Factors associated with influenza vaccination of general medicine interns in Nancy, France, in 2017

International audienc

Mapping ecosystem services bundles in a heterogeneous mountain region

International audienceRecent institutional and policy frameworks prescribe the incorporation of ecosystem services (ES) into land use management and planning, favouring co-production of ES assessments by stakeholders, land planners and scientists. Incorporating ES into land management and planning requires models to map and analyze ES. Also, because ES do not vary independently, many operational issues ultimately relate to the mitigation of ES trade-offs, so that multiple ES and their interactions need to be considered. Using a highly accurate LULC database for the Grenoble urban region (French Alps), we mapped twelve ES using a range of models of varied complexity. A specific, fine-grained (less than 1 ha) LULC database at regional scale (4450 km²) added great spatial precision in individual ES models, in spite of limits of the typological resolution for forests and semi-natural areas. We analysed ES bundles within three different socio-ecosystems and associated landscape types (periurban, rural and forest areas). Such type-specific bundles highlighted distinctive ES trade-offs and synergies for each landscape. Advanced approaches combining remote sensing, targeted field data collection and expert knowledge from scientists and stakeholders are expected to provide the significant progress that is now required to support the reduction of trade-offs and enhance synergies between management objectives

Cartographier les services écosystémiques : quelles données, quels modèles, quelles incertitudes ? Exemple autour du bassin de vie de Grenoble

National audienceThe evolution of institutional and policy frameworks for Ecosystem Services (ES), especially thenew 2016 biodiversity legislation in France, make accounting for ES in land use managementmandatory. This requires the use of spatially explicit information, and therefore thedevelopment of models to map ES. Most models are based on or use Land Use or Land Cover maps(LU/LC) as a proxy. Using a highly accurate spatialized LU/LC database, we applied or adaptedmodels to map 15 ES. We show that depending on the implication of the LU/LC database as inputto the models, the type of model (proxy vs. process based) and the processes modeled, theresulting spatial patterns are more or less dependent on the LU/LC database. The critical analysisof limits and uncertainties in the LU/LC mapping process (in general and for our database inparticular), and the use of these maps for modelling ES showed : 1 - the benefits, especially inagricultural areas, of precise description and monitoring of LU/LC inter-annual dynamics for thequantification of ES supply ; 2- the consequences of LU/LC typological limits for thequantification of ES, especially in our work in forest and semi-natural areas. The use of remotesensing should support a serious typological improvement to better characterize the LU/LC andalso use as independent input data in ES models.L’évolution des cadres institutionnels et politiques autour de la question des ServicesEcosystémiques (SE), notamment avec la nouvelle loi Biodiversité en 2016 en France, amène à uneobligation de leur prise en compte dans la gestion territoriale. Cela nécessite l’utilisationd’informations spatialement explicites, et par conséquent le développement de modèlespermettant de cartographier les SE. La plupart des modèles se basent sur ou utilisent commeproxy des cartes d’Occupation ou d’Utilisation des Sols (OS/US). À partir d’une base de donnéesspatialisée extrêmement précise, nous avons appliqué ou adapté des modèles permettant decartographier 15 SE. Les résultats montrent que selon l’implication de la base de données d’OS/US en entrée dans les modèles, le type de modèle choisi (proxy vs. processus) et les processusmodélisés, les patrons spatiaux résultants sont plus ou moins dépendants de la carte d’OS/USd’entrée. L’analyse critique des limites et incertitudes inhérentes à la constitution des cartesd’OS/US (en général et la notre en particulier), ainsi que l’utilisation de ces cartes à des fins demodélisation de SE a montré : 1- les apports notamment dans les milieux agricoles d’unedescription précise des dynamiques interannuelles de l’OS/US pour la quantification de SEd’approvisionnement ; 2- l’implication de limites typologiques d’OS/US pour la quantification deSE, notamment dans notre travail pour les milieux forestiers et semi-naturels. L’usage de latélédétection apparait alors comme une piste sérieuse d’amélioration à la fois typologique pourmieux caractériser l’OS/US et également à utiliser comme donnée d’entrée indépendante dans lesmodèles de SE

Co-constructing future land-use scenarios for the Grenoble region, France

International audiencePhysically and socially heterogeneous mountain landscapes support high biodiversity and multiple ecosystem services. But rapid landscape transformation from fast urbanisation and agricultural intensification around cities to abandonment and depopulation in higher and more remote districts, raises urgent environmental and planning issues. For anticipating their future in a highly uncertain socio-economic context, we engaged stakeholders of a dynamic urban region of the French Alps in an exemplary interactive Participatory Scenario Planning (PSP) for co-creating salient, credible and legitimate scenarios. Stakeholders helped researchers adapt, downscale and spatialize four normative visions from the regional government, co-producing four storylines of trend versus break-away futures. Stakeholder input, combined with planning documents and analyses of recent dynamics, enabled parameterisation of high-resolution models of urban expansion, agriculture and forest dynamics. With similar storylines in spite of stakeholders insisting on different governance arrangements, both trend scenarios met current local and European planning objectives of containing urban expansion and limiting loss and fragmentation of agricultural land. Both break-away scenarios induced considerable conversion from agriculture to forest, but with highly distinctive patterns. Under a commonly investigated, deregulated liberal economic context, encroachment was random and patchy across valleys and mountains. A novel reinforced nature protection scenario affecting primarily mountain and hilly areas fostered deliberate consolidation of forested areas and connectivity. This transdisciplinary approach demonstrated the potential of combining downscaled normative scenarios with local, spatially-precise dynamics informed by stakeholders for local appropriation of top-down visions, and for supporting land planning and subsequent assessment of ecosystem service trade-offs

Proportion of single-chain recombinant tissue plasminogen activator and outcome after stroke

International audienceTo determine whether the ratio single chain (sc)/(sc + 2 chain [tc]) recombinant tissue plasminogen activator (rtPA) influences outcomes in patients with cerebral ischemia.METHODS:We prospectively included consecutive patients treated with IV rtPA for cerebral ischemia in 13 stroke centers and determined the sc/(sc + tc) ratio in the treatment administered to each patient. We evaluated the outcome with the modified Rankin Scale (mRS) at 3 months (prespecified analysis) and occurrence of epileptic seizures (post hoc analysis). We registered Outcome of Patients Treated by IV Rt-PA for Cerebral Ischaemia According to the Ratio Sc-tPA/Tc-tPA (OPHELIE) under ClinicalTrials.gov identifier no. NCT01614080.RESULTS:We recruited 1,004 patients (515 men, median age 75 years, median onset-to-needle time 170 minutes, median NIH Stroke Scale score 10). We found no statistical association between sc/(sc + tc) ratios and handicap (mRS > 1), dependency (mRS > 2), or death at 3 months. Patients with symptomatic intracerebral hemorrhages had lower ratios (median 69% vs 72%, adjusted p = 0.003). The sc/(sc + tc) rtPA ratio did not differ between patients with and without seizures, but patients with early seizures were more likely to have received a sc/(sc + tc) rtPA ratio >80.5% (odds ratio 3.61; 95% confidence interval 1.26-10.34).CONCLUSIONS:The sc/(sc + tc) rtPA ratio does not influence outcomes in patients with cerebral ischemia. The capacity of rtPA to modulate NMDA receptor signaling might be associated with early seizures, but we observed this effect only in patients with a ratio of sc/(sc + tc) rtPA >80.5% in a post hoc analysis