Portail HAL de l'Université Picardie Jules Verne
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Interactive Effects of Weather and Forest Structure on Microclimate Buffering in European Deciduous Forests
No full textInternational audienceThe microclimate temperature within forests can substantially deviate from measurements outside forests. Yet, the amount and direction of this buffering strongly depend on meteorological conditions outside forests, such as free‐air temperature, wind speed, soil moisture, precipitation and solar radiation. Most studies on microclimate buffering focus on long‐term averages at coarse temporal resolution (e.g., monthly to seasonal), potentially overlooking the impact of daily fluctuations, which are nonetheless critical for many forest species and processes. Here, we linked in situ measured air and soil temperatures, at the daily resolution over a period of more than 5 years across 45 European deciduous forests spanning a 2300‐km latitudinal gradient, to daily variation in weather conditions (i.e., free‐air temperature, precipitation, wind speed, soil moisture, solar radiation, day length and snow cover). We assessed the interactive effects of weather conditions and forest structural complexity (plant area index) and distance to the forest edge on air and soil temperature offsets. Temperature offsets are the difference between understory air or soil temperature and macroclimate reference conditions measured at weather stations in the open field. We show that relative effect sizes of free‐air temperature prevailed over the effects of other weather variables to determine air and soil temperature buffering. In general, higher free‐air temperatures, soil moisture, wind speed and snow cover led to more negative air and soil temperature offsets, with variations depending on forest structural complexity and season. Conversely, slightly increased air and soil temperature offsets were found as precipitation and solar radiation increased. Our study highlights the dominant role of daily free‐air temperature fluctuations outside forests in shaping microclimatic buffering. We emphasize complex interaction paths between daily weather conditions, and forest structure and edge effects, offering valuable insights for next‐generation microclimate models and enhancing our understanding of forest ecosystem responses to environmental change that account for microclimate
Consensus-Harmonized Neuropsychological Assessment for Vascular Cognitive Impairment and Dementia
No full textInternational audienceImportance Harmonization of neuropsychological assessment for vascular cognitive impairment and dementia (VCID) is important for ensuring the highest standards and consistency of diagnosis. A battery proposed in 2006 by the National Institute for Neurological Disorders and Stroke and the Canadian Stroke Network (NINDS-CSN) has received much international support. Considering significant advances in the field, including the rise of computerized and remote assessment methods, a revision is needed. Objective To develop an updated harmonized battery and associated assessment guidelines for VCID. Evidence Review NINDS-CSN and other relevant published harmonized neuropsychological batteries, aided by literature review of recent developments in VCID, were used as reference points for an online Delphi survey (≥3 rounds, ≥75% threshold for agreement), including questions on a core test battery based on key cognitive domains that should be assessed for VCID, consideration of computerized and remote assessment methods, and assessment of diverse populations. International experts in neuropsychological assessment from diverse international regions were invited to participate in 2023. Data were analyzed from October 11, 2023, to June 20, 2024. Findings A total of 44 experts participated in 3 survey rounds, with 28 to 31 participants each. Consensus was reached on a core assessment battery of neuropsychological tests based on key cognitive domains, and additional guidelines for a more comprehensive test battery, cognitive screening, telehealth and computerized assessment methods, principles for normative standardization, and the assessment of diverse populations. The key cognitive domains were harmonized with the International Society for Vascular Behavioural and Cognitive Disorders version 2 World Stroke Organization (VasCog-2-WSO) diagnostic criteria for VCID. Conclusions and Relevance This consensus statement describes the development of a harmonized neuropsychological assessment battery and guidelines for VCID (VasCog-NP) that expands on the NINDS-CSN battery with more comprehensive and flexible assessment of VCID. Harmonized with the VasCog-2-WSO diagnostic criteria, VasCog-NP could be adopted internationally to further help more consistent neuropsychological evaluations related to VCID, facilitating global comparisons for clinicians and researchers
Exponential mixing of all orders and CLT for generic birational maps of .
