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Assessing real-world effectiveness of therapies: what is the impact of incretin-based treatments on hospital use for patients with type 2 diabetes?
No full textInternational audienceBACKGROUND: Managing type 2 diabetes represents a major public health concern due to its important and increasing prevalence. Our study investigates the impact of taking incretin-based medication on the risk of being hospitalized and the length of hospital stay for individuals with type 2 diabetes. METHOD: We use claim panel data from 2011 to 2015 and provide difference-in-differences (DID) estimations combined with matching techniques to better ensure the treatment and control groups’ comparability. Our propensity score selects individuals according to their probability of taking an incretin-based treatment in 2013 (N = 2,116). The treatment group includes individuals benefiting from incretin-based treatments from 2013 to 2015 and is compared to individuals not benefiting from such a treatment but having a similar probability of taking it. RESULTS: After controlling for health-related and socio-economic variables, we show that benefiting from an incretin-based treatment does not significantly impact the probability of being hospitalized but does significantly decrease the annual number of days spent in the hospital by a factor rate of 0.621 compared with the length of hospital stays for patients not benefiting from such a treatment. CONCLUSION: These findings highlight the potential implications for our health care system in case of widespread use of these drugs among patients with severe diabetes
ESR/U-series dating of Eemian human occupations of Northern France
No full textInternational audiencePalaeolithic sites associated with the Eemian Interglacial (MIS 5e) are very rare in NW Europe, and especially in Northern France, where their preservation is restricted to very specific geological contexts, in association with carbonated tufa (Caours) or peat deposits (Waziers). In order to check the reliability of ESR/U-series method to date teeth recovered from archaeological levels in such specific geological environments, teeth were sampled on these two Middle Palaeolithic sites and systematic in situ dosimetry was performed using portable gamma spectrometer. The ESR/U-series ages obtained on the Caours site are very homogeneous allowing the calculation of a mean age equal to 125 ± 11 ka, in agreement with the geological age, mammal's association and other available geochronological data (U-series on tufa carbonate, TL on burnt flints, OSL on sediments), despite a relatively heterogeneous dosimetric environment (gamma dose rate ranging between ca 200–450 μGy/a). At Waziers, reducing (water logging) environment linked to the peat leads to very specific U-series data of the analysed teeth (U content lower than 0.1 ppm in all the dental tissues, evidence of leaching in some tissues), but the mean ESR/U-series age, 129 ± 4 ka, is also in agreement with the available geological and palaeoenvironmental data indicating that the dated teeth were associated with Late Glacial deposits prior to the climatic interglacial optimum. These two case studies then confirm the reliability of ESR/U-series method to date with good reliability and accuracy the archaeological levels linked to such relatively short climatic events (ca 10 ka)
Interaction fidelity is less common than expected in plant-pollinator communities
No full textInternational audiencePairs of plants and pollinators species sometimes consistently interact throughout time and across space. Such consistency can be interpreted as a sign of interaction fidelity, that is a consistent interaction between two species when they co-occur in the same place. But how common interaction fidelity is and what determines interaction fidelity in plant–pollinator communities remain open questions.We aim to assess how frequent is interaction fidelity between plants and their pollinators and what drives interaction fidelity across plant–pollinator communities.Using a dataset of 141 networks around the world, we quantify whether the interaction between pairs of plant and pollinator species happens more (‘interaction fidelity’) or less (‘interaction avoidance’) often than expected by chance given the structure of the networks in which they co-occur. We also explore the relationship between interaction fidelity and species' degree (i.e. number of interactions), and the taxonomy of the species involved in the interaction.Our findings reveal that most plant–pollinator interactions do not differ from random expectations, in other words show neither fidelity nor avoidance. Out of the total 44,814 co-occurring species pairs we found 7,877 unique pair interactions (18%). Only 551 (7%) of the 7,877 plant–pollinator interactions did show significant interaction fidelity, meaning that these pairs interact in a consistent and non-random way across networks. We also find that 39 (0.09%) out of 44,814 plant–pollinator pairs showed significant interaction avoidance. Our results suggest that interactions involving specialist species have a high probability to show interaction fidelity and a low probability of interaction avoidance. In addition, we find that particular associations between plant and insect orders, as for example interactions between Hymenoptera and Fabales, showed high fidelity and low avoidance.Although niche and neutral processes simultaneously influence patterns of interaction in ecological communities, our findings suggest that it is rather neutral processes that are shaping the patterns of interactions in plant–pollinator networks
