Downside risk neutral probabilities

Risk neutral probabilities are adjusted to take into account the asset price effect of risk preferences. This paper introduces downside (respectively outer) risk neutral probabilities, which are adjusted to take into account the asset price effect of preferences for downside (resp. outer) risk and higher degree risks. Using risk preference theory, we interpret these three changes in probability measures in terms of risk substitution. With downside risk neutral probabilities, the pricing kernel is linear in wealth. Outer risk neutral probabilities can be viewed as a reasonable approximation of physical probabilities

Determinants of the access to remote specialised services provided by national sarcoma reference centres

BACKGROUND: Spatial inequalities in cancer management have been evidenced by studies reporting lower quality of care or/and lower survival for patients living in remote or socially deprived areas. NETSARC+ is a national reference network implemented to improve the outcome of sarcoma patients in France since 2010, providing remote access to specialized diagnosis and Multidisciplinary Tumour Board (MTB). The IGéAS research program aims to assess the potential of this innovative organization, with remote management of cancers including rare tumours, to go through geographical barriers usually impeding the optimal management of cancer patients. METHODS: Using the nationwide NETSARC+ databases, the individual, clinical and geographical determinants of the access to sarcoma-specialized diagnosis and MTB were analysed. The IGéAS cohort (n = 20,590) includes all patients living in France with first sarcoma diagnosis between 2011 and 2014. Early access was defined as specialised review performed before 30 days of sampling and as first sarcoma MTB discussion performed before the first surgery. RESULTS: Some clinical populations are at highest risk of initial management without access to sarcoma specialized services, such as patients with non-GIST visceral sarcoma for diagnosis [OR 1.96, 95% CI 1.78 to 2.15] and MTB discussion [OR 3.56, 95% CI 3.16 to 4.01]. Social deprivation of the municipality is not associated with early access on NETSARC+ remote services. The quintile of patients furthest away from reference centres have lower chances of early access to specialized diagnosis [OR 1.18, 95% CI 1.06 to 1.31] and MTB discussion [OR 1.24, 95% CI 1.10 to 1.40] but this influence of the distance is slight in comparison with clinical factors and previous studies on the access to cancer-specialized facilities. CONCLUSIONS: In the context of national organization driven by reference network, distance to reference centres slightly alters the early access to sarcoma specialized services and social deprivation has no impact on it. The reference networks' organization, designed to improve the access to specialized services and the quality of cancer management, can be considered as an interesting device to reduce social and spatial inequalities in cancer management. The potential of this organization must be confirmed by further studies, including survival analysis

Exstrophie de la vessie et grossesse

Thèse : Médecine : Université de Bordeaux : 1904N° d'ordre : 1

The Challenge of 3D Bioprinting of Composite Natural Polymers PLA/Bioglass: Trends and Benefits in Cleft Palate Surgery

Cleft lip and palate is the fourth most common congenital malformation. Its prevalence is about 1 in 750 to 1 in 2000 live births. The consequences of this malformation are major: maxillary growth deficit, unaesthetic appearance, phonation disorders, difficulty in eating, and psycho-social disorders. Cleft palate repair establishes the division between the oral and nasal cavities. The alveolar bone graft is a key step. Different sites of autogenous bone harvesting are used, the most common being the iliac crest. Nevertheless, the large number of complications associated with harvesting has led to the use of substitute biomaterials. Bioactive glasses, discovered in 1969, are a group of synthetic silica-based materials with bone-bonding properties. Although 45S5 granular composition is commonly used in bone surgery to repair critical defects, it is only rarely used in the repair of cleft palates because this galenic form is only moderately adapted. However, advances in bone tissue engineering allow the shaping of three-dimensional scaffolds, which support colonization by host cells. Recent advances in computer-aided design/computer-aided manufacturing (CAD/CAM) have even led to the 3D printing of scaffolds combining 45S5 bioglass with a natural and biocompatible poly-lactic acid matrix. The shape of the parts is customized and adapted to the particular shape of the critical bone defects. The objective of this literature review is to highlight the particularities of alveolar defects subsequent to facial clefts, then to detail the characteristics of the materials and technologies used to elaborate 3D matrices by bioprinting. Finally, we will explore research directions regarding their use in reconstructive surgery of cleft palates

Utilisation professionnelle du téléphone portable (enquête auprès de 1044 salariés vus en médecine interentreprise)

STRASBOURG-Medecine (674822101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Bioresorbable polylactic acid (PLA) and bioactive glasses (BG) composite: influence of gold coated of BG powder on mechanical properties and chemical reactivity

International audienceDue to the ageing of the population, the synthesis of biomaterials and the optimization of their physico-chemical characteristics are at the heart of many research projects in regenerative medicine. The emergence of 3D printing techniques has rapidly led to the manufacture PLA-BG compositescaffolds using the FFF (Fused Filament Fabrication) technic. However, this composite presents some problems including a lower mechanical strength than the two compounds alone, probably due to the ionic salting-out induced by the BG. This study aims to counter this phenomenon by coating the BG particles with a thin layer of gold. The 3D composite objects will then be characterized mechanically and biologically to ensure that the bioactive character of the composite is preserved

Les mégalithes de l'arrondissement de Brest, inventaire et essai de synthèse

International audienc

Les mégalithes de l'arrondissement de Brest, inventaire et essai de synthèse

International audienc