Rapport de la campagne SURTROPAC 15 à bord du N.O. NOROIT du 18 juillet au 15 août 1991 de 20°S à 10°N le long du méridien 165°E

Dans le cadre du programme international TOGA, la campagne SURTROPAC 15 a eu lieu du 18 juillet au 15 août 1991, le long du méridien 165°E de 20°S à 10°N. Cette campagne a été réalisée par le groupe ORSTOM-SURTROPAC de Nouméa, Nouvelle-Calédonie, avec la participation du groupe ORSTOM-PROPPAC (Nouméa) et du PMEL-NOAA (Seattle). Elle s'est déroulée à bord du navire océanographique LE NOROIT de la flotte océanographique nationale. Au cours de la campagne SURTROPAC 15, les travaux suivants ont été effectués : 64 stations à la sonde CTDO2 (0-1000 m) avec prélèvements à la rosette, 64 tirs XBT, des mesures en continu du courant absolu (0-400 m) à l'aide d'un profileur de courant à effet Doppler acoustique, des mesures de la température et de la salinité de surface, toutes les 2 minutes, des observations météorologiques toutes les 3 heures, ainsi que des relevages et poses de mouillages. Ce rapport décrit le déroulement de la campagne ainsi que le matériel et les méthodes utilisés. Il présente également les figures correspondant aux premiers résultats. (Résumé d'auteur

Transfusion practices in postpartum hemorrhage: a population-based study.: Transfusion in Postpartum Haemorrhage

International audienceOBJECTIVE: To describe transfusion practices and anemia in women with postpartum hemorrhage (PPH), according to the clinical context. DESIGN: Population-based cohort study. SETTING: A total of 106 French maternity units (146 781 deliveries, December 2004 to November 2006). POPULATION: All women with PPH (n = 9365). METHODS: Description of the rate of red blood cell (RBC) transfusion in PPH overall and compared with transfusion guidelines. MAIN OUTCOME MEASURES: Transfusion practices and postpartum anemia by mode of delivery and cause of PPH in women given RBCs within 12 h after PPH. RESULTS: A total of 701 women received RBCs (0.48 ± 0.04% of all women and 7.5 ± 0.5% of women with PPH). Half the women with clinical PPH and hemoglobin lower than 7.0 g/dL received no RBCs. In the group with clinical PPH and transfusion within 12 h (n = 426), operative vaginal delivery was associated with a larger maximal hemoglobin drop, more frequent administration of fresh-frozen plasma (FFP) and pro-hemostatic agents [odds ratio (OR) 3.54, 95% confidence interval (95% CI) 1.12-11.18], transfusion of larger volumes of RBCs and FFP, a higher rate of massive RBCs transfusion (OR 5.22, 95% CI 2.12-12.82), and more frequent use of conservative surgery (OR 3.2, 95% CI 1.34-7.76), compared with spontaneous vaginal delivery. CONCLUSIONS: The RBC transfusion for PPH was not given in a large proportion of women with very low hemoglobin levels despite guidelines to the contrary. Operative vaginal delivery is characterized by higher blood loss and more transfusions than spontaneous vaginal delivery

Biodiversity Informatics: An interactive computer- aided identification and knowledge base on tree species of Lao PDR

International audienceObjectives • To enrich the existing knowledge base (BIOTIK project*) on a major "hot spot" of biodiversity: the rain forests of Annamite Mountain range of Lao PDR, in the framework of the Inventory of biodiversity of forest canopies conducted in 2012 in Lao PDR under F. Hallé scientific direction, and also to participate to broader initiatives such as Pl@ntNet project**. • To translate the identification tool in the Lao language in order to contribute to the capacity-building in plant taxonomy in the country. • To transfer the identification system to touch pads, enabling plant identification and entering data directly in the field

Hémorragie du postpartum (profil épidémiologique et évaluation des pratiques d'anesthésie-réanimation en France)

La France se démarque par un ratio de mortalité maternelle par hémorragie du postpartum (HPP) élevé.Les objectifs de cette thèse étaient: 1/comparer les caractéristiques épidémiologiques de l'HPP entre la France et le Canada 2/décrire les pratiques d'anesthésie-réanimation dans l'HPP et évaluer leur adéquation par rapport aux recommandations chez les femmes décédées d'HPP et dans une population de femmes avec HPP.Les sources de données utilisées étaient: La base nationale canadienne de données hospitalières sur les séjours des patients, l'essai Pithagore6 et l'Enquête nationale confidentielle sur les morts maternelles.La comparaison du profil épidémiologique de l'HPP entre la France et le Canada montre que l'HPP n'est pas plus fréquente en France. Le recours plus fréquent à des traitements de seconde ligne suggère une incidence plus élevée de l'HPP sévère en France. Dans les décès maternels par HPP, certaines pratiques d'anesthésie-réanimation apparaissent comme inadéquates: le monitorage clinique et la mise en condition des patientes, la surveillance paraclinique, le protocole d'anesthésie générale et la stratégie transfusionnelle. La description en population des pratiques transfusionnelles dans l'HPP montre un recours insuffisant à la transfusion. Inversement des stratégies transfusionnelles dont l'efficacité n'est pas prouvée sont fréquemment appliquées.Ce travail suggère une sévérité importante de l'HPP en France, pouvant expliquer l'importance de la mortalité par HPP. Certaines pratiques d'anesthésie-réanimation apparaissant comme non-optimales pourraient être impliquées dans cette sévérité. L'association entre pratiques et sévérité de l'HPP reste à être étudiée.In France, the maternal mortality ratio due to postpartum hemorrhage (PPH) is higher than in other high resources countries. This situation remains partially unexplained. The objectives of this PhD thesis were: 1/ to compare PPH epidemiological characteristics between France and Canada, 2/ to describe anesthesia and intensive care practices in PPH and to compare them with guidelines, first in cases of maternal deaths from PPH and secondly in a large population of women with PPH. The data sources were: the Discharge Abstract Database from the Canadian Institute for Health Information, the Pithagore6 trial and the French Confidential Enquiry into Maternal Deaths. The comparison of PPH epidemiological profiles between France and Canada shows that PPH incidence is not higher in France. Second-line treatments in PPH management are more frequently performed, suggesting a higher incidence of severe PPH in France. Among maternal deaths from PPH, some practices in anesthesia and critical care management appear to be inadequate: clinical monitoring and laboratory assessment, protocol for general anesthesia and transfusion strategy. The description on transfusion practices in a large population of women with PPH shows that the use of blood products is not sufficient. Conversely, transfusion strategies with unproved efficacy are frequently used. These results suggest a higher rate of severe PPH in France, that may result in the higher maternal mortality due to PPH. Inadequate practices in anesthesia and critical care could be involved in this severity. But the association between specific components of anesthesia and critical care management and PPH severity remains to be exploredPARIS-JUSSIEU-Bib.électronique (751059901) / SudocSudocFranceF

