. Conclusion: This research suggests that the opening of a palliative day care hospital in Somme already generates significant interest and expectations from general physicians in the department, particularly regarding symptoms management and care coordination, all facilitated by easier access to services.Introduction : les soins palliatifs représentent un domaine en pleine évolution, au centre de nombreux débats éthiques et sociétaux. Le plan décennal 2024-2034, visant à renforcer le développement des soins palliatifs au niveau national, met en avant plusieurs initiatives, dont la création d'hôpitaux de jour (HDJ) de médecine palliative. Un tel projet est en cours de réalisation dans le département de la Somme. L'objectif principal de notre étude était d'identifier les besoins et attentes des médecins généralistes de la Somme concernant la prise en charge palliative de leurs patients en ambulatoire, dans la perspective de l'ouverture de cet HDJ de médecine palliative. Matériel et méthodes : nous avons mené une étude observationnelle, descriptive, quantitative, et transversale à l'aide d'un questionnaire numérique anonyme adressé aux médecins généralistes de la Somme. Résultats : au total, 94 questionnaires ont été analysés. 96,8% des répondants étaient favorables à l'ouverture d'un HDJ de médecine palliative. Les 3 attentes principales étaient la gestion des symptômes, l'accès facilité et la coordination des soins. Discussion : cette étude met en lumière l'accueil favorable et les attentes élevées concernant l'ouverture du futur HDJ de médecine palliative, dans un contexte où la couverture actuelle des soins palliatifs dans la Somme reste mitigée. Les résultats révèlent un besoin de soutien dans la gestion des situations complexes, associé à une demande d'accès facilité et d'une meilleure coordination des soins. Ces attentes traduisent l'espoir d'une amélioration significative de la prise en charge palliative dans le département. Conclusion : ce travail de recherche laisse penser que l'ouverture d'un HDJ de médecine palliative dans la Somme porte avant même sa création beaucoup d'attentes et d'intérêt par les médecins généralistes du département notamment pour la gestion des symptômes et pour la coordination des soins, le tout à travers un accès facilité
Crystalline vs. amorphous Li4PS4I: Impact of structure on ionic transport and performances in solid-state battery
No full textInternational audienceAll-solid-state batteries (ASSBs) are emerging as next-generation energy storage solutions due to their potential advantages, including enhanced safety, higher energy density, and broader operational temperature ranges. Among various solid electrolytes, amorphous and crystalline Li4PS4I, have attracted interest due to their predicted high conductivity, and high moisture-tolerance. However, experimental studies have reported a wide variation in conductivity values for Li4PS4I, ranging from 0.03 to 3.5 mS.cm−1 at 298 K which are significantly lower than theoretical predictions. Herein, by employing a combination of X-ray diffraction (XRD), 31P magic-angle spinning nuclear magnetic resonance (31P MAS NMR), electrical impedance spectroscopy (EIS), we demonstrate that controlling the crystallinity of Li4PS4I plays a crucial role in its electrochemical performance. Pair distribution function (PDF) analysis reveals the differences in local atomic arrangements between amorphous and crystalline Li4PS4I. Additionally, the analysis indicates that mechanical milling alters the local environment of PS4 tetrahedra and iodide anions, which may explain the discrepancy in conductivity. Furthermore, ASSBs incorporating amorphous-ceramic Li4PS4I in the cathode composite exhibit enhanced cycling stability compared to amorphous Li4PS4I. These findings underscore the potential of tuning crystallinity as an effective approach to optimize the ionic transport properties and cycling performance of ASSBs, paving the way for further advancements in solid electrolytes
Évaluation du risque hémorragique lors de la co-prescription des anticoagulants oraux et des inhibiteurs sélectifs de la recapture de la sérotonine (ISRS) : méthodologie d’une étude émulant un essai contrôlé randomisé à partir du SNDS en France
