BMC Psychiatry

BACKGROUND: Depressive disorders in University students have risen dramatically in the past few decades to the extent that students' mental health has become a current global public health priority. Obtaining information from University students about their mental health is challenging because of potential embarrassment of disclosing one's concerns and fear of stigmatization. Self-rated health might be a good solution to evaluate mental health state by a simple and neutral indicator. The aim of the study is to investigate the association between depressive symptoms and self-rated health by sex among University students in France and Japan. METHODS: A cross-sectional study was conducted by using two large cohorts of students aged ≥18 years (n = 5655 in Bordeaux, France and n = 17,148 in Kyoto, Japan). Depressive symptoms (PHQ-2 scale), Likert scale of self-rated health, socio-demographic characteristics and health habits were collected through self-administered questionnaires. Multivariate logistic regression models were performed to describe the association between depressive symptoms and other variables including self-rated health, stratified by sex. RESULTS: A high score of PHQ-2 (high depressive symptoms) was associated with poor self-rated health in both cohorts independently of all other variables (OR 2.82, 95%CI 1.99-4.01 in France, OR 7.10, 95%CI 5.76-8.74 in Japan). Although the prevalence of depressive symptoms between sexes was different in French students (males 15.4%, females 25.0%, p < 0.001), it was similar in Japanese students (males 3.5%, females 3.3%, p = 0.466), who reported less depressive symptoms than French students. The association between depressive symptoms and poor self-rated health was greater in Japanese females (OR 12.40, 95%CI 7.74-20.00) than in males (OR 6.30, 95%CI 4.99-7.95), whereas the strength of the association was almost similar in French students (OR 2.17, 95%CI 0.86-5.47 in males, OR 2.98, 95%CI 2.03-4.38 in females). CONCLUSIONS: Depressive symptoms were associated with self-rated health among University students in both countries with slightly differences in sex. Self-rated health would be a simple, reliable and universal indicator for healthcare professionals and University staff to identify students at risk of depression

Epidemiology and outcome predictors in 450 patients with hanging-induced cardiac arrest: a retrospective study

BackgroundCardiac arrest is the most life-threatening complication of attempted suicide by hanging. However, data are scarce on its characteristics and outcome predictors.MethodsThis retrospective observational multicentre study in 31 hospitals included consecutive adults admitted after cardiac arrest induced by suicidal hanging. Factors associated with in-hospital mortality were identified by multivariate logistic regression with multiple imputations for missing data and adjusted to the temporal trends over the study period.ResultsOf 450 patients (350 men, median age, 43 [34–52] years), 305 (68%) had a psychiatric history, and 31 (6.9%) attempted hanging while hospitalized. The median time from unhanging to cardiopulmonary resuscitation was 0 [0–5] min, and the median time to return of spontaneous circulation (ROSC) was 20 [10–30] min. Seventy-nine (18%) patients survived to hospital discharge. Three variables were independently associated with higher in-hospital mortality: time from collapse or unhanging to ROSC&gt;20 min (odds ratio [OR], 4.71; 95% confidence intervals [95%CIs], 2.02–10.96; p = 0.0004); glycaemia &gt;1.4 g/L at admission (OR, 6.38; 95%CI, 2.60–15.66; p &lt; 0.0001); and lactate &gt;3.5 mmol/L at admission (OR, 6.08; 95%CI, 1.71–21.06; p = 0.005). A Glasgow Coma Scale (GCS) score of &gt;5 at admission was associated with lower in-hospital mortality (OR, 0.009; 95%CI, 0.02–0.37; p = 0.0009).ConclusionIn patients with hanging-induced cardiac arrest, time from collapse or unhanging to return of spontaneous circulation, glycaemia, arterial lactate, and coma depth at admission were independently associated with survival to hospital discharge. Knowledge of these risk factors may help guide treatment decisions in these patients at high risk of hospital mortality

Familial hypercholesterolaemia in children and adolescents from 48 countries: a cross-sectional study

