DMTs and Covid-19 severity in MS: a pooled analysis from Italy and France

We evaluated the effect of DMTs on Covid-19 severity in patients with MS, with a pooled-analysis of two large cohorts from Italy and France. The association of baseline characteristics and DMTs with Covid-19 severity was assessed by multivariate ordinal-logistic models and pooled by a fixed-effect meta-analysis. 1066 patients with MS from Italy and 721 from France were included. In the multivariate model, anti-CD20 therapies were significantly associated (OR = 2.05, 95%CI = 1.39–3.02, p < 0.001) with Covid-19 severity, whereas interferon indicated a decreased risk (OR = 0.42, 95%CI = 0.18–0.99, p = 0.047). This pooled-analysis confirms an increased risk of severe Covid-19 in patients on anti-CD20 therapies and supports the protective role of interferon

The Changing Landscape for Stroke\ua0Prevention in AF: Findings From the GLORIA-AF Registry Phase 2

Background GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non\u2013vitamin K antagonist oral anticoagulant (NOAC), became available. Objectives This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase 1. Methods During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients\u2019 baseline characteristics. Atrial fibrillation disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics. Results Of the total patients, 45.5% were female; median age was 71 (interquartile range: 64, 78) years. Patients were from Europe (47.1%), North America (22.5%), Asia (20.3%), Latin America (6.0%), and the Middle East/Africa (4.0%). Most had high stroke risk (CHA2DS2-VASc [Congestive heart failure, Hypertension, Age  6575 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score  652; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc = 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N = 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients received NOAC, VKA, and antiplatelet drugs, respectively; 7.5% received no antithrombotic treatment. NOAC use was less common in Asia (27.7%), where 27.5% of patients received VKA, 25.0% antiplatelet drugs, and 19.8% no antithrombotic treatment. Conclusions The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in Asia and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [GLORIA-AF]; NCT01468701

Les ménages sous la contrainte carbone : exercice de modélisation prospective des secteurs résidentiel et transports avec TIMES

The energy and political context in France suggests that households would have to deal with a strong constraint of CO2 emissions reduction in the next decades. Many questions then arise: Which technologies would enable this level of emission reduction? What policies should be implemented to achieve such a reduction ? What is the impact of these policies on household budget ? This PhD work tries to answer to these issues thanks to a residential and transports sectors TIMES model, which is a bottom-up model based on an optimization paradigm. This model relies on a highly disaggregated representation of households that allows a largely enhanced level of confidence in the results obtained, compared to other bottom-up models. Moreover, thanks to a survey we have launched among 2000 French households we are able to better design household energy consumption behavior. It is thus possible to take into account the constraints faced by the households and the tradeoffs they make between cost and comfort. This model is very useful for evaluating different policy tools considering their ability to lead to strong reductions and their impact on the household budget. A carbon tax then seems a good way to reduce CO2 emissions and subsidies seem to enhance the impact of the tax and help to reduce its distorting effect on household budget.Le contexte énergétique et politique en France laisse présager de l'apparition d'une forte contrainte de réduction des émissions de CO2 des ménages dans les décennies à venir. Plusieurs interrogations se posent alors : Quelles sont les technologies permettant d'atteindre une telle réduction ? Quelles politiques mettre en œuvre pour atteindre un tel objectif ? Et quel est l'impact de ces politiques sur le budget des ménages ? Le présent travail de thèse s'attache à répondre à ces questions à partir d'un modèle bottom-up d'optimisation de type TIMES portant sur les secteurs résidentiel et transports, réalisé dans le cadre de cette thèse. Ce modèle s'appuie notamment sur une représentation des ménages très désagrégée qui permet d'apporter beaucoup plus de robustesse par rapport aux autres modèles de ce type, basés sur la description d'un ménage moyen. De plus, à l'aide d'une enquête auprès de 2000 ménages réalisée dans le cadre de cette thèse, il est possible de prendre en compte le comportement de consommation des ménages de manière relativement fine, notamment en rendant compte des contraintes subies par les ménages et des arbitrages qu'ils réalisent entre coût et confort. L'exercice de prospective réalisé à partir de ce modèle permet d'évaluer l'efficacité en terme de réduction et l'impact sur le budget des ménages de différents outils politiques. Il permet notamment de visualiser que l'instauration d'une taxe carbone est un moyen efficace de réduire les émissions et que la mise en place conjointe de subventions ciblées permet de compléter l'action de cette taxe tout en diminuant son impact distorsif sur le budget des ménages

Impact of a carbon tax on french tranports sector: A TIMES model for mobility

International audienceIn order provide insights about realistic pathways to low-carbon transports in 2050, we have developed a TIMES model with a strongly detailed module for transports in France. In particular we have developed an original approach that takes households heterogeneity and households investment behavior as well as daily consumption behavior into account. We are then able to better design realistic technology diffusion curves. Then we study the impact of a carbon tax in transports sector and its ability to reduce CO2 emissions

Les ménages français et la contrainte carbone: le secteur résidentiel

20 pagesInternational audienceDemande d'énergie et impact du revenu - Modèle TIMES Résidentiel - Résultat

Une approche désagrégée de la demande au niveau technique et comportemental dans le secteur résidentiel

International audience1 - Segmentation de la demande d'énergie 2 - Modèle prospective TIMES/MARKAL 3 - Résultat

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Article dans "la Montagne et l'alpinism

"Households under carbon constraint What policies for a pathway toward low-carbon consumption in France ?"

International audienc

Does energy efficiency reduce inequalities? Impact of policies in residential sector on household budgets

International audienceThe European energy and political context suggests that households will have to face up to making significant reductions of their energy consumption over the coming decades. Indeed European Union has adopted a 20 % reduction in energy consumption by 2020 in its climate energy package. The aim of this paper is not only to study the refurbishment and technological changes implied by such targets but also to show its impact on household budget as this ambitious target may imply strong efforts from households. Studies that deal with efficiency of policy tools generally adopt a global economic point of view and rarely consider dis-tributional impacts on final consumers and if so, do not consider possible differences in consumer behavior patterns regarding energy use. How can we therefore assess the suitability of such policies without clearly anticipating their repercussions on households, whose behavior is obviously heterogeneous? In order to provide useful insights about the impact of such policies on residential sector, it appears crucial to capture both household heterogeneity and household behaviour in long-term planning models. Our analysis relies on the TIMES-Households model which is a bottom-up optimization model from the MARKAL/TIMES family of energy models that allows for a very significant disag-gregation of demand and technological processes. The building stock and its inhabitants are then represented in a very detailed manner considering both technical and socio-demographic characteristics. Moreover, thanks to analyses picked from a detailed household survey we are then able to differentiate access to technologies, level of energy demand and equipment purchasing behaviour according to household characteristics (income, size, type of housing, occupation status). We show the impact on household budget of the 38 % reduction target of primary energy consumption in residential building stock by 2020 adopted by the French government

Qu'est ce qu'un géoparc?

Article dans "la Montagne et l'alpinism