L'intermodalité-voyageurs au prisme de la mondialisation : vers la structuration d'un méta-réseau intégré

Globalization sees world as a pertinent scale in the analysis of growing mobilities. Defined as network system, passenger intermodality seeks to improve transcalar trips and is thought as a tool for a new mobility paradigm : from a monomodal networks multiplicity to the meta-network integration, thanks to places of interchange, linking scales. Taking world as a whole, this study is primarily focused on passenger intermodality related to airport ground access. Indeed, airports, linking cities, regions and the world reveal the burning issues and stakes of a potential integrated intermodal network. Thought as a worldwide system, based upon gateway-status airports, this new meta-network doesn’t materialize. Still highly fragmented, dominant dynamics are macro-regional ones, which lead networks and services integration. The networks emergence drifts from a pioneering source : Rhinelander model, either imitated (Europe, Americas) or perfected (Eastern Asia). Three features define this model : making the use of networks easy for users from the start to the end thanks to interchanges. Secondly, actors adopt a broad systemic and territorial viewpoint. Customer’s needs and path are thought as a whole. Third, rules of (de)regulated markets demand innovation. Passenger intermodality is concerned with territorial marketing strategies within a globalization made of competition between metropolises. Regarded as a marketed product, intermodality produces interdependences between system’s actors then discovered. Optimal gestion makes intermodal system success, as proven by german model. At last, we underline complexity of passenger intermodality, linking three facets of globalization : by networks (including services), by speeches and pictures, by entrepreneurial strategies. Passenger intermodality, as a prism for globalization dynamics, is a mean to think of key concepts of geography and social sciences: place, individual, world.La mondialisation induit l’émergence du monde comme échelle désormais pertinente pour l’analyse de mobilités en croissance. L’intermodalité-voyageurs entendue comme un système actoriel favorisant les déplacements transcalaires, devient alors l’outil majeur d’un possible changement d’analyse des mobilités. La juxtaposition de réseaux monomodaux fait place à un méta-réseau déployant des interfaces multiples entre petites et grandes échelles. Ce travail à l’échelle mondiale se concentre sur les manifestations intermodales liées à l’accessibilité aéroportuaire. En effet, les aéroports, joignant la petite échelle, le monde, à la grande échelle (la ville, la région ou le quartier), concentrent les enjeux de la mise en place d’un réseau intermodal intégré, érigé en système. Centré sur les plates-formes aéroportuaires dotées du statut de gateway et se déployant uniformément à l’échelle mondiale, ce nouveau méta-réseau ne se concrétise pas. Il apparaît encore largement fragmenté, dominé par des dynamiques d’échelles régionales ou supra-nationales, marquées par une intégration plus ou moins avancée des réseaux-supports et des réseaux-services. L’émergence de tels réseaux provient d’une même matrice : l’imitation (Europe, Amériques) voire le perfectionnement (Asie Orientale), plus ou moins assumés et selon des conditions diverses, du modèle pionnier rhénan. Trois facteurs principaux expliquent la force de ce modèle. Au fondement de son efficacité pratique apparaît le principe de transcalarité, définie comme la capacité des utilisateurs à profiter de toute la capillarité des réseaux. Ce modèle s’appuie également sur une approche systémique et territoriale, favorisant les interactions entre acteurs. Ceux-ci envisagent globalement les besoins du client et l’ensemble de son cheminement. Ce changement d’attitude est rendu possible par l’introduction des règles du marché, troisième facteur de ce modèle. Dès lors, l’intermodalité-voyageurs s’inscrit dans des stratégies de promotion territoriale au sein d’une mondialisation compétitive et inter-métropolitaine. Considérée alors comme un produit, elle génère des interdépendances entre acteurs. La gestion optimale de ces interdépendances fait le succès du système intermodal. Cette recherche met ainsi en évidence la complexité de l’objet intermodalité-voyageurs, à la confluence d’une triple dynamique de mondialité : rétistique et servicielle, discursive et iconique et enfin capitalistique par les firmes. L’intermodalité-voyageurs permet enfin de réfléchir à des concepts-clés de la géographie et des sciences sociales : le lieu, l’individu, le monde

