Les évaluations de coûts en santé sont-elles transférables ?

Cette étude de la transférabilité des résultats des évaluations de coûts en santé repose sur l'analyse en composantes principales et les distances euclidiennes. Elle permet de montrer si les résultats sont faiblement, moyennement ou largement transférables. Le recours à ces deux méthodes validées pour mesurer la transférabilité des résultats constitue, de ce point de vue, une démarche originale. Son opérationnalité est également démontrée dans le cadre d'un traitement innovant, la radiothérapie par ions carbone. Une analyse « globale » témoigne, par exemple, d'une forte distance entre l'Italie et les Pays-Bas. Tous facteurs confondus, les résultats sont donc faiblement transférables entre ces deux pays. Une analyse plus fine montre que les distances sont maximales et donc la transférabilité minimale pour les coûts des bâtiments et les paramètres organisationnels.cost ; economic assessment ; health ; oncology ; transferability

TLR3 agonists induce fibronectin aggregation by activated astrocytes:a role of pro-inflammatory cytokines and fibronectin splice variants

Multiple sclerosis (MS) is a chronic demyelinating disease of the central nervous system which eventually results in axonal loss mainly due to failure of remyelination. Previously we have shown that the persistent presence of stable astrocyte-derived fibronectin aggregates in MS lesions impairs OPC differentiation, and thereby remyelination. Here we set out to discern whether and, if so, how inflammatory mediators as present in MS lesions trigger astrocytes to form fibronectin aggregates. Our findings revealed that in slice cultures only upon demyelination, the TLR3 agonist Poly(I:C) evoked astrocytes to form fibronectin aggregates. Consistently, pro-inflammatory cytokine-pretreated astrocytes were more susceptible to Poly(I:C)-induced fibronectin aggregation, indicating that astrocytes form fibronectin aggregates upon a double hit by inflammatory mediators. The underlying mechanism involves disrupted fibronectin fibrillogenesis at the cell surface as a result of a cytokineinduced increase in relative mRNA levels of EIIIA(pos)-Fn over EIIIBpos-Fn and a Poly(I:C)-mediated decrease in integrin affinity. Remarkably, fibronectin aggregation is exacerbated by white matter astrocytes compared to grey matter astrocytes, which may be a reflection of higher expression levels of EIIIA(pos)-fibronectin in white matter astrocytes. Hence, interfering with alternative fibronectin splicing and/or TLR3-mediated signaling may prevent fibronectin aggregation and overcome remyelination failure in MS lesions

Colloidal stability of tannins: astringency, wine tasting and beyond

Tannin-tannin and tannin-protein interactions in water-ethanol solvent mixtures are studied in the context of red wine tasting. While tannin self-aggregation is relevant for visual aspect of wine tasting (limpidity and related colloidal phenomena), tannin affinities for salivary proline-rich proteins is fundamental for a wide spectrum of organoleptic properties related to astringency. Tannin-tannin interactions are analyzed in water-ethanol wine-like solvents and the precipitation map is constructed for a typical grape tannin. The interaction between tannins and human salivary proline-rich proteins (PRP) are investigated in the framework of the shell model for micellization, known for describing tannin-induced aggregation of beta-casein. Tannin-assisted micellization and compaction of proteins observed by SAXS are described quantitatively and discussed in the case of astringency

Reversible Al Propagation in Si x Ge 1-x Nanowires

While reversibility is a fundamental concept in thermodynamics, most reactions are not readily reversible, especially in solid state physics. For example, thermal diffusion is a widely known concept, used among others to inject dopant atoms into the substitutional positions in the matrix and improve the device properties. Typically, such a diffusion process will create a concentration gradient extending over increasingly large regions, without possibility to reverse this effect. On the other hand, while the bottom up growth of semiconducting nanowires is interesting, it can still be difficult to fabricate axial heterostructures with high control. In this paper, we report a reversible thermal diffusion process occurring in the solid-state exchange reaction between an Al metal pad and a SixGe1-x alloy nanowire observed by in-situ transmission electron microscopy. The thermally assisted reaction results in the creation of a Si-rich region sandwiched between the reacted Al and unreacted SixGe1-x part, forming an axial Al/Si/SixGe1-x heterostructure. Upon heating or (slow) cooling, the Al metal can repeatably move in and out of the SixGe1-x alloy nanowire while maintaining the rod-like geometry and crystallinity, allowing to fabricate and contact nanowire heterostructures in a reversible way in a single process step, compatible with current Si based technology. This interesting system is promising for various applications, such as phase change memories in an all crystalline system with integrated contacts, as well as Si/SixGe1-x/Si heterostructures for near-infrared sensing applications

Experiences on altimeter calibration at Ibiza island and Cape of Begur (Spain)

Three preliminary camp aigns for TOPEX /POSEIDON (T/P) wer e made in March 1999 and July 2000 and for JASON-1 in August 2002, in the NW Mediterran ean Sea at th e Begur Cape area. Dir ect abso lute altimeter calibration , and mapping of the sea surface, w ere made in these camp aigns from dir ect overflights using GPS buoys with a toroidal design performed at the I CC based in the orig inal design of the Univ ersity of Colorado at Boulder and a estimation of the TOPEX A lt- B bias w as made. A Spanish JASON-1 geoid gradien t campaign with Fench support has been made in June 2003 at the Ibiza island in the NW Mediterr anean Sea. Th e main objectiv e has b een to map w ith a new d esign ed, builded and calibrated GPS catamar an, the lo cal geoid gradien t in three ar eas around Ibiza island under the ascending (187) and descending (248) Jason-1ground tracks. The catamaran equ ipped with two GPS antennas to perform continuous sea lev el measur ements was towed by the Patro l Dev a from th e Span ish N avy. Five GPS reference stations were dep loyed on Ibiza island: one in Portinatx, two in San Anton io and two in Ibiza. The marin e geo id has been used to relate the coastal tide gauge data from Ibiza and San An tonio h arbours to off- shore altimetric data. In th e framework of the campaign, the levelling of the Ibiza and San Anton io tide gauges to the r espective GPS mark ers w as p erformed. We present synth esis of the resu lts obtained from Topex/Poseidon and th e first r esults on Jason-1 altimeter calibration using the direct measurements from GPS buoys and the derived marin e geoid. Th e Ibiza results agree relativ ely w ell with resu lts ob tained at Corsica, Harvest and Bass Strait calibration permanen t sites. Moreov er, the geod etic activities (e.g., GPS, levelling) has p ermitted to build a very accurate (few mm) local n etwork link ed to th e European one, w ith a reference frame compatible with th e satellite altimetry missions (ITRF2000). The GPS kinematic data wer e processed using two d ifferen t sof twar es allowing to check th e consistency of the solutions. A perspective of a new Jason-1, in cluding Envisat, Ibiza campaign to be made around 2007 will be pr esen ted. These camp aigns w ere supporte by th e Span ish Ministery of Scien ce and Technology under projects of the N ational Space Program ref : ESP1997-1816-CO4- 03 and ESP2001-4534-PE.Peer ReviewedPostprint (published version