La Tour-Blanche – Grotte de Jovelle

Identifiant de l'opération archéologique : 025473 Date de l'opération : 2008 (PT) État des lieux historique et archéologique I) Contexte Récemment acquise par le département de la Dordogne (2006) et vierge de toute étude scientifique approfondie, la cavité ornée de Jovelle est constituée d’une unique galerie se développant sur une trentaine de mètres selon un axe nord-ouest - sud-est, au dépend d’une assise de calcaire attribuable au Turonien moyen c3b..

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

Vibroimpact unduced damping in an architected sandwich composite

International audienceSandwich composites are widely used in design especially in transport because they combine bending rigidity and lightness. On the other hand, their attenuation properties are not always as good as expected, and it is necessary to overcome this limitation in order to improve the vibratory comfort and the durability of the structures in which they are integrated. Several strategies exist such as the introduction into the core of the sandwich of passive materials with viscoelastic properties for example to allow energy dissipation, or the use of electronic circuits for active control strategies. The approach presented in this paper is based in the introduction of vibro-impact zones to generate damping. The local interactions occurring during the impacts allow to dissipate the vibratory energy: it is about nonlinear phenomena which have the advantage to be effective over a wide range of frequencies, and to be few sensitive to environmental conditions such as temperature. A sandwich composite prototype has been designed for the purpose of the study, and small ceramic balls have been inserted in the sandwich core to generate impacts phenomena. Experiments have been performed to evaluate the damping performances obtained depending on the number of balls, on the amplitude on excitation and on the frequency band. Analytical and numerical models of the structure have also been developed to perform parametric studies and evaluate the impact of parameters such as the ball added mass or the positions of the masses for instance : numerical results have been confronted to experimental ones. It has thus been observed that good damping performances could be obtained on a large frequency band

Atypical response of spondyloarthritis to biologics revealing Whipple's disease: a case-report

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Sur un poisson gravé magdalénien de la grotte Margot (Thorigné-en-Charnie, Mayenne) [On a Magdalenian engraved fish in the Margot cave (Thorigne-en-Charnie, Mayenne, France)]

National audienceAn engraved fish that can be attributed to the final Magdalenian period was discovered in 2010 in the Margot cave (Thorigne-en-Charnie, Mayenne, France). It shows graphic details that allow us to propose some clues to taxonomic determination. It must be a freshwater fish; the hypothesis of a Cyprinidae such as a tench is acceptable, considering that the 3.1 layer of the nearby Rochefort cave, attributable to the Final Paleolithic, has yielded a branchial arch of another Cyprinidae (probably a chub or a dace). Fish is not a usual theme in Paleolithic wall art. Here it is associated with another engraved animal figure, which is not fully determinable (seal or other fish). (C) 2014 Academie des sciences. Published by Elsevier Masson SAS. All rights reserved

Hypomethylation of the aquatic invasive plant, Ludwigia grandiflora subsp. hexapetala mimics the adaptive transition into the terrestrial morphotype

International audienceOngoing global changes affect ecosystems and open up new opportunities for biological invasion. The ability of invasive species to rapidly adapt to new environments represents a relevant model for studying short‐term adaptation mechanisms. The aquatic invasive plant, Ludwigia grandiflora subsp. hexapetala, is classified as harmful in European rivers. In French wet meadows, this species has shown a rapid transition from aquatic to terrestrial environments with emergence of two distinct morphotypes in 5 years. To understand the heritable mechanisms involved in adjustment to such a new environment, we investigate both genetic and epigenetic as possible sources of flexibility involved in this fast terrestrial transition. We found a low overall genetic differentiation between the two morphotypes arguing against the possibility that terrestrial morphotype emerged from a new adaptive genetic capacity. Artificial hypomethylation was induced on both morphotypes to assess the epigenetic hypothesis. We analyzed global DNA methylation, morphological changes, phytohormones and metabolite profiles of both morphotype responses in both aquatic and terrestrial conditions in shoot and root tissues. Hypomethylation significantly affected morphological variables, phytohormone levels and the amount of some metabolites. The effects of hypomethylation depended on morphotypes, conditions and plant tissues, which highlighted differences among the morphotypes and their plasticity. Using a correlative integrative approach, we showed that hypomethylation of the aquatic morphotype mimicked the characteristics of the terrestrial morphotype. Our data suggest that DNA methylation rather than a new adaptive genetic capacity is playing a key role in L. grandiflora subsp. hexapetala plasticity during its rapid aquatic to terrestrial transition

Effects of highest dose of sacubitril/valsartan association compared to lower doses on mortality and ventricular arrhythmias

Background: Sudden cardiac death is a major healthcare issue in reduced ejection fraction heart failure (HFrEF) patients. Recently, the new association of sacubitril/valsartan showed a reduction of both ventricular arrhythmias (VA) and mortality even at low dose compared to enalapril in HF patients. The purpose of our study was to assess whether the highest dose of sacubitril/valsartan compared to lower doses may improve the rate of death and VA in a population of patients with HFrEF and with an implantable cardiac defibrillator (ICD). Methods: 104 HF patients with reduced EF under sacubitril/valsartan with an ICD were divided in 2 groups: the first one with the lower doses of sacubitril/valsartan (24/26 mg or 49 mg/51 mg twice daily) and the second with the maximal dose (97mg/103mg twice daily). The primary outcome was a composite of death or appropriate ICD therapy for VA. Results: After a median follow-up of 14 months, 39 patients were treated with lower doses and 65 patients with the highest dose. Patients from the lower doses group were older (70 [60-80] vs. 66 [60-70]; p = 0,03), more symptomatic at initiation (NYHA 3: 44% vs. 19%; p < 0,01) and more often in atrial fibrillation (31% vs. 12%; p = 0,04). The primary composite endpoint occurred in 14 patients (36%) in the low doses group versus 7 patients (11%) in high dose group (p < 0,01). This difference was particularly observed in the subgroup of patients with ischemic cardiomyopathy. In a multivariable analysis, the higher dose was independently associated with the primary outcome with an HR = 2,934 [IC 95% 1,147 – 7,504]; p = 0,03. Kaplan-Meier curve showed an early effect of the highest dose of sacubitril/valsartan association. Conclusion: Patients with HFrEF under the highest dose of sacubitril/valsartan showed better clinical outcomes with a decrease of both mortality or appropriated ICD therapies related to ventricular arrhythmias