Ten Years of Valuation of the Local Impact of Atmospheric Pollution: from Scientific Assessments to Political Decisions

This paper focuses on the economic valuation of the impact of local air pollution. Two main issues are considered: 1. The scientific issue: what is estimated, how and why? The main studies from the nineties are presented here. Two strong issues are stressed, with the diversity of valuation methods, on the one hand, and the debates on how to take the long term into account and the discount technique, on the other. 2. The political issue: how the results from the economic field are analysed and used to establish official values for public policies? The methods used in the transport sector in three different European countries (France, Sweden and Switzerland) are studied here.To conclude, we highlight the discrepancy between these two processes and, wherever possible, offer solutions to reach better synergy.Local air pollution ; External costs ; Economic valuation ; Official values ; Public decision ; International comparison

Facteurs influençant positivement l installation en médecine générale libérale chez les internes et les jeunes médecins récemment installés en Rhône-Alpes (étude qualitative par focus groups et entretiens semi-dirigés)

L installation est peu prisée des internes de médecine générale, comme en témoigne le faible nombre d installations après la thèse, pourtant les jeunes médecins généralistes ne sont pas opposés à ce mode d exercice. L objectif de cette étude était de mettre en évidence les facteurs influençant positivement la volonté de s installer en libéral chez les internes et jeunes médecins généralistes. Une étude qualitative a été réalisée par des entretiens collectifs d internes de médecine générale, et individuels de médecins généralistes récemment installés en Rhône-Alpes. L étude a été conduite en recherche de variation maximale, suivant un guide d entretien, et jusqu à saturation des données. Neuf médecins et 28 internes ont été inclus entre avril et décembre 2012. L analyse a mis en évidence cinq thèmes : le rôle des stages ambulatoires pour la formation décisionnelle et technique, l apport des remplacements pour le choix du type d exercice, la place de l histoire personnelle et des projets familiaux, l envie d un exercice médical en groupe, modulable et diversifiable, enfin, le rôle attractif du médecin de famille, acteur de santé sur un territoire. Ces thèmes rendent l installation envisageable, à condition qu une opportunité soit présente. Parmi ces facteurs, plusieurs peuvent servir de base à des interventions, en pédagogie et sur le plan réglementaire. Les internes et les jeunes médecins ont des opinions et expériences positives sur l exercice libéral. Les facteurs mis en évidence doivent être présents au cours des études afin de favoriser la culture de l installation chez les futurs généralistes.Private practice is not popular among residents, referring to the small number of those who choose in private practice after graduating their MD. However, young general practitioners are not strictly against this kind of practice. This study aimed at pointed out factors that had a positive impact on the wish to settle in private practice among residents and junior general practitioners. A qualitative study was conducted, using focus groups for general medical practice residents and individual interviews with physicians who recently settled in the Rhone-Alpes region. Interviews were designed to obtain maximum variation and following an interviewer s guide, until saturation of data. Nine physicians and 28 residents have been included from April through December 2012. The analysis brought up five themes : the role of practical internships to acquire decisional and technical skills, the contribution of replacements in the choice of future mode of practice, the role of personal history and family projects, the specific qualities of group practice, combining modularity and versatility, and the appealing function of family doctor, in charge of public health in an area. All these themes make private practice acceptable, if an opportunity exists. Among those factors, many can be used for changing teaching methods and legislative framework. Residents and young general practitioners have positive opinions and good experiences about private practice in primary care. Pointed out factors must become part of medical training, in order to promote the culture of private practice among future general practitioners.GRENOBLE1-BU Médecine pharm. (385162101) / SudocSudocFranceF

Can the gracilis replace the anterior cruciate ligament in the knee? A biomechanical study

Purpose The purpose of this study was to determine whether a four-strand gracilis-only construct possesses the biomechanical properties needed to act as an anterior cruciate ligament (ACL) reconstruction graft. Methods This was a pilot study with 32 cadaver specimens. The biomechanical properties of three types of grafts were determined using validated tensile testing methods: patellar tendon (BTB), both hamstring tendons together (GST4) and gracilis alone (G4). Results The maximum load at failure of the G4 was 416.4 N (±187.7). The GST4 and BTB had a maximum load at failure of 473.5 N (±176.9) and 413.3 N (±120.4), respectively. The three groups had similar mean maximum load and stiffness values. The patellar tendon had significantly less elongation at failure than the other two graft types. Conclusions The biomechanical properties of a four-strand gracilis construct are comparable to the ones of standard grafts. This type of graft would be useful in the reconstruction of the anteromedial bundle in patients with partial ACL ruptures