Background: Approximately 450 000 children are born with familial hypercholesterolaemia worldwide every year, yet only 2·1% of adults with familial hypercholesterolaemia were diagnosed before age 18 years via current diagnostic approaches, which are derived from observations in adults. We aimed to characterise children and adolescents with heterozygous familial hypercholesterolaemia (HeFH) and understand current approaches to the identification and management of familial hypercholesterolaemia to inform future public health strategies. Methods: For this cross-sectional study, we assessed children and adolescents younger than 18 years with a clinical or genetic diagnosis of HeFH at the time of entry into the Familial Hypercholesterolaemia Studies Collaboration (FHSC) registry between Oct 1, 2015, and Jan 31, 2021. Data in the registry were collected from 55 regional or national registries in 48 countries. Diagnoses relying on self-reported history of familial hypercholesterolaemia and suspected secondary hypercholesterolaemia were excluded from the registry; people with untreated LDL cholesterol (LDL-C) of at least 13·0 mmol/L were excluded from this study. Data were assessed overall and by WHO region, World Bank country income status, age, diagnostic criteria, and index-case status. The main outcome of this study was to assess current identification and management of children and adolescents with familial hypercholesterolaemia. Findings: Of 63 093 individuals in the FHSC registry, 11 848 (18·8%) were children or adolescents younger than 18 years with HeFH and were included in this study; 5756 (50·2%) of 11 476 included individuals were female and 5720 (49·8%) were male. Sex data were missing for 372 (3·1%) of 11 848 individuals. Median age at registry entry was 9·6 years (IQR 5·8-13·2). 10 099 (89·9%) of 11 235 included individuals had a final genetically confirmed diagnosis of familial hypercholesterolaemia and 1136 (10·1%) had a clinical diagnosis. Genetically confirmed diagnosis data or clinical diagnosis data were missing for 613 (5·2%) of 11 848 individuals. Genetic diagnosis was more common in children and adolescents from high-income countries (9427 [92·4%] of 10 202) than in children and adolescents from non-high-income countries (199 [48·0%] of 415). 3414 (31·6%) of 10 804 children or adolescents were index cases. Familial-hypercholesterolaemia-related physical signs, cardiovascular risk factors, and cardiovascular disease were uncommon, but were more common in non-high-income countries. 7557 (72·4%) of 10 428 included children or adolescents were not taking lipid-lowering medication (LLM) and had a median LDL-C of 5·00 mmol/L (IQR 4·05-6·08). Compared with genetic diagnosis, the use of unadapted clinical criteria intended for use in adults and reliant on more extreme phenotypes could result in 50-75% of children and adolescents with familial hypercholesterolaemia not being identified. Interpretation: Clinical characteristics observed in adults with familial hypercholesterolaemia are uncommon in children and adolescents with familial hypercholesterolaemia, hence detection in this age group relies on measurement of LDL-C and genetic confirmation. Where genetic testing is unavailable, increased availability and use of LDL-C measurements in the first few years of life could help reduce the current gap between prevalence and detection, enabling increased use of combination LLM to reach recommended LDL-C targets early in life

Contribution à la commande de robot mobile poly-articulé à roues sur sol naturel : application à la conduite autonome des engins agricoles

