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Real‐world comparison of effectiveness between tofacitinib and vedolizumab in patients with ulcerative colitis exposed to at least one anti‐ TNF agent
No full textInternational audienceBackground: Data comparing tofacitinib and vedolizumab in ulcerative colitis (UC) are lacking.Aims: To compare the effectiveness of tofacitinib and vedolizumab in patients with UC who had prior exposure to anti-TNF therapy METHODS: In this multicentre study, we included consecutive patients with UC ≥18 years old with partial Mayo score >2 and prior anti-TNF exposure, who started tofacitinib or vedolizumab between January 2019 and June 2021. Comparisons were performed using propensity score analyses (inverse probability of treatment weighting).Results: Overall, 126 and 178 patients received tofacitinib and vedolizumab, respectively. Intensified induction (vedolizumab infusion at week 10 or tofacitinib 10 mg b.d until week 16) was performed in 28.5% and 41.5% of patients, respectively. After propensity-score analysis, corticosteroid-free clinical remission (partial Mayo score ≤2) was achieved at week 16 in 45.1% and 40.2% of patients receiving tofacitinib and vedolizumab, respectively (aOR = 0.82 [0.35-1.91], p = 0.64). Endoscopic improvement (corticosteroid-free clinical remission and endoscopic Mayo score ≤1) (aOR = 0.23[0.08-0.65], p = 0.0032) and histological healing (endoscopic improvement + Nancy histological index ≤1) (13.4% vs 3.2%, aOR = 0.21[0.05-0.91], p = 0.023) were higher at week 16 in patients treated with tofacitinib. No factor was predictive of tofacitinib effectiveness. At least one primary failure to a biologic (OR = 0.46[0.22-0.99], p = 0.049), partial Mayo score >6 (OR = 0.39[0.17-0.90], p = 0.029) and CRP level > 30 mg/L at baseline (OR = 0.08[0.01-0.85], p = 0.036) were associated with vedolizumab failure.Conclusion: Tofacitinib and vedolizumab are effective in UC after failure of anti-TNF agents. However, tofacitinib seems more effective, especially in severe disease and primary failure to biologics
TNF-alpha inhibitors biosimilar use in France: a nationwide population-based study using the French National Health Data System
No full textInternational audienceAbstract TNF-alpha inhibitors have revolutionized the therapeutic care in chronic inflammatory diseases. Several biosimilar products were commercialized at their patent expiry, substantially decreasing the cost of treatment. This longitudinal descriptive study aimed at assessing infliximab, etanercept and adalimumab biosimilar penetration rates using data of the French National Health Data System. A total of 207,118 new or prevalent users from the date of first biosimilar commercialization in France (respectively January 2015, May 2016 and October 2018) were included in the study and followed until September 30, 2021. Biosimilars represented respectively 78%, 46% and 53% of the overall initiations, and 94%, 66% and 60% last year’s initiations. A total of 46%, 19% and 17% of originator product prevalent users switched for a biosimilar during the follow-up. Biosimilar penetration rate was much higher for infliximab than for its counterparts, due to its hospital delivery modality. Biosimilar initiation and originator-to-biosimilar switch tended to be observed more in rheumatology than in the other specialties. Biosimilar use was mostly consistent across patient socio-demographic characteristics. Biosimilar initiation rate increased rapidly from their market arrival and originator-to-biosimilar switch rate remained moderate, highlighting the need and usefulness of political action and biosimilar use tracking
Decrease of hospital- and community-acquired bloodstream infections due to Streptococcus pneumoniae and Streptococcus pyogenes during the first year of the COVID-19 pandemic: A time-series analysis in Paris region
No full textMembers of the Collégiale de Bactériologue – Virologie – Hygiène (CBVH)Guillaume Arlet, Laurence Armand Lefevre, Alexandra Aubry, Laurent Belec, Béatrice Bercot, Stéphane Bonacorsi, Vincent Calvez, Emmanuelle Cambau, Etienne Carbonnelle, Stéphane Chevaliez, Jean-Winoc Decousser, Constance Delaugerre, Diane Descamps, Florence Doucet-Populaire, Jean-Louis Gaillard, Antoine Garbarg-Chenon, Elyanne Gault, Jean-Louis Herrmann, Vincent Jarlier, Jérôme Le Goff, Jean-Christophe Lucet, Jean-Luc Mainardi, Anne-Geneviève Marcellin, Laurence Morand-Joubert, Xavier Nassif, Jean-Michel Pawlotsky, Jérôme Robert, Anne-Marie Roque Afonso, Martin Rottman, Christine Rouzioux, Flore Rozenberg, François Simon, Nicolas Veziris, David Skurnik, Jean-Ralph Zahar, Guilene Barnaud, Typhaine Billard Pomares, Gaëlle Cuzon, Dominique Decré, Alexandra Doloy, Jean-Luc Donay, Laurence Drieux-Rouzet, Isabelle Durand, Agnès Ferroni, Vincent Fihman, Nicolas Fortineau, Camille Gomart, Nathalie Grall, Christelle Guillet Caruba, Françoise Jaureguy, Valérie Lalande, Luce Landraud, Véronique Leflon, Patricia Mariani, Liliana Mihaila, Didier Moissenet, Latifa Noussair, Isabelle Podglajen, Isabelle Poilane, Hélène Poupet, Emilie Rondinaud, Valérie Sivadon Tardy, David Trystram, Charlotte Verdet, Emmanuelle Vigier, Sophie Vimont BillarantInternational audienceThe impact of the COVID-19 pandemic on bloodstream infections (BSIs) due to Streptococcus pneumoniae and Streptococcus pyogenes was assessed in 25 university hospitals of Paris. Monthly BSIs incidence rates that appeared stable in 2018 and 2019, decreased for the 2 pathogens during the 2 COVID-19 lockdown periods of 2020. Containment policies, including social distancing, masking and hand hygiene strengthening in both community and hospital settings are likely to reduce BSIs due to these pathogens