Planification de missions multi-satellites par système multi-agent coopératif

La planification de mission de constellations de satellites est un problème complexe soulevant d’importants défis technologiques pour les systèmes spatiaux de demain. L’augmentation de la taille des constellations, les performances évoluées et l’hétérogénéité des satellites sont tous des critères impliquant une combinatoire très élevée. Les techniques actuelles présentent des limites, car elles planifient un satellite à la fois et non la constellation dans son ensemble. Dans cet article, nous proposons de résoudre ce problème difficile par les systèmes multiagents coopératifs. Une amélioration du modèle AMAS4Opt est présentée, permettant de maximiser la coopération entre les agents du système. De par leurs interactions locales, ces agents, permettent d’obtenir une solution de bonne qualité en un temps raisonnable, en assurant un partage équitable des tâches au sein de la constellation. Enfin, une comparaison avec l’algorithme Glouton Chronologique, couramment utilisé dans le domaine spatial, souligne les avantages de l’approche proposée

001 Predictive Value of Post Treatment Platelet Reactivity for Occurrence of Post-discharge Bleeding After Non ST Elevation Acute Coronary Syndrome

AimsWe assessed prospectively the association between occurrence of post-discharge non–CABG-related TIMI major and minor bleedings and post treatment platelet reactivity in patients with Non ST Elevation Acute Coronary Syndrome (NSTE ACS).Methods and Results597 consecutive patients admitted with NSTE ACS were prospectively included. Between hospital discharge and one month follow-up, we observed 16 (2.7%) non–CABG-related TIMI hemorrhagic complications including 5 (0.84%) major and 11 (1.8%) minor bleeds. Patients with bleeding had significantly lower post treatment values of ADP-induced aggregation (43±14% versus. 56±19%, P=0.002) and platelet reactivity index VASP (43±14% versus 54±23%; P=0.04) and a trend for lower values of arachidonic acid-induced aggregation (2.4±5.4 versus 13±21; P=0.27). After stratification by quartiles based on post treatment ADP-induced platelet aggregation, we identified patients in the first quartile as hyper-responders with very low post treatment platelet reactivity, below <40%. The risk of TIMI major and minor bleeding was significantly higher in the first quartile of hyper-responders than in the others quartiles: 10 (6.6%) versus 6 (1.4%), p=0.001.ConclusionOur results suggest that assessment of post treatment platelet reactivity might be used to detect hyper responders to antiplatelet therapy with higher risk of non-CABG related bleedings and tailor antiplatelet therapy according to both ischemic and bleeding risk

From scientific models to companion modelling: engaging a dialogue with local actors in an Amazonian floodplain about biodiversity management at a territorial level

The Amazonian floodplain is among the most productive and diversified ecosystems in the world. The moving littoral enables a rapid nutrient recycling, explaining the large productivity and biodiversity of the system. Attracted by such favourable conditions for agricultural activities and fishing, populations have settled in the floodplains and developed complementary activities to cope with important variations in their environment, between the flood season and the dry season. However, in the past decades, the rhythm of these floodplains has changed, obliging the actors to deal with great uncertainty. Based on several years of hydrological and biogeochemical studies to understand the reasons of these environmental changes, the “life scientists” of our team invited the “social scientists” with the following question: Can the results about the dynamics of these floodplains help local populations better anticipate the future fluctuations of the river and adapt their activities to be less vulnerable to such change? To address this, we first chose to turn the perspective around: what were the preoccupations and strategies of local populations and what did they expect from scientists? The challenge was to enable the perceptions and knowledge of local populations to dialogue with scientific knowledge. Based on a Companion Modelling approach, we engaged a participatory process to collectively discuss the current situation and possible future scenarios. Using a role-playing game as an interface for this dialogue, we have progressively built a model to integrate both the knowledge of the local actors regarding their practices and possible environmental impacts and the knowledge of the scientists on environmental dynamics. This has obliged researchers to learn to work together and simplify their knowledge, and requires finding common points of interest with local populations, translating “biodiversity” into concrete issues that have a meaning for local actors. (Texte intégral