No full textInternational audienceIntroduction et objectifsLes anticoagulants oraux (AOD ou AVK) sont largement utilisés en pratique courante notamment dans le traitement de la MTEV ou en prévention des accidents thromboemboliques en cas d’arythmie [1]. Le principal effet indésirable de cette classe est le risque hémorragique. Les interactions médicamenteuses d’ordre pharmacodynamique peuvent majorer ce risque. Du fait de la présence de sérotonine au sein des plaquettes, les inhibiteurs sélectifs de la recapture de la sérotonine (ISRS) pourraient être un facteur de risque de saignement lors de prise concomitante avec un anticoagulant. Plusieurs études de pharmacovigilance et épidémiologiques rapportent une majoration du risque [2]. Cependant dans la littérature, aucune étude de pharmaco-épidémiologie récente n’a utilisé les données du Système national des données en santé (SNDS) afin de comparer le risque hémorragique chez les patients dépressifs sous anticoagulants oraux et traités par ISRS et ceux recevant un autre type d’antidépresseur.Du fait de la difficulté de tester cette hypothèse dans un essai thérapeutique, l’objectif de ce travail utilisant des méthodes de pharmaco-épidémiologie est d’évaluer le risque hémorragique lors de la co-prescription d’anticoagulants oraux et d’ISRS par rapport à un comparateur actif pour guider la stratégie thérapeutique.MéthodologieNotre étude émulant un essai contrôlé randomisé à partir des données du SNDS français permettra de constituer deux groupes de patients : un groupe AOD/AVK + ISRS et un groupe comparateur actif AOD/AVK + autre antidépresseur. Dans chaque groupe, les patients recevant un anticoagulant seront inclus avec un suivi prospectif à partir de la date index correspondant à l’initiation de l’ISRS ou du comparateur actif. Le critère de jugement principal est défini comme le premier épisode d’hémorragie majeure (basé sur les causes d’hospitalisation et selon la Société internationale de thrombose et d’hémostase).RésultatsUn modèle de Cox avec pondération par score de propension (SP) permettra d’estimer les hazard ratios des saignements majeurs dans chacun des groupes. Les variables utilisées pour construire le SP seront l’âge, le sexe, les antécédents (diabète, HTA, insuffisance cardiaque, hépatique ou rénale, FA, cardiopathie, MTEV, hémorragie) et les traitements concomitants majorant le risque hémorragique.DiscussionEn se basant sur les données du SNDS et par une approche de pharmaco-épidémiologie, notre étude permettra de limiter le risque hémorragique des patients sous antidépresseurs et anticoagulants oraux
OP38 Comparative efficacy of infliximab and vedolizumab after failure of a first anti-TNF in patients with ulcerative colitis: a double-blind randomized controlled trial (EFFICACI)
No full textInternational audienceBackground No clinical trial has previously assessed the best therapeutic strategy between switching to another anti-TNF or swapping to another class of biologic class after the failure of a first anti-TNF in ulcerative colitis (UC). The aim of the EFFICACI trial was to compare the efficacy of vedolizumab with infliximab in patients who had failed a first sub-cutaneous anti-TNF (golimumab and/or adalimumab). Methods EFFICACI was a French double-blind multicenter randomized controlled trial (1:1) comparing intravenous vedolizumab 300 mg at weeks 0-2-6 to intravenous infliximab 5 mg/kg at weeks 0-2-6. Eligible patients had moderate-to-severe UC, defined by a total Mayo score ≥ 6, despite at least 12 weeks (W) of treatment with adalimumab or golimumab as first line of advanced therapy. The primary endpoint was steroid free clinical remission at W14. The number of patients (N=150) was estimated for a 20% difference in favor of vedolizumab with a type 1 risk of 5% and a power of 80%. Patients were subsequently followed in an open-label fashion until week 54. The analysis was performed on an intention-to-treat basis. Only results at W14 will be presented. (CPP: 2018-002673-21; ClinicalTrial: 35RC17_8841_EFFICACI) Results From January 2018 to December 