Overall Survival and Prognostic Factors among Older Patients with Metastatic Pancreatic Cancer: A Retrospective Analysis Using a Hospital Database
No full textInternational audiencePre-therapeutic factors associated with overall survival (OS) among older patients ≥70 years with metastatic pancreatic cancer (mPC) are not known. This was a retrospective single-centre cohort study in Paris including 159 consecutive older patients with mPC between 2000 and 2018. Alongside geriatric parameters, specific comorbidities, cancer-related data and chemotherapy regimens were retrieved. Cox multivariate models were run to assess predictors for OS. The median age was 80 years, 52% were women, 21.5% had diabetes, and 48% had pancreatic head cancer and 72% liver metastases. 62% of the patients (n = 99) received chemotherapy, among which the gemcitabine + nab-paclitaxel (GnP) regimen was the most frequent (72%). Median OS [95%CI] was 7.40 [5.60–10.0] and 1.40 [0.90–2.20] months respectively for patients with and without chemotherapy. The GnP regimen (aHR [95%CI] = 0.47 [0.25–0.89], p = 0.02) and diabetes (aHR = 0.44 [0.24–0.77], p = 0.004) (or anti-diabetic therapy) were multivariate protective factors for death, while ECOG-PS, liver metastases, and the neutrophil cell count were multivariate risk factors for death. In the chemotherapy group, ECOG-PS, number of metastatic sites and the GnP remained significantly associated with OS. Our study confirms the feasibility and efficacy of chemotherapy and the protective effects of diabetes among older patients with mPC
Quantum dynamics beyond the Born-Oppenheimer approximation in molecular systems
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Variational Approach for Linearly Dependent Moving Bases in Quantum Dynamics: Application to Gaussian Functions
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From cyclins to CDKIs: Cell cycle regulation of skeletal muscle stem cell quiescence and activation
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Évolution des connaissances en calcul mental des élèves du cycle trois et influence d'une pratique régulière du logiciel Mathador sur les apprentissages
No full textThe main goal of that thesis is to evaluate the effects of the regular use of the Mathador software on the student's learnings. To answer this question, an analysis methodology including a rich and diversified (game data, knowledge tests and classes observations) were elaborated. The tests, identical on the 3 levels of the "third Cycle" are informing us about students' knowledge, on the evolution from nine to eleven years old and give us the ability to measure the eventual influence of the software on learnings. The analysis "a priori" of the tasks linked to drawings allowed us to make some indicators meant for an effective analysis of game data up and put under lights a nonconvergence between a logic of a player looking to reach the highest score and a learner knowledge logic, looking to use rich knowledges. The data analysis shows that students are mainly bringing "cheap solutions" (from a knowledge standpoint) and are using "surfaces strategy" that enable for great scoring without use of deeper knowledges. The teachers practices are a reflection and sometimes brings deeper this nonconvergence observation. The weakest students are going to mainly improve their knowledges about additive structures while best ones from multiplicative one. With the help of those results some software improving ideas and on how to follow teachers were proposed.L'objectif principal de cette thèse est d'évaluer les effets d'un dispositif intégrant la pratique régulière du logiciel Mathador sur les apprentissages des élèves. Afin de répondre à cette question, une méthodologie d'analyse incluant un recueil de data riche et diversifié (data de jeu, tests de connaissances et observations en classe) a été élaborée. Les tests, identiques sur les trois niveaux du cycle 3 nous renseignent sur les connaissances des élèves, sur l'évolution de ces connaissances du CM1 à la 6e et permettent de mesurer l'éventuelle influence du logiciel sur les apprentissages. L 'analyse a priori des tâches liées aux tirages a permis de construire des indicateurs destinés à l'analyse effective des data de jeu et a mis en évidence une non-convergence entre une logique de joueur incitant à obtenir un score meilleur et une logique d'apprenant recherchant l'utilisation de connaissances riches. L'analyse des data indique que les élèves produisent principalement des solutions économiques (du point de vue des connaissances) et utilisent des « stratégies de surface » qui permettent l'obtention d'un score meilleur sans pour autant mobiliser des connaissances plus riches. Les pratiques des enseignants reflètent et parfois accentuent ce constat de non convergence. Les élèves faibles vont principalement enrichir leurs connaissances sur les structures additives et les élèves plus performants sur les structures multiplicatives. En s'appuyant sur ces différents résultats, des pistes pour améliorer le logiciel et l'accompagnement en direction des professeurs sont proposées