Agriculture has today the challenge to increase its productivity in order to supply enough food for the growing needs of the world population. However, this activity strongly damages environmental ressources as water and soil, and new solutions are today required to reduce the impact of agricultural practices on environment. Automatic guidance systems for farm vehicles are some new technologies that contribute to this objective, allowing accurate path following in the fields and therefore improving efficiency and quality of the agricultural work carried out. Essential functionalities are however absent in these systems, as the capacities to compensate for the crabway motion of the vehicle on sliding sloping fields, to control the trajectories of the towed implement,and to perform U-turn maneuvers in headland. This thesis studies these problems through the control in presence of sliding of a poly-articulated wheeled mobile robot called RMPA, composed of a four-wheel-steering vehicle and n passive trailers hooked up at some distance from the rear axle of the previous one. An extended kinematic model of the RMPA is first used in order to take into account for the sliding effects on the overall behaviour of the robot. The sliding parameters, introduced on each rolling and steering axle of the RMPA, are estimated using a state observer built as a control law. The reference path [gamma] to be followed is either previously learned or specially planned using elementary primitives connected together with pieces of clothoid to produce the U-turn maneuvers. In a first step, both front and rear steering actuations of the robot are used to accurately control both lateral and angular deviations of the RMPA's four-wheel-steering vehicle with respect to [gamma] : the control of the front steering wheels is based on the transformation of the extended kinematic model into a chained system, allowing to dissociate the lateral and longitudinal commands, and on exact linearization techniques in order to servo lateral deviation. The control of the rear steering wheels is built from the angular deviation dynamic and ensures the convergence of the vehicle deviation to the desired set point. In a second step, these control laws are extended to control the lateral deviation of the ith trailer of the RMPA with respect to [gamma] : a backstepping approach is proposed to calculate the control law for the RMPA's front steering wheels from the study of a virtual control law for the ith trailer. Finally, the longitudinal control law of the RMPA is based on model predictive control, in order to accurately follow the velocity references linked to [gamma]. Numerous experiments relying on an actual RMPA, composed of a passive trailer hooked up at some distance from the rear axle of a four-wheel-steering vehicle, permit to validate the various approaches presented in this thesis and to appreciate the capabilities of the proposed control laws.L'agriculture est un secteur d'activité qui est confronté aujourd'hui à des objectifs d'accroissement de productivité pour subvenir aux besoins alimentaires de la population mondiale en pleine explosion démographique. Cependant, cette activité sollicite fortement les biens environnementaux tels que l'eau et le sol, et des solutions sont aujourd'hui recherchées pour limiter l'incidence des pratiques agricoles sur l'environnement. Les systèmes de guidage des véhicules agricoles font partie de ces nouvelles technologies qui contribuent à cet objectif, en offrant la possibilité d'assurer la précision du suivi des trajectoires dans les parcelles, et de favoriser ainsi l'efficacité et la qualité du travail agronomique réalisé. Des fonctionnalités essentielles font néanmoins aujourd'hui défaut à ces systèmes. Citons la capacité à compenser la marche en crabe du véhicule sur les terrains glissants en pente, la capacité à contrôler les trajectoires des outils agricoles traînés, et la capacité à effectuer certaines manoeuvres en zone de fourrière. Ce travail de thèse aborde l'ensemble de ces problématiques au travers l'étude de la commande en milieu naturel de robot mobile poly-articulé à roues (RMPA), composé d'un véhicule " tracteur " à deux trains directeurs associé à n remorques passives à attache déportée. Une modélisation cinématique étendue est d'abord adoptée pour tenir compte des effets induits par les faibles conditions d'adhérence sur le comportement global du RMPA. Les variables de glissement introduites sur chacun des trains directeurs et roulants sont estimées à l'aide d'un observateur bâti à la manière d'une loi de commande. La trajectoire de référence à suivre gamma est quant à elle préalablement apprise ou construite à l'aide de primitives élémentaires et d'arcs de clothoïdes pour générer les manoeuvres de demi-tour. En premier lieu, les deux trains directeurs du RMPA sont exploités pour contrôler avec précision non seulement l'écart latéral mais également l'écart angulaire du véhicule " tracteur " par rapport à gamma : la commande du train directeur avant est basée sur la transformation du modèle en un système chaîné, conduisant à un découplage exact des performances latérales et longitudinales, puis sur des techniques de linéarisation exacte pour assurer la régulation latérale. La commande du train directeur arrière se base sur la dynamique de l'écart angulaire pour compenser les glissements et asservir cet écart sur le point de fonctionnement choisi. En second lieu, ces commandes sont étendues pour asservir latéralement la ieme remorque du RMPA le long de gamma : une approche en cascade est utilisée pour traduire une commande virtuelle de la ieme remorque en terme de commande du train directeur avant du véhicule " tracteur ". La commande longitudinale du RMPA est quant à elle basée sur une stratégie de commande prédictive à modèle interne, afin de suivre avec précision le profil de vitesse associé à gamma. De nombreuses expérimentations en conditions réelles, effectuées sur un RMPA composé d'un véhicule " tracteur " à deux trains directeurs et d'une remorque passive à attache déportée, viennent valider les différentes approches présentées dans ce mémoire et permettent d'apprécier les performances des lois de commande proposées