No full textFor Hénon maps, Bianchi and Dinh recently proved the exponential mixing of all orders for the measure of maximal entropy and, as a consequence of the recent work of Björklund and Gorodnik, the CLT for Hölder observables. We extend their results to generic birational maps of . Because of the indeterminacy set, Hölder maps are not stable under iteration, so we need to work with a suitable space of test functions
Etude des facteurs pronostiques de mortalité en soins intensifs et réanimation des cancers broncho-pulmonaires non à petites cellules de stade avancé au CHU d’Amiens
No full textIntroduction : Advanced non-small cell lung cancer (NSCLC) is common, and its prognosis has recently improved thanks to immunotherapy and targeted therapies. The admission of these patients of these patients raises the question of benefit-risk. The MUSIC study, conducted at CHU d'Amiens, aims to identify patient profiles that could benefit from intensive care management. Material and methods : Retrospective, observational, monocentric study including 101 patients with stage IIIA to IVB admitted to critical care units between 2018 and 2023. Clinical, oncological and resuscitation data were analyzed. The primary endpoint was intra-ICU mortality. Results : Intra-ICU mortality was 31.7%. Two independent protective factors were identified: a performance status (PS) of 0-1 and tumor stage III or oligometastatic. On the other hand, mechanical ventilation was a poor prognostic factor. The median survival of surviving patients was close to that of NSCLC patients treated outside the ICU, and more than a third of patients were able to resume oncological treatment afterwards. Discussion : Our results confirm that some patients with advanced NSCLC may benefit from admission to the intensive care unit, provided rigorous selection. Intensive care does not appear to compromise their therapeutic future. Conclusion : Identifying patients eligible for intensive management in the event of acute deterioration is essential to optimize prognosis without inducing disproportionate care. Our study provides arguments to facilitate this therapeutic decision.Introduction : Le cancer broncho-pulmonaire non à petites cellules (CBNPC) de stade avancé est fréquent et son pronostic s’est récemment amélioré grâce à l’utilisation de l’immunothérapie et des thérapies ciblées. L’admission en réanimation de ces patients soulève la question de la balance bénéfices-risques. L’étude MUSIC, menée au CHU d’Amiens, vise à identifier les profils de patients pouvant tirer profit d’une prise en charge en soins intensifs. Matériel et méthodes : Étude rétrospective, observationnelle, monocentrique incluant 101 patients atteints de CBNPC de stade IIIA à IVB admis en unités de soins critiques entre 2018 et 2023. Les données cliniques, oncologiques et de réanimation ont été analysées. Le critère de jugement principal était la mortalité intra-USI. Résultats : La mortalité intra-USI est de 31,7 %. Deux facteurs indépendants protecteurs de cette mortalité ont été identifiés : un performance status (PS) de 0-1 et un stade tumoral III ou oligométastatique. En revanche, la ventilation mécanique était un facteur de mauvais pronostic. La médiane de survie des patients survivants était proche de celle des CBNPC traités hors réanimation, et plus d’un tiers des patients ont pu reprendre un traitement oncologique par la suite. Discussion : Nos résultats confirment que certains patients atteints de CBNPC avancés peuvent bénéficier d’une admission en réanimation, à condition d’une sélection rigoureuse. La réanimation ne semble pas compromettre leur avenir thérapeutique. Conclusion : L’identification de patients éligibles à une prise en charge intensive en cas de dégradation aigue est essentielle pour optimiser le pronostic sans induire de soins disproportionnés. Notre étude apporte des arguments pour faciliter cette décision thérapeutique
Evaluation of a pro-recovery training intervention (REFOCUS-RETAFORM) in specialist mental health services across France: stepped-wedge cluster randomised controlled trial protocol
No full textInternational audienceBackground: While recovery orientation is national policy in many countries, evidence remains limited for the effectiveness at a service level. This paper describes the protocol for implementing a pro-recovery training intervention (REFOCUS-RETAFORM) in specialist mental health services across France. The aim is to evaluate whether REFOCUS-RETAFORM plus usual care leads to improved outcomes for adolescent and adult mental health service users compared with usual care alone.Methods: A two-step stepped wedge cluster randomised controlled trial will be conducted, with a nested qualitative sub-study exploring stakeholders' views on changes in staff-user relationships and implementation influences. The REFOCUS-RETAFORM intervention is a training intervention for mental health staff, to develop recovery-promoting relationships and pro-recovery working practices. Clusters are services, which transition sequentially from control to intervention condition in a randomised order. Eight clusters are randomised to deliver REFOCUS-RETAFORM in year one and eight clusters in year two. Each cluster delivers REFOCUS-RETAFORM to two teams from their organisation (32 teams in total). Participants are a) service users aged 13-65 years attending services implementing REFOCUS-RETAFORM, and b) staff receiving the intervention. The primary outcome is the Questionnaire about the Process of Recovery. Secondary outcomes include perceived stigma and coercion, self-stigma and wellbeing for service users, and recovery-orientation for staff. Data will be collected from 540 service users (180 at baseline, 180 at month 12, 180 at month 24) and 220 staff. We will use multilevel mixed-effects models, adjusting for secular trends and thematic analysis for the qualitative interview data.Discussion: Findings will inform the continued transformation of French specialist mental health services toward a recovery orientation.Trial registration: Clinical Trials NCT05824234, registered 21 April 2023