2023, 151 patients were randomized among 19 centers: 78 in the vedolizumab arm and 73 in the infliximab arm. Characteristics and demographics at inclusion were similar between groups, with 102/151 (67.5%) patients failing adalimumab and 49/151 (32.5%) failing golimumab. Concomitant immunosuppressive treatment with thiopurine or methotrexate was associated with infliximab and vedolizumab for 37/72 (51.4%) patients and 43/78 (55.1%) patients, respectively. At W14, proportions of patients in clinical remission (primary endpoint) were 34.6% (27/78) with vedolizumab and 19.2% (14/73) with infliximab (p=0.033). The clinical response rates were 46/78 (59.0%) with vedolizumab and 36/72 (50.0%) with infliximab (p=0.27). Proportions of patients in clinical response at W2, W6 and W14 are shown in Figure 1. At W14, endoscopic improvement (Mayo endoscopic subscore 0 or 1) was observed in 36/77 (46.8%) patients in the vedolizumab arm and 21/72 (29.2%) in the infliximab arm (p=0.027). No factor at inclusion was predictive of remission at week 14, including pharmacokinetic data for the first-line anti-TNF. Adverse event rates were similar in both groups - 46 (63.9%) infliximab arm, 55/78 (70.51%) vedolizumab arm. Eight patients were hospitalized for a severe flare (5 in the infliximab arm and 3 in the vedolizumab arm). Conclusion After failure of a first subcutaneous anti-TNF, induction therapy with vedolizumab was superior to infliximab in achieving steroid free clinical remission at week 14 in patients with UC
Gut microbiota restoration with oral pooled fecal microbiotherapy after intensive chemotherapy: the phase Ib CIMON trial
No full textInternational audienceIntensive chemotherapy (IC) combined with broad-spectrum antibiotics for acute myeloid leukemia (AML) leads to gut microbiota dysbiosis, promoting pathological conditions and an increased incidence of complications, possibly limiting eligibility to allogenic hematopoietic cell transplantation (alloHCT). The purpose of this dose-ranging phase I study (CIMON) was to evaluate the first-in-man use of MaaT033, a pooled, allogeneic, lyophilized, and standardized fecal microbiotherapeutic product, formulated as a delayed-release capsule for oral administration. Primary objectives of the study were to evaluate the maximum tolerable dose of MaaT033 in 21 AML patients having undergone IC and antibiotics. Secondary objectives were to assess MaaT033 safety, its efficacy in restoring the patients' gut microbiome using shotgun sequencing in order to evaluate the recommended dose regimen, and patient compliance (ClinicalTrials.gov number: NCT04150393). MaaT033 was shown to be safe and effective for gut microbiota restoration in AML patients receiving IC and antibiotics, with an excellent gut microbiota reconstruction based on diversity indices at the species level, and restoration of microbial communities close to the composition of the drug product. Moreover, inflammatory markers (C-reactive protein, interleukin-6) decrease with treatment, while short-chain fatty acids increase over time. A randomized, placebo-controlled phase IIb trial, in recipients of alloHCT patients in ongoing
SUM-OF-SQUARES APPROACH FOR MODELING AND CONTROL OF HAIL POWER SYSTEM WITH TIME DELAY AND CONFORMABLE FRACTIONAL-ORDER DERIVATIVE
No full textInternational audienceThis research focuses on stabilization challenges of a Power System (PS) described by a delayed conformable fractional-order nonlinear model. We adopt the Polynomial Fitting Approximation Algorithm (PFAA) to approximate the cardinal sine function by a Square Of Polynomial (SOP). A polynomial representation is made for PS with different behaviors by dividing the operating range into [Formula: see text] regions and then calculating an SOP approximation for each region. Thus, the PS is characterized by [Formula: see text] distinct models, each applicable within its respective region. An Observer Based Control (OBC) is designed to stabilize the considered PS. The proposed result ensures the stabilization of the different [Formula: see text] models by satisfying sufficient conditions based on the sum-of-squares (SOS) approach