Contribution to the control of a poly-articulated wheeled mobile robot in presence of sliding - Application to the automatic guidance of farm vehicles

L'agriculture est un secteur d'activité qui est confronté aujourd'hui à des objectifs d'accroissement de productivité pour subvenir aux besoins alimentaires de la population mondiale en pleine explosion démographique. Cependant, cette activité sollicite fortement les biens environnementaux tels que l'eau et le sol, et des solutions sont aujourd'hui recherchées pour limiter l'incidence des pratiques agricoles sur l'environnement. Les systèmes de guidage des véhicules agricoles font partie de ces nouvelles technologies qui contribuent à cet objectif, en offrant la possibilité d'assurer la précision du suivi des trajectoires dans les parcelles, et de favoriser ainsi l'efficacité et la qualité du travail agronomique réalisé. Des fonctionnalités essentielles font néanmoins aujourd'hui défaut à ces systèmes. Citons la capacité à compenser la marche en crabe du véhicule sur les terrains glissants en pente, la capacité à contrôler les trajectoires des outils agricoles traînés, et la capacité à effectuer certaines manoeuvres en zone de fourrière. Ce travail de thèse aborde l'ensemble de ces problématiques au travers l'étude de la commande en milieu naturel de robot mobile poly-articulé à roues (RMPA), composé d'un véhicule " tracteur " à deux trains directeurs associé à n remorques passives à attache déportée. Une modélisation cinématique étendue est d'abord adoptée pour tenir compte des effets induits par les faibles conditions d'adhérence sur le comportement global du RMPA. Les variables de glissement introduites sur chacun des trains directeurs et roulants sont estimées à l'aide d'un observateur bâti à la manière d'une loi de commande. La trajectoire de référence à suivre gamma est quant à elle préalablement apprise ou construite à l'aide de primitives élémentaires et d'arcs de clothoïdes pour générer les manoeuvres de demi-tour. En premier lieu, les deux trains directeurs du RMPA sont exploités pour contrôler avec précision non seulement l'écart latéral mais également l'écart angulaire du véhicule " tracteur " par rapport à gamma : la commande du train directeur avant est basée sur la transformation du modèle en un système chaîné, conduisant à un découplage exact des performances latérales et longitudinales, puis sur des techniques de linéarisation exacte pour assurer la régulation latérale. La commande du train directeur arrière se base sur la dynamique de l'écart angulaire pour compenser les glissements et asservir cet écart sur le point de fonctionnement choisi. En second lieu, ces commandes sont étendues pour asservir latéralement la ieme remorque du RMPA le long de gamma : une approche en cascade est utilisée pour traduire une commande virtuelle de la ieme remorque en terme de commande du train directeur avant du véhicule " tracteur ". La commande longitudinale du RMPA est quant à elle basée sur une stratégie de commande prédictive à modèle interne, afin de suivre avec précision le profil de vitesse associé à gamma. De nombreuses expérimentations en conditions réelles, effectuées sur un RMPA composé d'un véhicule " tracteur " à deux trains directeurs et d'une remorque passive à attache déportée, viennent valider les différentes approches présentées dans ce mémoire et permettent d'apprécier les performances des lois de commande proposées.Agriculture has today the challenge to increase its productivity in order to supply enough food for the growing needs of the world population. However, this activity strongly damages environmental ressources as water and soil, and new solutions are today required to reduce the impact of agricultural practices on environment. Automatic guidance systems for farm vehicles are some new technologies that contribute to this objective, allowing accurate path following in the fields and therefore improving efficiency and quality of the agricultural work carried out. Essential functionalities are however absent in these systems, as the capacities to compensate for the crabway motion of the vehicle on sliding sloping fields, to control the trajectories of the towed implement,and to perform U-turn maneuvers in headland. This thesis studies these problems through the control in presence of sliding of a poly-articulated wheeled mobile robot called RMPA, composed of a four-wheel-steering vehicle and n passive trailers hooked up at some distance from the rear axle of the previous one. An extended kinematic model of the RMPA is first used in order to take into account for the sliding effects on the overall behaviour of the robot. The sliding parameters, introduced on each rolling and steering axle of the RMPA, are estimated using a state observer built as a control law. The reference path [gamma] to be followed is either previously learned or specially planned using elementary primitives connected together with pieces of clothoid to produce the U-turn maneuvers. In a first step, both front and rear steering actuations of the robot are used to accurately control both lateral and angular deviations of the RMPA's four-wheel-steering vehicle with respect to [gamma] : the control of the front steering wheels is based on the transformation of the extended kinematic model into a chained system, allowing to dissociate the lateral and longitudinal commands, and on exact linearization techniques in order to servo lateral deviation. The control of the rear steering wheels is built from the angular deviation dynamic and ensures the convergence of the vehicle deviation to the desired set point. In a second step, these control laws are extended to control the lateral deviation of the ith trailer of the RMPA with respect to [gamma] : a backstepping approach is proposed to calculate the control law for the RMPA's front steering wheels from the study of a virtual control law for the ith trailer. Finally, the longitudinal control law of the RMPA is based on model predictive control, in order to accurately follow the velocity references linked to [gamma]. Numerous experiments relying on an actual RMPA, composed of a passive trailer hooked up at some distance from the rear axle of a four-wheel-steering vehicle, permit to validate the various approaches presented in this thesis and to appreciate the capabilities of the proposed control laws