Hauts fonctionnaires des outre-mer sous la Cinquième République. Une enquête collective
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Tinzaparin Pharmacokinetics in Patients with Cancer: A Comparative Modeling Study
No full textInternational audienceCancer-associated thrombosis (CAT) is common and a leading cause of mortality in patients with cancer. In specific CAT scenarios, low-molecular-weight heparins (LMWHs), including tinzaparin, are preferred over direct oral anticoagulants. Despite the importance of understanding LMWH pharmacokinetics (PK) in cancer for optimizing CAT management, available data remain limited. To compare tinzaparin PK in cancer and non-cancer patients by developing a population PK model. This prospective, multicenter, case–control trial enrolled patients receiving once-daily subcutaneous tinzaparin at a therapeutic dose of 175 IU·kg−1, including matched cancer and non-cancer patients. Plasma anti-Xa activity was measured at multiple time points and analyzed using a non-linear mixed-effect modeling. A PK model was developed, and covariate effects were assessed for parameters of the model. The impact of cancer on tinzaparin PK was evaluated by incorporating cancer status as a categorical covariate. A total of 333 patients (including 46 matched cancer and non-cancer patients) were included in the analysis. A monocompartmental model with first-order absorption best described tinzaparin PK. The volume of distribution was associated with body weight, while clearance and anti-Xa activity were associated with creatinine clearance. No significant differences were observed between matched cancer and non-cancer patients in anti-Xa activity exposure at day 1 and steady state. PK profiles were comparable between cancer and non-cancer patients. Additionally, further studies should clarify the role of renal function in guiding tinzaparin dosing
Ornamental plants and mistletoe as catalysts of spring populations of Drosophila suzukii
No full textInternational audienceWinter is a critical bottleneck for many insects and for pests in particular; not only they have to cope withharsh environmental conditions but they also need to find alternative resources as cultivated fruit arelacking. In this study, we questioned if fruit of ornamental and wild plants could sustain the populationsof the pest Drosophila suzukii during end of winter / early spring. We measured fly infestations incommonly occurring ornamental plants and in Viscum album between January and July 2022 in northernFrance. Most plant species allowed the emergence of the fly and the fruiting succession provided aresource continuum. Climatic factors (e.g. cumulative precipitation, number of frost hours), landscapecomposition (e.g. grassland, shrubland and water cover) and local variables (e.g. resource abundance,vegetation architecture) influenced infestations with effects varying between host plants. Interestingly,while D. suzukii cooccurred with D. subobscura in V. album, no competitors were found in ornamentalplants. With infestations up to 60% in some species, our study indicated that non-crop plants couldcatalyse D. suzukii populations early in the season, before commercial fruit become available (e.g.strawberries, cherries), and should be considered in integrative pest management strategies
Clinical Presentation and Mid-Term Results of Mitral Valve Surgery for Calcified Mitral Valve Disease - The MITRACURE registry
No full textInternational audienceBackgroundCalcified mitral valve disease (CMVD) is an increasingly recognized condition associated with specific management challenges. MITRACURE, a large multicenter observational registry conducted in France and Canada, provides real-world insights into the characteristics and outcomes of patients with CMVD undergoing MV surgery.MethodsAmong the 3,522 patients included in MITRACURE, patients identified with CMVD were matched 4:1 for age, sex, and concomitant procedures with patients with myxomatous MV disease.ResultsSixty patients (2%) with CMVD were matched to 240 with myxomatous MV disease. Compared to the myxomatous cohort, CMVD patients had a greater burden of cardiovascular risk-factors, more comorbidities, and a more advanced presentation, with 70% vs. 52% in NYHA class III–IV (P=0.01). In-hospital mortality and major complication rates (composite of death, cardiogenic shock/low cardiac output requiring inotropes, acute renal failure requiring dialysis, and stroke or transient ischemic attack) were significantly higher in CMVD than myxomatous patients (20% vs. 4%, and 38% vs. 20%, both P<0.01). Median EuroSCORE II was slightly higher in CMVD patients (3.5 [IQR 2.2-5.7]) compared with those with myxomatous disease (2.6 [IQR 1.5-4.2], P<0.01). However, the observed mortality in the CMVD group was three to four times higher than predicted, whereas in the myxomatous group it was consistent with predicted values.ConclusionCMVD defines a high-risk surgical population with substantial baseline cardiovascular morbidity and markedly elevated postoperative mortality and complication rates that were substantially underestimated by EuroSCORE II emphasizing the need for refined risk prediction models and individualized management strategies in this subset of patients