Impact du niveau de désignation des centres de traumatologie sur le délai chirurgical, la mortalité, les complications et la durée de séjour : une étude de cohorte multicentrique

Les trajectoires des patients avec blessures hémorragiques et l’impact des niveaux de désignations des centres de traumatologie sur les résultats cliniques des patients sont peu connus. Nous avons conduit une étude de cohorte rétrospective sur un système de traumatologie inclusif canadien pour examiner si le délai chirurgical, la mortalité, les complications et la durée de séjour varient selon le niveau de désignation des hôpitaux au Québec pour les patients en choc hémorragique. Les patients examinés sont âgés de 18 ans et plus, ont une tension artérielle < 90 mm Hg à l’arrivée à l’hôpital et sont opérés ou décèdent dans les six premières heures. Environ 52% des patients ont été admis directement dans un centre tertiaire/secondaire régional et moins de 10% dans un centre primaire. Un quart des patients ont été traités dans la première heure suivant leur arrivée. Les centres primaires n’avaient pas de délais chirurgicaux significativement plus longs (RC : 1,13; IC à 95% : 0,53 – 2,41) et semblaient avoir une incidence de mortalité plus élevée (RC : 1,84; IC à 95% : 0,90 – 3,74) ainsi qu’une incidence de complications (RC : 0,51; IC à 95% : 0,24 – 1,12) et une durée de séjour moyen observées (RR : 0,40; IC à 95% : 0,29 – 0,55) plus basses que les centres tertiaires. Cette étude représente une étape importante pour améliorer la configuration des systèmes de traumatologie pour la prise en charge patients en choc hémorragique.Few studies have been conducted regarding the trajectories of patients with major hemorrhagic injuries and the potential benefit of level I/II care for these patients. We performed a retrospective cohort study based on a Canadian inclusive trauma system including adults in hemorrhagic shock in Quebec. We examined the influence of trauma center designation level on surgical delays, mortality, complications and length of stay. Examined patients were at least 18 years old, had systolic blood pressure < 90 mm Hg upon arrival at the ER and were operated on or died within the first six hours following arrival. About 52% of patients were directly admitted to a level I/II center and less than 10% of patients received treatment in level IV centers. A quarter of patients were treated within one hour of arrival. Results suggest that level IV centers do not perform better in terms of surgical delays (OR : 1.13; 95% CI: 0.53 – 2.41), may have higher mortality (OR : 1.84; 95% CI: 0.90 – 3.74), a lower incidence of complications (OR : 0.51; 95% CI: 0.24 – 1.12) and a shorter average length of stay (RR : 0.40; 95% CI: 0.29 – 0.55). This study represents an important step towards obtaining evidence-based information that can be used to enhance trauma system configuration to optimize outcomes in patients suffering hemorrhagic injuries

PROGRAMME DE DATATIONS DES FONDATIONS DU CHATEAU GRIMALDI, MUSEE PICASSO, ANTIBES. Rapport scientifique final auprès de la mairie d'Antibes, janvier 2016

Dans le cadre d’un programme archéologique dirigé par Eric Delaval sur les fondations du Château Grimaldi, l'IRAMAT-CRP2A est intervenu afin de dater les structures architecturales correspondantes par des méthodes physiques. Une intervention des membres de l'IRAMAT-CRP2A a eu lieu en décembre 2012. Elle a permis d'échantillonner des terres cuites (briques) et 5 échantillons de mortier de blocage et de jointoiement pour la datation par luminescence, ainsi que 92 échantillons de briques pour la datation par archéomagnétisme.Les objectofs de ce travail sont à la fois archéologiques et méthodologiques :- Dater la construction du mur de fondation grâce aux terres cuites architecturales dont on a envisagé de déterminer la datation de la production à partir des données d’archéomagnétisme et de luminescence.- Mettre en place la datation des mortiers par OSL monograin, en comparant les datations obtenues avec celles de terres cuites architecturales.Les résultats obtenus par le couplage entre l'archéomagnétisme des terres cuites et l'OSL des mortiers montrent que les fondations gallo-romaines du château Grimaldi (actuel Musée Picasso) ont été construites dans l'intervalle 30-220 AD (à 95% de probabilité) avec une médiane située vers 100 AD. Sur le plan méthodologique, il s'agit de la première datation de mortiers par OSL single grain véritablement aboutie

Why climate sensitivity may not be so unpredictable ?