La justification de la nécessité (recherche sur le sens et sur les origines du fatalisme moderne)

Que signifie le concept de "fatalisme" chez Diderot, chez d'Holbach et, plus généralement, dans la pensée française du siècle des Lumières? Répondre à cette question suppose bien sûr d'étudier minutieusement les textes et les contextes du "fatalisme moderne" depuis les premiers néologismes jusqu'aux années 1780 afin d'en restituer la signification, d'en préciser l'évolution et d'apprécier ainsi la spécificité du nécessitarisme philosophique au regard des autres figures du destin que son le libertinage, la théologie ou l'astrologie. Mais plus fondamentalement, cette enquête suppose que l'on questionne les "justifications de la nécessité opérées par les penseurs, classiques (Hobbes, Spinoza, Leibniz...) ou modernes (Collins, La Mettrie, Diderot, d'Holbach...), taxés de "fatalisme" au XVIIIe siècle. On impute traditionnellement à la thèse du destin et de la nécessité les conséquences les plus terribles : déresponsabilisant l'homme en niant sa liberté, elle l'inclinerait à la paresse et à l'immoralité. Tel est le procès de "l'argumentation morale antifataliste", principal défi adressé à la possibilité du nécessitarisme. La nécessité peut-elle être justifiée? Comment fonder une responsabilité sans la liberté? Et quelles stratégies conceptuelles les philosophes classiques et modernes ont-ils établies à cette fin? Plutôt que de Spinoza ou de Leibniz, le fatalisme des Lumières françaises n'est-il pas l'héritier de Thomas Hobbes?LYON3-Bibliothèques (693872102) / SudocLYON-BIU-LSH (693872101) / SudocSudocFranceF

La critique sous influence ?

International audienc

Proximity, technology and mode of diffusion as determinants of knowledge flows

International audienceIn this paper, we analyze the cooperative relations of firms, in term of knowledge diffused and shared, proximities between partners, and modes of diffusion. An empirical investigation is undertaken near 348 firms. The results are consistent with the literature: the distance, the virtual communication and the know-what increase the codified knowledge shared among firms, while the real communication have the opposite effect. However, the results do not suggest an opposition between virtual and real communication or between know-what and know-how, but rather a complementarity of these elements. Indeed, the more firms share know-what, the more they share complementary types of knowledge (know-how and know-why), and the more the collaboration is inter-regional and funded on virtual communication, and the more the shared knowledge is codified