Perceptions et stratégies d’adaptation aux changements climatiques : le cas des communes d’Adjohoun et de Dangbo au Sud-Est Bénin

La présente étude met en exergue la variable humaine, responsable des perturbations climatiques suite aux actions anthropiques. Elle a été conduite dans deux communes de la vallée de l’Ouémé, compte tenu de leurs nombreuses potentialités hydro‑agricoles et de leur vulnérabilité aux intenses activités agricoles. La méthodologie de recherche comprend : une étude exploratoire permettant de choisir les villages sur la base de critères tels que la toposéquence et l’importance des activités agricoles, une phase d’enquêtes approfondies avec l’administration de questionnaires structurés auprès de 70 producteurs, des entretiens semi-structurés, informels individuels et de groupes, des transects participatifs et une triangulation de sources d’informations complémentaires. Les analyses de perceptions et stratégies d’adaptation ont été faites avec les populations et SAS a été utilisé pour l’analyse en composantes principales. Les résultats révèlent que les producteurs perçoivent et vivent les effets des changements climatiques avec pour conséquences de profonds bouleversements socio-économiques ces quinze dernières années. Ces bouleversements concernent les précipitations caractérisées par des séquences d’inondation, de sècheresse prolongée, de fortes températures et une fréquence élevée des vents violents. Les causes de ces changements sont attribuées aux bouleversements des normes sociales et les petits producteurs sont les plus vulnérables. Diverses stratégies développées comprennent l’adoption de variétés à cycles plus courts, la mise en valeur de différentes unités de paysage, l’intensification de l’utilisation des engrais chimiques, la diversification des sources de revenus.Perceptions and strategies of adaptation to climate changes : the cases of Adjohoun and Dangbo districts in South-East BeninThis study focuses on human variable as responsible for climate change. It was carried out in two districts of Ouémé Valley based on its numerous hydro-agricultural potentialities and their vulnerability to intensified agricultural activities. The research methodology includes an exploratory study which enabled to choose villages based on criteria such as toposequence, and the importance of agricultural activities ; in-depth survey with the administration of a structured questionnaire to 70 small-scale individual farmers ; semi structured, informal individual and focus group interviews, participatory transect walks and triangulation of complementary information sources. The analysis of perceptions and adaptation strategies were jointly made with interviewed farmers and SAS was used to analyse main components. The results revealed that farmers perceived and acknowledged climate change effects, which brought about serious socio-economic upheavals the last fifteen years. These upheavals relate to erratic precipitations characterized with sequences of flooding, lengthened drought, higher temperature and increased frequency of violent wind. The causes of this climate change were attributed to the disruption of social norms and values and small-scale farmers are the most vulnerable. Various developed strategies include : use of extra early maturing varieties, cultivation of different toposequences, application of additional chemical fertilisers, diversification sources of income

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

L’Afrique face aux changements climatiques

Les cinq études sont extraites du séminaire organisé à Poitiers par le laboratoire RURALITES (EA 2252, Université de Poitiers) les 19 et 20 mai 2011 sur le thème « Les effets du changement climatique en Afrique » qui avait pour but d’interroger « la réalité » du phénomène en changeant d’échelle d’observation et en partant de ses effets avérés, probables ou ressentis aux niveaux local et régional, en essayant de répondre aux questions soulevées par les phénomènes climatiques et leur interprétation. Si l’incertitude prévaut aujourd’hui, elle tient en partie à la complexité des phénomènes climatiques observés et à leur interprétation; il semblerait également qu’on n’ait pas suffisamment souligné l’importance des jeux d’échelles et la nécessité de toujours replacer les questions liées au climat dans le temps, l’espace et les contextes locaux. L’Afrique apparaît bien comme l’une des régions les plus exposées au changement climatique et vulnérables

Benchmark performance of laparoscopic left lateral sectionectomy and right hepatectomy in expert centers

International audienceHerein, we aimed to establish benchmark values - based on a composite indicator of healthcare quality - for the performance of laparoscopic left lateral sectionectomy (LLLS) and laparoscopic right hepatectomy (LRH) using data from expert centers

Laparoscopic versus open liver resection for intrahepatic cholangiocarcinoma. Report of an international multicenter cohort study with propensity score matching

Background: Intrahepatic cholangiocarcinoma is a rare disease with a poor prognosis. In patients where surgical resection is possible, outcome is influenced by perioperative morbidity and lymph node status. Laparoscopic liver resection is associated with improved clinical and oncological outcomes in primary and metastatic liver cancer compared with open liver resection, but evidence on intrahepatic cholangiocarcinoma is still insufficient.The primary aim of this study was to compare overall survival for a large series of patients treated for intrahepatic cholangiocarcinoma by open or laparoscopic approach. Secondary objectives were to compare disease-free survival, predictors of death, and recurrence.Methods: Patients treated with laparoscopic or open liver resection for intrahepatic cholangiocarcinoma from 2000 to 2018 from 3 large international databases were analyzed retrospectively. Each patient in the laparoscopic resection group (case) was matched with 1 open resection control (1:1 ratio), through a propensity score calculated on clinically relevant preoperative covariates. Overall and disease-free survival were compared between the matched groups. Predictors of mortality and recurrence were analyzed with Cox regression, and the Textbook Outcomes were described.Results: During the study period, 855 patients met the inclusion criteria (open liver resection = 709, 82.9%; laparoscopic liver resection = 146, 17.1%). Two groups of 89 patients each were analyzed after propensity score matching, with no significant difference regarding pre-and postoperative variables. Overall survival at 1, 3, and 5 years was 92%, 75%, and 63% in the laparoscopic liver resection group versus 92%, 58%, and 49% in the open liver resection group (P = .0043). Adjusted Cox regression revealed severe postoperative complications (hazard ratio: 10.5, 95% confidence interval [1.01-109] P = .049) and steatosis (hazard ratio: 13.8, 95% confidence interval [1.23-154] P = .033) as predictors of death, and transfusion (hazard ratio: 19.2, 95% confidence interval [4.04-91.4] P < .001) and severe postoperative complications (hazard ratio: 4.07, 95% confidence interval [1.15-14.4] P = .030) as predictors of recurrence.Conclusion: The survival advantage of laparoscopic liver resection over open liver resection for intrahepatic cholangiocarcinoma is equivocal, given historical bias and missing data. (C) 2021 Elsevier Inc. All rights reserved