La philosophie mathématique de Roger Apéry

Pour qui s’intéresse à la philosophie des mathématiques, Roger Apéry (1916-1994) incarne le défenseur de la mathématique constructive et l’adversaire résolu du formalisme et du bourbakisme. On sait moins qu’il est aussi l’un des premiers universitaires français à avoir fait la promotion de la théorie des catégories, pourtant hautement structuraliste et souvent jugée comme très formelle. L’objectif principal de notre étude est de préciser les conditions historiques et la teneur philosophique du double enthousiasme d’Apéry, afin de vérifier la cohérence d’une pensée libre, originale et attachante.For anybody interested in philosophy of mathematics, Roger Apéry (1916-1994) is well known for advocating constructive mathematics and for being a resolute opponent to formalism and Bourbakism. It is less known that he was also one of the first French academics to promote category theory, in spite of its highly structural and formal nature. This study attempts to trace the historical conditions and philosophical content of Apéry’s double enthusiasm, in order to check the consistance of a free, original and attaching thought

Émergence d’un savoir mathématique euro-islamique : L’Offrande du converti pour ranimer la flamme éteinte

Nous étudions un traité scientifique en langue arabe, achevé à Belgrade en 1779. Son titre est L’Offrande du converti pour ranimer la flamme éteinte. Il ne fut jamais imprimé, mais dix copies, d’aspect semblable à celui des manuscrits arabes traditionnels, attestent de sa circulation dans l’Empire ottoman. L’auteur, un converti à l’islam qu’on appelait Osman Efendi, y aborde la géométrie euclidienne, la géométrie d’arpentage, la dynamique galiléenne et leurs applications aux sciences militaires. Il affiche son ambition de « faire revivre et renouveler » la géométrie, « science oubliée et délaissée », et révèle in fine avoir pour cela traduit des livres allemands et français. Après un essai de reconstruction de la biographie d’Osman Efendi, nous montrerons que son ouvrage est en réalité une production élaborée, dépassant largement la simple démarche de traduction. Montage soigneux de différentes sources européennes que nous identifierons, il incorpore aussi un grand nombre d’éléments directement empruntés au savoir islamique de la tradition vivante. Il est ainsi le témoin remarquable d’une tentative de constitution d’un savoir hybride euro-islamique.We studied a scientific treatise in Arabic, completed in Belgrade in 1779. Its title is The Offering of the Convert to Rekindle the Extinguished Flame. It never appeared in print, but ten copies, similar in appearance to that of traditional Arabic manuscripts, give evidence that it circulated in the Ottoman Empire. The author, a convert to Islam called Osman Efendi, addresses Euclidean geometry, surveying geometry, Galilean dynamics and their applications in military science. He displays his ambition to “revive and renew” geometry, “a forgotten and neglected science”, and ultimately reveals that he translated some German and French books for this purpose. After a tentative reconstruction of Osman Efendi’s biography, we will show that his book is actually an elaborate work going far beyond simple translation process. Carefully putting together various European sources that we shall identify, it also incorporates a large number of elements directly borrowed from Islamic knowledge of the living tradition. It is thus a remarkable testimony to an attempt to create a Euro-Islamic form of hybrid knowledge

A regional trauma system to optimize the pre-hospital triage of trauma patients.

