9 research outputs found

    Les infrastructures bocagÚres pour la biodiversité

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    National audienceLa biodiversitĂ© est actuellement peu intĂ©grĂ©e dans la rĂ©flexion autour de la conservationdu bocage et l’élaboration de plans de gestion individuels des haies. Le projet « Bocageet biodiversitĂ© » menĂ© en Ă©troite coopĂ©ration entre chercheurs et gestionnaires sur le bassinversant du LĂ©guer, dans les CĂŽtes d’Armor, a permis de dĂ©velopper et tester deux outilsappropriables et utilisables Ă  plusieurs Ă©chelles pour Ă©valuer le potentiel d’accueilde la biodiversitĂ© du bocage. L’un concerne l’état des haies et le second l’état du rĂ©seaude haies. Les outils ont ensuite Ă©tĂ© testĂ©s avec succĂšs sur quatre autres sites bretons,puis dans le Gers. La biodiversitĂ© Ă©tait reprĂ©sentĂ©e par le groupe des colĂ©optĂšres carabiquesen Bretagne et l’avifaune dans le Ger

    Professionnalisation(s) et État

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    Faire la sociologie politique des groupes professionnels, c’est mettre en lumiĂšre les formes variĂ©es de leur imbrication avec diffĂ©rents segments de la puissance publique. Cet ouvrage analyse les logiques de pouvoir de ces interdĂ©pendances Ă  l’aune de la professionnalisation. La reconnaissance, l’autonomisation et la dĂ©fense d’un territoire professionnel ou la production de rĂšgles et de normes professionnelles autonomes sont le produit de rapports de force qui se jouent entre professionnels mais aussi dans leur relation Ă  l’État. À la croisĂ©e de la sociologie et de la science politique, les neuf enquĂȘtes empiriques mobilisĂ©es analysent deux phĂ©nomĂšnes : la maniĂšre dont les dĂ©tenteurs du pouvoir Ă©tatique contrĂŽlent et agissent sur les activitĂ©s et les groupes professionnels, et le recours diffĂ©renciĂ© Ă  l’État opĂ©rĂ© par les groupes professionnels pour maintenir, amĂ©liorer et/ou lĂ©gitimer leur position sociale.The political sociology of professional and occupational groups is mainly concerned by the relations between those groups and the State. In this book, the authors want to tackle the issue by shedding new light on the logics of power that lie within these relations. To get the jurisdiction of an occupation or a profession recognized involves power struggles inside those groups as much as between those groups and the State: this book is about understanding those power struggles in their most concrete aspects. In the cross-cutting area of sociology and political science, nine enquiries address two phenomena: one the one hand, the way those who have political authority control and influence occupational groups, and on the other hand, the wild range of strategies developed by the latter ones to obtain legitimacy or/and protection from the State

    Effect of anakinra versus usual care in adults in hospital with COVID-19 and mild-to-moderate pneumonia (CORIMUNO-ANA-1): a randomised controlled trial

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    International audienc

    Sarilumab in adults hospitalised with moderate-to-severe COVID-19 pneumonia (CORIMUNO-SARI-1): An open-label randomised controlled trial

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    International audienc

    Effect of Tocilizumab vs Usual Care in Adults Hospitalized With COVID-19 and Moderate or Severe Pneumonia

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    International audienceImportance Severe pneumonia with hyperinflammation and elevated interleukin-6 is a common presentation of coronavirus disease 2019 (COVID-19).Objective To determine whether tocilizumab (TCZ) improves outcomes of patients hospitalized with moderate-to-severe COVID-19 pneumonia.Design, Setting, and Particpants This cohort-embedded, investigator-initiated, multicenter, open-label, bayesian randomized clinical trial investigating patients with COVID-19 and moderate or severe pneumonia requiring at least 3 L/min of oxygen but without ventilation or admission to the intensive care unit was conducted between March 31, 2020, to April 18, 2020, with follow-up through 28 days. Patients were recruited from 9 university hospitals in France. Analyses were performed on an intention-to-treat basis with no correction for multiplicity for secondary outcomes.Interventions Patients were randomly assigned to receive TCZ, 8 mg/kg, intravenously plus usual care on day 1 and on day 3 if clinically indicated (TCZ group) or to receive usual care alone (UC group). Usual care included antibiotic agents, antiviral agents, corticosteroids, vasopressor support, and anticoagulants.Main Outcomes and Measures Primary outcomes were scores higher than 5 on the World Health Organization 10-point Clinical Progression Scale (WHO-CPS) on day 4 and survival without need of ventilation (including noninvasive ventilation) at day 14. Secondary outcomes were clinical status assessed with the WHO-CPS scores at day 7 and day 14, overall survival, time to discharge, time to oxygen supply independency, biological factors such as C-reactive protein level, and adverse events.Results Of 131 patients, 64 patients were randomly assigned to the TCZ group and 67 to UC group; 1 patient in the TCZ group withdrew consent and was not included in the analysis. Of the 130 patients, 42 were women (32%), and median (interquartile range) age was 64 (57.1-74.3) years. In the TCZ group, 12 patients had a WHO-CPS score greater than 5 at day 4 vs 19 in the UC group (median posterior absolute risk difference [ARD] −9.0%; 90% credible interval [CrI], −21.0 to 3.1), with a posterior probability of negative ARD of 89.0% not achieving the 95% predefined efficacy threshold. At day 14, 12% (95% CI −28% to 4%) fewer patients needed noninvasive ventilation (NIV) or mechanical ventilation (MV) or died in the TCZ group than in the UC group (24% vs 36%, median posterior hazard ratio [HR] 0.58; 90% CrI, 0.33-1.00), with a posterior probability of HR less than 1 of 95.0%, achieving the predefined efficacy threshold. The HR for MV or death was 0.58 (90% CrI, 0.30 to 1.09). At day 28, 7 patients had died in the TCZ group and 8 in the UC group (adjusted HR, 0.92; 95% CI 0.33-2.53). Serious adverse events occurred in 20 (32%) patients in the TCZ group and 29 (43%) in the UC group (P = .21).Conclusions and Relevance In this randomized clinical trial of patients with COVID-19 and pneumonia requiring oxygen support but not admitted to the intensive care unit, TCZ did not reduce WHO-CPS scores lower than 5 at day 4 but might have reduced the risk of NIV, MV, or death by day 14. No difference on day 28 mortality was found. Further studies are necessary for confirming these preliminary results.Trial Registration ClinicalTrials.gov Identifier: NCT0433180

    A highly virulent variant of HIV-1 circulating in the Netherlands

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    We discovered a highly virulent variant of subtype-B HIV-1 in the Netherlands. One hundred nine individuals with this variant had a 0.54 to 0.74 log10 increase (i.e., a ~3.5-fold to 5.5-fold increase) in viral load compared with, and exhibited CD4 cell decline twice as fast as, 6604 individuals with other subtype-B strains. Without treatment, advanced HIV-CD4 cell counts below 350 cells per cubic millimeter, with long-term clinical consequences-is expected to be reached, on average, 9 months after diagnosis for individuals in their thirties with this variant. Age, sex, suspected mode of transmission, and place of birth for the aforementioned 109 individuals were typical for HIV-positive people in the Netherlands, which suggests that the increased virulence is attributable to the viral strain. Genetic sequence analysis suggests that this variant arose in the 1990s from de novo mutation, not recombination, with increased transmissibility and an unfamiliar molecular mechanism of virulence
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