25 research outputs found
The Principles of Campus Conception: A Spatial and Organizational Genealogy.What knowledge Can We Use from a Historical Study in Order to Analyse the Design Processes of a New Campus?
International audienceThis chapter participates to the interest of scholars concerning the relationship between spatial structure and organisational practice. Most researches analyse this relationship through built-up spaces and few studies are focusing on design phase. The study of design processes â organisational and spatial â raises methodological challenges and interrogate how the relationship between these processes could be analysed. In order to discuss the nature of the relationship between both designs: organisational and spatial, this contribution relies on an analysis of the conception processes of a campus.The hypothesis is that a genealogical approach of the history of campus architecture could reveal some specific properties of the campus and could generate a tool â an analytical framework â in order to explore the campus design project processes
Promoting advance planning for health care and research among older adults: A randomized controlled trial
<p>Abstract</p> <p>Background</p> <p>Family members are often required to act as substitute decision-makers when health care or research participation decisions must be made for an incapacitated relative. Yet most families are unable to accurately predict older adult preferences regarding future health care and willingness to engage in research studies. Discussion and documentation of preferences could improve proxies' abilities to decide for their loved ones. This trial assesses the efficacy of an advance planning intervention in improving the accuracy of substitute decision-making and increasing the frequency of documented preferences for health care and research. It also investigates the financial impact on the healthcare system of improving substitute decision-making.</p> <p>Methods/Design</p> <p>Dyads (<it>n </it>= 240) comprising an older adult and his/her self-selected proxy are randomly allocated to the experimental or control group, after stratification for type of designated proxy and self-report of prior documentation of healthcare preferences. At baseline, clinical and research vignettes are used to elicit older adult preferences and assess the ability of their proxy to predict those preferences. Responses are elicited under four health states, ranging from the subject's current health state to severe dementia. For each state, we estimated the public costs of the healthcare services that would typically be provided to a patient under these scenarios. Experimental dyads are visited at home, twice, by a specially trained facilitator who communicates the dyad-specific results of the concordance assessment, helps older adults convey their wishes to their proxies, and offers assistance in completing a guide entitled <it>My Preferences </it>that we designed specifically for that purpose. In between these meetings, experimental dyads attend a group information session about <it>My Preferences</it>. Control dyads attend three monthly workshops aimed at promoting healthy behaviors. Concordance assessments are repeated at the end of the intervention and 6 months later to assess improvement in predictive accuracy and cost savings, if any. Copies of completed guides are made at the time of these assessments.</p> <p>Discussion</p> <p>This study will determine whether the tested intervention guides proxies in making decisions that concur with those of older adults, motivates the latter to record their wishes in writing, and yields savings for the healthcare system.</p> <p>Trial Registration</p> <p><a href="http://www.controlled-trials.com/ISRCTN89993391">ISRCTN89993391</a></p
The management of acute venous thromboembolism in clinical practice. Results from the European PREFER in VTE Registry
Venous thromboembolism (VTE) is a significant cause of morbidity and mortality in Europe. Data from real-world registries are necessary, as clinical trials do not represent the full spectrum of VTE patients seen in clinical practice. We aimed to document the epidemiology, management and outcomes of VTE using data from a large, observational database. PREFER in VTE was an international, non-interventional disease registry conducted between January 2013 and July 2015 in primary and secondary care across seven European countries. Consecutive patients with acute VTE were documented and followed up over 12 months. PREFER in VTE included 3,455 patients with a mean age of 60.8 ± 17.0 years. Overall, 53.0 % were male. The majority of patients were assessed in the hospital setting as inpatients or outpatients (78.5 %). The diagnosis was deep-vein thrombosis (DVT) in 59.5 % and pulmonary embolism (PE) in 40.5 %. The most common comorbidities were the various types of cardiovascular disease (excluding hypertension; 45.5 %), hypertension (42.3 %) and dyslipidaemia (21.1 %). Following the index VTE, a large proportion of patients received initial therapy with heparin (73.2 %), almost half received a vitamin K antagonist (48.7 %) and nearly a quarter received a DOAC (24.5 %). Almost a quarter of all presentations were for recurrent VTE, with >80 % of previous episodes having occurred more than 12 months prior to baseline. In conclusion, PREFER in VTE has provided contemporary insights into VTE patients and their real-world management, including their baseline characteristics, risk factors, disease history, symptoms and signs, initial therapy and outcomes
Plasmonic DNA: Towards Genetic Diagnosis Chips
"Plasmonics and DNA" special issueInternational audienc
Nommer l'espace dans les établissements d'enseignement supérieur - Toponymie des lieux de savoir et de pouvoir : un patrimoine immatériel des institutions ?: un patrimoine immatériel des institutions ?