Cadaveric study comparing the biomechanical properties of grafts used for knee anterolateral ligament reconstruction

Purpose: To measure the biomechanical properties (maximum load, stiffness, and elongation) of the anterolateral ligament (ALL), gracilis, and iliotibial band (ITB) within the same subject. METHODS: Thirteen unpaired knees were used (7 women, 6 men). The donors had a mean age at death of 54 years (range: 37 to 70 years). The mechanical properties of two types of ALL grafts were evaluated: ITB and two-strand gracilis. The mechanical properties of ALL were also measured. Validated methods were used to perform the tensile tests to failure and to record the results. Student's t-test was used to compare the various samples. RESULTS: The maximum load to failure was 141 N (±40.6) for the ALL, 200.7 N (±48.7) for the gracilis, and 161.1 N (±27.1) for the ITB. Only the gracilis had a significantly higher failure load than ITB and ALL (P = .001 and P = .03). The stiffness was 21 N mm-1 (±8.2) for the ALL, 131.7 N mm-1 (±43.7) for the gracilis, and 39.9 N mm-1 (±6) for the ITB. The elongation at failure was 6.2 mm (±3.2) for the ALL, 19.9 mm (±6.5) for the gracilis, and 20.8 mm (±14.7) for the ITB. CONCLUSIONS: The gracilis had the highest maximum load to failure. The ITB's mechanical properties most closely resemble those of the ALL. CLINICAL RELEVANCE: The biomechanical properties of each potential ALL graft can be factored in when deciding which type of graft to use

Algorithme de transformation en distance généralisée en un balayage, mises en oeuvre séquentielle et vectorielle

Dans ce papier, un algorithme de transformation en distance généralisée est présenté et utilisé pour la mise en oeuvre de l'opérateur d'érosion morphologique dans des images binaires. La généralité de la transformation permet d'utiliser en tant que famille de pseudo-disques toute suite d'éléments structurants obtenue par des dilatations ce qui réunit les méthodes basées sur la décomposition d'éléments structurants par dilatations et celles basées sur les transformations de distance en profitant de la variété de formes des premières et de la faible complexité (indépendante de la taille des éléments) des secondes. La décomposition en éléments convexes de Xu [Xu91], initialement élaborée pour une architecture parallèle, est prise en exemple et utilisée pour construire la famille de disques de la transformation en distance. Finalement, cette transformation est présentée sous les formes séquentielle et vectorielle

Sacroiliitis secondary to catheter-related bacteremia due to Mycobacterium abscessus (sensu stricto).

International audienceWe describe a case of sacroiliitis secondary to catheter-related bacteremia due to Mycobacterium abscessus (sensu stricto). This case confirms that MultiLocus sequence typing and variable-number tandem-repeat methods are very robust techniques to identify the pathogen species and to validate molecular epidemiological links among complex M. abscessus isolates

Dix ans de monétarisation des effets locaux de la pollution atmosphérique : des évaluations scientifiques aux décisions politiques

Cette communication s'intéresse à la valorisation monétaire des impacts environnementaux de la pollution atmosphérique locale. Comment, d'un côté, ces chiffres sont-ils construits par les économistes, et comment, de l'autre, sont-ils repris et utilisés pour établir des valeurs officielles dans le cadre des politiques publiques ? Nous mettons en lumière les écarts existant entre les deux et proposons des solutions pour les réduire.Pollution locale ; effets ; monétarisation ; actualisation ; valeurs tutélaires ; décision publique ; comparaison internationale

The HDAC inhibitor SAHA does not rescue CFTR membrane expression in Cystic Fibrosis

International audienc

Hamstring graft incorporation according to the length of the graft inside tunnels