International audienceDifferent explanations have been proposed as to why the range of climate sensitivity predicted by GCMs have not lessened substantially in the last decades, and subsequently if it can be reduced. One such study (\textit{Why is climate sensitivity so unpredictable?}, \cite{RB07}) adressed these questions using rather simple theoretical considerations and reached the conclusion that reducing uncertainties on climate feedbacks and underlying climate processes will not yield a large reduction in the envelope of climate sensitivity. In this letter, we revisit the premises of this conclusion. We show that it results from a mathematical artefact caused by peculiar definitions of uncertainty used by these authors. Applying standard concepts and definitions of descriptive statistics to the exact same framework of analysis as Roe and Baker, we show that within this simple framework, reducing inter-model spread on feedbacks does in fact induce a reduction of uncertainty on climate sensitivity, almost proportionally. Therefore, following Roe and Baker assumptions, climate sensitivity is actually not so unpredictable. %We then briefly focus on ongoing advances in cloud physics that may narrow the spread on feedbacks, thus reducing the uncertainty on climate sensitivity

Unusual duplication of the insulin-like receptor in the crustacean Daphnia pulex

Background: The insulin signaling pathway (ISP) has a key role in major physiological events like carbohydrate metabolism and growth regulation. The ISP has been well described in vertebrates and in a few invertebrate model organisms but remains largely unexplored in non-model invertebrates. This study is the first detailed genomic study of this pathway in a crustacean species, Daphnia pulex. Results: The Daphnia pulex draft genome sequence assembly was scanned for major components of the ISP with a special attention to the insulin-like receptor. Twenty three putative genes are reported. The pathway appears to be generally well conserved as genes found in other invertebrates are present. Major findings include a lower number of insulin-like peptides in Daphnia as compared to other invertebrates and the presence of multiple insulin-like receptors (InR), with four genes as opposed to a single one in other invertebrates. Genes encoding for the Dappu_InR are likely the result of three duplication events and bear some unusual features. Dappu_InR-4 has undergone extensive evolutionary divergence and lacks the conserved site of the catalytic domain of the receptor tyrosine kinase. Dappu_InR-1 has a large insert and lacks the transmembranal domain in the b-subunit. This domain is also absent in Dappu_InR-3. Dappu_InR-2 is characterized by the absence of the cystein-rich region. Real-time q-PCR confirmed the expression of all four receptors. EST analyses of cDNA libraries revealed that the four receptors were differently expressed under various conditions. Conclusions: Duplications of the insulin receptor genes might represent an important evolutionary innovation in Daphnia as they are known to exhibit extensive phenotypic plasticity in body size and in the size of defensive structures in response to predation

Non Ribosomal Peptides : A monomeric puzzle

National audienceNonribosomal peptides (NRPs) are increasingly studied because they harbor activities which can be exploited in various domains. They are often denoted as graphs illustrating their chemical structure, where the atoms are represented by nodes and the chemical bonds by arcs. Another possible representation is the monomeric structure. This structure, inspired by the biosynthetic pathway of these peptides, is effectuated by large enzymatic complexes which assemble together smaller compounds called monomers. Consequently, the nonribosomal peptides are composed of a great variety of monomers (more than 500 are known) including amino acids, lipids and carbohydrates. Likewise, nonpetidic bonds are formed between multiple monomers, producing peptides with cycles and/or branches. Thus, the monomeric structure is a graph formed by the monomers present in the peptide and their interlinking chemical bonds. Until now, there did not exist a tool allowing for the conversion between the atomic and monomeric structures. This article presents a novel algorithm capable of localising the monomers from a reference list in the chemical structures of peptides extracted from the Norine database. The algorithm is based on a heuristic that utilizes chemical information of NRPs. The preliminary results are encouraging, and should lead to further studies.Les peptides non-ribosomiques (NRP) sont des molécules de plus en plus étudiées car elles présentent des activités ayant des applications principalement dans le domaine pharmaceutique. Elles sont souvent décrites par leur structure chimique, c'est-a-dire un graphe dont les noeuds sont des atomes et les arêtes les liaisons chimiques. Une autre représentation possible est la structure monomérique. Cette structure, inspirée de la voie de synthèse de ces peptides, est réalisé par de gros complexes enzymatiques qui assemblent les briques de base, appelées monomères. Ainsi, les peptides non-ribosomiques sont composés d'une grande variété de monomères (plus de 500 recensés jusqu'à présent) tels que des acides aminés, mais aussi des lipides ou des sucres. De plus, des liaisons non-peptidiques peuvent être formées entre certains monomères, ce qui produit des peptides contenant des cycles et/ou des branchements. La structure monomérique est donc le graphe formé par les monomères présents dans le peptide et les liaisons qui les relient. A l'heure actuelle, il n'existe pas d'outil permettant de convertir la structure chimique d'un peptide non-ribosomique en sa structure monomérique. Cet article présente un algorithme capable de localiser les monomères d'une liste de référence dans les structures chimiques des peptides de la base de données Norine. Il est basé sur une heuristique gloutonne qui utilise des connaissances sur la chimie des NRP. Les résultats préliminaires sont satisfaisants et devraient conduire à de nouvelles études

A discrete interaction numerical model for coagulation and fragmentation of marine detritic particulate matter (Coagfrag v.1)