L'aire d'Ă©tude choisie est celle des institutions d'enseignement supĂ©rieur (universitĂ©s, grandes Ă©coles et grands Ă©tablissements), de la fin du XVIIIe au dĂ©but du XXIe siĂšcle, principalement Ă Paris. La toponymie de ces institutions recouvre pour nous aussi bien les dĂ©signations officielles qui sont donnĂ©es Ă certains espaces (salles de rĂ©unions, amphithĂ©Ăątres, cours, etc.) que les appellations usuelles ou argotiques donnĂ©es par les Ă©lĂšves ou Ă©tudiants et qui finissent par s'imposer Ă toute la communautĂ©. Les variations et les dĂ©placements de cette toponymie peuvent s'apprĂ©hender dans le temps comme dans l'espace, soit Ă travers l'Ă©volution des noms confĂ©rĂ©s Ă un mĂȘme lieu, soit par le remploi d'une mĂȘme dĂ©signation Ă l'occasion des changements d'implantation des institutions (voir le cas du transfert des grandes Ă©coles). Cette importance accordĂ©e aux noms de lieux est rĂ©vĂ©latrice de leur rĂŽle structurant dans l'identitĂ© de la communautĂ©, soit pour signifier sa permanence, soit pour incarner son Ă©volution. Elle sera mise en parallĂšle avec d'autres formes de reprĂ©sentations du groupe.On tentera enfin d'apprĂ©hender ce phĂ©nomĂšne Ă travers le prisme de la notion de patrimoine immatĂ©riel, tel qu'il est envisagĂ© dans le texte de la convention de l'UNESCO de 2003, et d'ouvrir des pistes pour une rĂ©flexion sur les relations entre ce concept et les Ă©tudes de toponymie en gĂ©nĂ©ral
Oligomerization of a G protein-coupled receptor in neurons controlled by its structural dynamics
International audienceG protein coupled receptors (GPCRs) play essential roles in intercellular communication. Although reported two decades ago, the assembly of GPCRs into dimer and larger oligomers in their native environment is still a matter of intense debate. Here, using number and brightness analysis of fluorescently labeled receptors in cultured hippocampal neurons, we confirm that the metabotropic glutamate receptor type 2 (mGlu 2) is a homodimer at expression levels in the physiological range, while heterodimeric GABA B receptors form larger complexes. Surprisingly, we observed the formation of larger mGlu 2 oligomers upon both activation and inhibition of the receptor. Stabilizing the receptor in its inactive conformation using biochemical constraints also led to the observation of oligomers. Following our recent observation that mGlu receptors are in constant and rapid equilibrium between several states under basal conditions, we propose that this structural heterogeneity limits receptor oligomerization. Such assemblies are expected to stabilize either the active or the inactive state of the receptor
Substrate Mode-Integrated SPR Sensor
We present the design, implementation and characterisation of an integrated surface plasmon resonance (SPR) biosensor chip involving diffractive optical coupling elements avoiding the need of prism coupling. The integrated sensor chip uses the angular interrogation principle and includes two diffraction gratings and the SPR sensing zone. The theoretical design is presented as well as the fabrication process. Experimental results (response of a reference water droplet and phosphate-buffered saline/water kinetic) are presented and compared with those obtained with the classical Kretschmann prism coupling setup. We believe that this prism-free architecture is perfectly suitable for low-cost and reproducible SPR biochemical sensor chips since the sensing zone can be functionalised as any other oneINTERREG IV FW1.1.9 âPlasmobio
Imaging of the Moho depth in Madagascar through the inversion of gravity data: geodynamic implications
Spiro Iminosugars: Structural Diversity and Synthetic Strategies
International audienceFrom their discovery in the late 1960s, iminosugars have undergone an expansion from an area of science limited to a few researchers to a field that now attracts the interest of members of the whole synthetic organic chemistry community. Indeed, many tasks concern structural modifications of standard iminosugars in order to improve their biological and pharmacological properties. In this way, the introduction of an adjoining spirocycle afforded unprecedented polyhydroxy-azaspiranes, the structures and syntheses of which are presented in this chapter. Special attention is paid to the key steps involved in the generation of the pivotal quaternary spiro atom