A Conservative Cartesian Cut Cell Method for the Solution of the Incompressible Navier-Stokes Equations on Staggered Meshes
No full textThe treatment of complex geometries in Computational Fluid Dynamics applications is a challenging endeavor, which immersed boundary and cut-cell techniques can significantly simplify by alleviating the meshing process required by body-fitted meshes. These methods however introduce new challenges, as the formulation of accurate and well-posed discrete operators becomes nontrivial. Here, a conservative cartesian cut cell method is proposed for the solution of the incompressible Navier--Stokes equation on staggered Cartesian grids. Emphasis is set on the structure of the discrete operators, designed to mimic the properties of the continuous ones while retaining a nearest-neighbor stencil. For convective transport, a divergence is proposed and shown to also be skew-symmetric as long as the divergence-free condition is satisfied, ensuring mass, momentum and kinetic energy conservation (the latter in the inviscid limit). For viscous transport, conservative and symmetric operators are proposed for Dirichlet boundary conditions. Symmetry ensures the existence of a sink term (viscous dissipation) in the discrete kinetic energy budget, which is beneficial for stability. The cut-cell discretization possesses the much desired summation-by-parts (SBP) properties. In addition, it is fully conservative, mathematically provably stable and supports arbitrary geometries. The accuracy and robustness of the method are then demonstrated with flows past a circular cylinder and an airfoil
A stochastic volatility model for the valuation of temperature derivatives
No full textThis paper develops a new stochastic volatility model for the temperature that is a natural extension of the Ornstein-Uhlenbeck model proposed by Benth and Benth (2007). This model allows to be more conservative regarding extreme events while keeping tractability. We give a method based on Conditional Least Squares to estimate the parameters on daily data and estimate our model on eight major European cities. We then show how to calculate efficiently the average payoff of weather derivatives both by Monte-Carlo and Fourier transform techniques. This new model allows to better assess the risk related to temperature volatility
Counting what really counts? Assessing the political impact of science
No full textThe production of scientific knowledge is expected to benefit society in a variety of ways. However, and despite the many theoretical models available in the literature, there are few practical frameworks for assessing the dimensions of the effect of research on society—including its political impacts. As part of the ASIRPA approach, in this paper we propose an ordinal rating scale to allow assessment of the political impact of research, based on a review of the literature, qualitative evidence of political impact gleaned from a collection of case studies, and an expert panel. The resulting metric uses a 1–5 scale to evaluate the intensity of the political impact of research according to generic criteria associated to each rating level. Routine application of this scale in case study research is increasing, and is allowing robust, simple and consistent self-assessments of the political impacts across cases, to complement qualitative case study descriptions. The methodology used to design the rating scale prompted the panel experts to reveal their evaluation rationales and justify their judgments, increasing the transparency of the assessments. We believe that the benefits of assigning an ordinal measure to the political impact of research outweigh the risks of misuse of an impact number. The advantages include influencing political agenda-setting by showing what really matters, the opportunities it provides for scaling-up analyses of multidimensional impacts and identifying impact-generating mechanisms, and learning about and promoting discussion of the value systems reflected in the assessment
Decimations for Two-dimensional Ising and Rotator Models
No full textInternational audienceWe extend proofs of non-Gibbsianness of decimated Gibbs measures at low temperatures to include long-range, as well as vector-spin interactions. Our main tools consist in a two-dimensional use of "Equivalence of boundary conditions" in the long-range case and an extension of Global specifications for two-dimensional vector spins
Zones de contacts inversés et stratégies de réduction des tensions identitaires des minorités culturelles
No full textInternational audienc
La carte au cœur des apprentissages disciplinaires
No full textInternational audienceLa cartographie est au cœur des apprentissages en géographie. Son apprentissage est complexe et parfois réduit à des tâches de faible intensité intellectuelle. Ce chapitre interroge la manière dont les manuels scolaires se sont emparés de la nouvelle épreuve du baccalauréat (exercice de transposition d'un texte en croquis) pour initier les élèves au langage cartographique