A simplified model, representing the dynamics of marine organic particles in a given size range experiencing coagulation and fragmentation reactions, is developed. The framework is based on a discrete size spectrum on which reactions act to exchange properties between different particle sizes. The reactions are prescribed according to triplet interactions. Coagulation combines two particle sizes to yield a third one, while fragmentation breaks a given particle size into two (i.e. the inverse of the coagulation reaction). The complete set of reactions is given by all the permutations of two particle sizes associated with a third one. Since, by design, some reactions yield particle sizes that are outside the resolved size range of the spectrum, a closure is developed to take into account this unresolved range and satisfy global constraints such as mass conservation. In order to minimize the number of tracers required to apply this model to an ocean general circulation model, focus is placed on the robustness of the model to the particle size resolution. Thus, numerical experiments were designed to study the dependence of the results on (i) the number of particle size bins used to discretize a given size range (i.e. the resolution) and (ii) the type of discretization (i.e. linear vs. nonlinear). The results demonstrate that in a linearly size-discretized configuration, the model is independent of the resolution. However, important biases are observed in a nonlinear discretization. A first attempt to mitigate the effect of nonlinearity of the size spectrum is then presented and shows significant improvement in reducing the observed biases.Fil: Gremion, Gwenaëlle. Institut des Sciences de la Mer de Rimouski; CanadáFil: Nadeau, Louis Philippe. Institut des Sciences de la Mer de Rimouski; CanadáFil: Dufresne, Christiane. Institut des Sciences de la Mer de Rimouski; CanadáFil: Schloss, Irene Ruth. Ministerio de Relaciones Exteriores, Comercio Interno y Culto. Dirección Nacional del Antártico. Instituto Antártico Argentino; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Austral de Investigaciones Científicas; Argentina. Universidad Nacional de Tierra del Fuego. Instituto de Ciencias Polares, Recursos Naturales y Ambiente; ArgentinaFil: Archambault, Philippe. Laval University; CanadáFil: Dumont, Dany. Institut des Sciences de la Mer de Rimouski; Canad

Trabectedin and its potential in the treatment of soft tissue sarcoma

Trabectedin is a new marine-derived compound that binds the DNA minor groove and interacts with proteins of the DNA repair machinery. Phase I trials have established the standard regimen as 1500 μg/m2 24-hour continuous infusion repeated every 3 weeks. Several phase II trials have shown response in 5%–10% of unselected patients with soft tissue sarcoma failing prior chemotherapy and disease stabilisation in 30%–40%. Furthermore, prolonged disease control has been described in 15%–20% of patients. Toxicities are mainly haematological and hepatic with grade 3–4 neutropenia and thrombocytopenia observed in approximately 50% and 20% of patients respectively, and grade 3–4 elevation of liver enzymes observed in 35%–50% of patients treated with trabectedin. Current research focuses on the identification of predictive factors for patients with soft tissue sarcoma treated with trabectedin

Les transformations de la végétation du bassin parisien par la modélisation des données polliniques holocènes

International audienceLa synthèse palynologique du Bassin parisien repose sur un corpus de 91 séquences de fonds de vallées qui résume l’histoire de la végétation holocène régionale. Parmi elles, 22 ont été utilisées pour reconstruire quantitativement le couvert végétal, en utilisant un nouveau modèle de reconstitution des paysages, REVEALS. Il corrige la relation non linéaire entre pollen et végétation et permet ainsi de convertir les assemblages polliniques en surfaces de couverture relatives aux différents taxons végétaux. Les dynamiques de ces plantes, ou groupes de plantes, reconstituent alors l’évolution de la structure des paysages du Bassin parisien durant l’Holocène

Les terres cuites architecturales comme sources d'information chronologique et technique des édifices avant l'an mil

A partir de l'étude d'un édifice phare de l'Ouest de la France (Église Notre-Dame sous Terre au Mont-Saint-Michel) mous montrons comment le couplage des études de bâti permettant l'identification d'ensembles maçonnés et leur chronologie relative, avec les méthodes de datation des terres cuites par thermoluminescence et archéomagnétisme, et des charbons de mortier par radiocarbone, aboutit à des informations particulièrement novatrices sur la chronologie de la production des briques, leur éventuel remploi ou sur leur production ad nove, mais aussi, plus inattendu, sur des éléments technologiques de leur production. Les orientations actuelles des recherches méthodologiques pour la datation physique des structures bâties sont également mises en perspectiv

Norine, the knowledgebase dedicated to nonribosomal peptides, is now open to crowdsourcing

International audienceSince its creation in 2006, Norine remains the unique knowledgebase dedicated to non-ribosomal pep-tides (NRPs). These secondary metabolites, produced by bacteria and fungi, harbor diverse interesting biological activities (such as antibiotic, anti-tumor, siderophore or surfactant) directly related to the diversity of their structures. The Norine team goal is to collect the NRPs and provide tools to analyze them efficiently. We have developed a user-friendly interface and dedicated tools to provide a complete bioinformatics platform. The knowledgebase gathers abundant and valuable annotations on more than 1100 NRPs. To increase the quantity of described NRPs and improve the quality of associated annotations , we are now opening Norine to crowdsourc-ing. We believe that contributors from the scientific community are the best experts to annotate the NRPs they work on. We have developed MyNorine to facilitate the submission of new NRPs or modifications of stored ones. This article presents MyNorine and other novelties of Norine interface released since the first publication. Norine is freely accessible from the following URL: http://bioinfo.lifl.fr/NRP