INTRODUCTION: Pre-hospital triage is a key element in a trauma system that aims to admit patients to the most suitable trauma center, and may decrease intra-hospital mortality. We evaluated the performance of a pre-hospital procedure in a regional trauma system through measurements of the quality of pre-hospital medical assessment and the efficacy of a triage protocol. METHODS: Our regional trauma system included 13 hospitals categorized as Level I, II or III trauma centers according to their technical facilities. Each patient was graded A, B or C by an emergency physician, according to the seriousness of their injuries at presentation on scene. The triage was performed according to this grading and the categorization of centers. This study is a registry analysis of a three-year period (2009 to 2011). RESULTS: Of the 3,428 studied patients, 2,572 were graded using the pre-hospital grading system (Graded group). The pre-hospital gradation was closely related with injury severity score (ISS) and intra-hospital mortality rate. The triage protocol had a sensitivity of 92% (95% confidence interval (CI) 90% to 93%) and a specificity of 41% (95% CI 39% to 44%) to predict adequate admission of patients with ISS more than 15. A total of 856 patients were not graded at the scene (Non-graded group). Undertriage rate was significantly reduced in the Graded group compared with the Non-graded group, with a relative risk of 0.47 (95% CI 0.40 to 0.56) according to the definition of the American College of Surgeons Committee on Trauma (P <0.001). Where adjusted for trauma severity, the expected mortality rate at discharge from hospital was higher than observed mortality, with a difference of +2.0% (95% CI 1.4 to 2.6%; P <0.01). CONCLUSIONS: Implementation of a regional trauma system with a pre-hospital triage procedure was effective in detecting severe trauma patients and in lowering the rate of pre-hospital undertriage. A beneficial effect on outcome of such an organization is suggested

Gram and acridine orange staining for diagnosis of septic arthritis in different patient populations

Purpose: The sensitivity of Gram staining is known to be suboptimal for the diagnosis of native joint septic arthritis. We lack information about the accuracy of Gram compared to other microscopic staining techniques for predicting infection in different patient populations. Methods: This was a cohort study with cost evaluations at the Orthopaedic Service of Geneva University Hospitals (January 1996-October 2012). Results: Among 500 episodes of arthritis (196 with immunosuppression, 227 with underlying arthroplasties and 69 with gout or other crystals in synovial fluid), Gram staining revealed pathogens in 146 episodes (146/500, 29%) or in 146 of the 400 culture-positive episodes (37%). Correlation between the Gram and acridine staining of the same sample was good (Spearman 0.85). Overall, the sensitivity, specificity, positive predictive value and negative predictive value of Gram stain for rapid diagnosis of septic arthritis was 0.37, 0.99, 0.99 and 0.28, respectively, compared to microbiological cultures. Quite similar values were recorded across the different patient subpopulations, in particular for sensitivity values that were 0.33 for patients with prosthetic joint infections, 0.40 for immunosuppressed patients, 0.36 for patients under antibiotic administration and 0.52 for patients with concomitant crystalline disease. Conclusions: The sensitivity of Gram or acridine orange staining for a rapid diagnosis of episodes of septic arthritis is suboptimal compared to microbiological culture, regardless of underlying conditions, immunosuppression or antibiotic therapy. The sensitivity in the presence of synovial fluid crystals is moderate. Acridine orange and Gram stains are equivalent

Management of upper gastrointestinal bleeding in emergency departments, from bleeding symptoms to diagnosis: a prospective, multicenter, observational study.

BACKGROUND: Upper gastrointestinal bleeding (UGB) is common in emergency departments (EDs) and can be caused by many eso-gastro-duodenal lesions. Most available epidemiological data and data on the management of UGB comes from specialized departments (intensive care units or gastroenterology departments), but little is known from the ED perspective. We aimed to determine the distribution of symptoms revealing UGB in EDs and the hemorrhagic lesions identified by endoscopy. We also describe the characteristics of patients consulting for UGB, UGB management in the ED and patients outcomes. METHOD: This was a prospective, observational, multicenter study covering 4 consecutive days in November 2013. Participating EDs were part of the Initiatives de Recherche aux Urgences network coordinated by the French Society of Emergency Medicine. All patients with suspected UGB in these EDs were included. RESULTS: In total, 110 EDs participated, including 194 patients with suspected UGB (median age 66 years [Q1-Q3: 51-81]). Overall, 104 patients (54%) had hematemesis and 75 (39%) melena. Endoscopy revealed lesions in 121 patients, mainly gastroduodenal ulcer or ulcerations (41%) or bleeding lesions due to portal hypertension (20%). The final diagnosis of UGB was reversed by endoscopy in only 3% of cases. Overall, 67 patients (35%) had at least one severity sign. Twenty-one patients died (11%); 40 (21%) were hospitalized in intensive care units and 126 (65%) in medicine departments; 28 (14%) were outpatients. Mortality was higher among patients with clinical and biological severity signs. CONCLUSION: Most of the UGB cases in EDs are revealed by hematemesis. The emergency physician diagnosis of UGB is rarely challenged by the endoscopic findings