BACKGROUND: Anterior cruciate ligament (ACL) reconstruction with a quadrupled semitendinosus (ST4) graft is an evolution of the standard technique with 2 hamstring tendons (semitendinosus + gracilis [STG]). However, there is no published comparison of how well these 2 types of hamstring grafts are incorporated into the bone tunnels. Because the ST4 graft is shorter, there is less graft material inside the tunnels. PURPOSE: To use magnetic resonance imaging (MRI) to compare graft incorporation in the tibial bone tunnels 1 year after ACL reconstruction with either an STG graft or ST4 graft. STUDY DESIGN: Cohort study. METHODS: Sixty-two patients who underwent ACL reconstruction were enrolled prospectively: 31 with an ST4 graft and 31 with an STG graft. The same surgical technique, fixation method, and postoperative protocol were used in both groups. Graft incorporation and ligamentization were evaluated with MRI after 1 year of follow-up. The following parameters were evaluated: signal-to-noise quotient (SNQ), tibial tunnel enlargement, signal intensity at the bone-graft interface, and graft signal according to the Howell scale. The number of participants needed to show that the mean SNQ did not differ between the 2 techniques was 31 in each group (with a 1-sided alpha of 2.5% and a 1-sided beta of 10.0%). The Student t test was used to compare the distribution of continuous secondary endpoints. RESULTS: The mean SNQ was 5.2 ± 4.5 for the STG group and 5.9 ± 3.7 for the ST4 group ( P = .5100). The mean tibial tunnel widening was 93.7% ± 51.7% for the STG group versus 80.0% ± 42.9% for the ST4 group ( P = .2605). The groups did not differ in signal intensity at the bone-graft interface ( P = .7502) or in graft signal according to the Howell scale ( P = .4544). CONCLUSION: At the 1-year postoperative follow-up, incorporation and ligamentization of the STG and ST4 grafts were the same based on MRI analysis. The results were at least as good with the ST4 technique as with the standard STG technique in terms of incorporation and ligamentization

Neurosmart, une histoire de cerveau et de passionné·e·s de science

We propose a participatory science outreach approach allowing us to co-construct with our audiences resources aimed at understanding and demystifying the most disruptive results obtained regarding human brain by the conjunction of computer science, applied mathematics and neuroscience (computational neuroscience). The context is that of science and technology with a heavy societal impact, for which there is a strong need to allow everyone to build models of representation of these results and to forge an enlightened citizen's vision on these subjects.We rely here on our experience in sharing scientific culture on these subjects and our ability to create large diffusion content and resources, easy to appropriate and to operate.We propose to discover the models of the cerebral functions at the origin of our sensorimotor and vital cognitive behaviors (instinctive and motivated behavior, selection of embodied action, emotional decision-making or not, sites of self-awareness, etc. ) through :- a course of evolving content each time giving minimal key ideas on these subjects, also showing the simple use of mathematical concepts,- a Web-application (3D visualization of the brain in synergy with multi-media content and explanatory texts) with the possibility of interacting with the content. e.g., quizzes.The implementation is a free and open code, easily reusable by anyone with basic computing skills.This is also in itself a tool for learning the code, in addition to the acquisition of skills in integrative neuroscience, and it is a lever for co-creation.On propose la mise en place d’une démarche de médiation scientifique participative pour permettre de co-construire avec nos publics des ressources visant à comprendre et démystifier les résultats les plus disruptifs concernant le cerveau humain obtenus par la conjonction de l’informatique, mathématiques appliquées et des neurosciences (neurosciences computationnelles).Le contexte est celui de sciences et technologies à lourd impact sociétal avec un besoin fort de permettre à chacune et chacun de se construire des modèles de représentation de ces résultats et de se forger une vision citoyenne éclairée sur ces sujets. On s’appuie ici sur notre expérience en matière de partage de culture scientifique sur ces sujets et notre capacité à créer des contenus et des ressources, à forte diffusion, faciles à s’approprier et à faire fonctionner.On propose de découvrir les modèles des fonctions cérébrales à l’origine de nos comportements sensori-moteurs et cognitifs vitaux (comportement instinctif et motivé, sélection de l’action incarnée, prise de décision émotionnelle ou non, siège de la conscience de soi, …) à travers :- un parcours de contenus évolutifs donnant à chaque fois des idées clés minimales sur ces sujets, en montrant aussi l’utilisation simple de notions mathématiques, - une Web-application (visualisation 3D du cerveau en synergie avec des contenus multi-médias et des textes explicatifs) avec la possibilité d’interagir avec les contenus, par exemple un quiz.L’implémentation est un code libre et ouvert, facilement réutilisable par toute personne initiée à l’informatique.Cela constitue aussi en soi un outil d’apprentissage du code, en plus de l’acquisition de compétences en neuroscience intégrative, et c’est un levier de co-création