Reception Test of Petals for the End Cap TEC+ of the CMS Silicon Strip Tracker

The silicon strip tracker of the CMS experiment has been completed and was inserted into the CMS detector in late 2007. The largest sub system of the tracker are its end caps, comprising two large end caps (TEC) each containing 3200 silicon strip modules. To ease construction, the end caps feature a modular design: groups of about 20 silicon modules are placed on sub-assemblies called petals and these self-contained elements are then mounted onto the TEC support structures. Each end cap consists of 144 such petals, which were built and fully qualified by several institutes across Europe. Fro

Integration of the End Cap TEC+ of the CMS Silicon Strip Tracker

The silicon strip tracker of the CMS experiment has been completed and inserted into the CMS detector in late 2007. The largest sub-system of the tracker is its end cap system, comprising two large end caps (TEC) each containing 3200 silicon strip modules. To ease construction, the end caps feature a modular design: groups of about 20 silicon modules are placed on sub-assemblies called petals and these self-contained elements are then mounted into the TEC support structures. Each end cap consists of 144 petals, and the insertion of these petals into the end cap structure is referred to as TEC integration. The two end caps were integrated independently in Aachen (TEC+) and at CERN (TEC--). This note deals with the integration of TEC+, describing procedures for end cap integration and for quality control during testing of integrated sections of the end cap and presenting results from the testing

Dans le cabinet de travail du pasteur Samuel Bochart: L’érudit et ses sources arabes

International audienceLe pasteur Samuel Bochart (Rouen, 1599-Caen, 1667) fut un érudit accompli qui fit parler de lui dans toute l’Europe savante. Formé dans les académies protestantes de Sedan et Saumur, où il avait cultivé le grec et l’hébreu, il étudia à Leyde l’arabe et l’araméen de 1620 à 1622. Durant l’année académique 1622-1623, il compléta ce parcours à Oxford. De 1624 à sa mort, il exerça son ministère pastoral à Caen et ne sortit plus du royaume que pour répondre, comme avant lui Descartes ou Saumaise, à l’invitation de la très intellectuelle reine Christine de Suède : il était alors âgé de 54 ans. Le plus clair de son temps fut consacré à la composition de deux ouvrages extraordinaires et monumentaux : sa Geographia sacra (Caen, 1646) sur les peuples de la Bible et les Phéniciens, et son Hierozoicon (Londres, 1663), traité de zoologie sacrée. Bochart y mit à profit une quantité ahurissante de sources latines, grecques, hébraïques, arabes, araméennes, syriaques, samaritaines, éthiopiennes. Une telle érudition a profondément impressionné ses contemporains et ses lecteurs de toutes époques. Très impressionné moi aussi, presque incrédule, j’ai voulu comprendre comment Bochart travaillait. D’où venaient ses sources ? Où achetait-il ses livres et où trouvait-il des manuscrits rares ? Comment lisait-il ? Avec quelle facilité comprenait-il les langues orientales ? Quelles places la lecture et l’écriture tenaient-elles dans son travail ? Comment prenait-il des notes ? Faisait-il des fiches ? Rédigeait-il des brouillons successifs ? Quels usages respectifs faisait-il du latin et du français ? Qui étaient ses premiers lecteurs, ses correspondants, son réseau ? Comment ses ouvrages étaient-ils imprimés, financés, commercialisés ? Comment étaient réalisés leurs multiples index ? Et quid à côté de ce labeur démesuré du temps réservé à la vie de famille, ou au travail pastoral ? En bref, j’ai désiré entrer dans le cabinet de travail de Samuel Bochart