Quando as escalas se cruzam: medidas de desenvolvimento no Brasil e na França

O presente trabalho aborda numa perspectiva comparada as experiências francesa e brasileira na construção de índices e indicadores de desenvolvimento, em diversas escalas geográficas, do plano nacional ao plano intraurbano. Inicialmente, destacam-se as virtudes, limites, aspectos conceituais e metodológicos de medidas tradicionais de riqueza e desenvolvimento originalmente trabalhadas na escala das nações, tais como o produto interno bruto, e algumas de suas principais e mais utilizadas alternativas: o Índice de Desenvolvimento Humano. Num segundo momento, trabalham-se algumas experiências regionais na mensuração do desenvolvimento operacionalizadas na França e no Brasil: IDH-2-4 e o IDH-M; passando, em seguida, ao exame de experiências intraurbanas focando a Região Nord-Pas-de-Calais, com o ISS (Indicador de Saúde Social) e o IPBE (Indicador Participativo de Bem-Estar) e o Índice de Qualidade de Vida Urbana (IQVU) de Belo Horizonte

Carbon diffusivity and kinetics of spinodal decomposition of martensite in a model Fe-Ni-C alloy

From direct observations and measurements at the atomic scale by atom probe tomography coupled with calculations using a mean-field approach, the kinetics of low temperature carbon redistribution in martensite of a Fe-Ni-C alloy was investigated for duration up to 4.5 years. The results suggest that the ordered phase α″-Fe16C2 forms via a spinodal decomposition mechanism, in the range of a few days at room-temperature. The approach proposed allows us to retrieve the diffusivity of carbon in a large composition range during decomposition kinetics of martensite into α-Fe and α″-Fe16C2.Etude de la décomposition spinodale dans les aciers martensitiques Fe-X-

Carbon diffusivity and kinetics of spinodal decomposition of martensite in a model Fe-Ni-C alloy

International audienceFrom direct observations and measurements at the atomic scale by atom probe tomography coupled with calculations using a mean-field approach, the kinetics of low temperature carbon redistribution in martensite of a Fe-Ni-C alloy was investigated for duration up to 4.5 years. The results suggest that the ordered phase α″-Fe16C2 forms via a spinodal decomposition mechanism, in the range of a few days at room-temperature. The approach proposed allows us to retrieve the diffusivity of carbon in a large composition range during decomposition kinetics of martensite into α-Fe and α″-Fe16C2

A score-based method for quality control of fetal hard palate assessment during routine second-trimester ultrasound examination

International audienceINTRODUCTION: When an orofacial cleft lip is discovered, precise characterization of this malformation is necessary, especially the extension of this cleft to the secondary palate. We aimed to develop and evaluate the feasibility/reproducibility of a score-based quality control for the visualization of the fetal hard palate during the second-trimester scan. MATERIAL AND METHODS: All ultrasound images of fetal hard palate assessed routinely during second-trimester scan were retrospectively retrieved for a 6-month period. One hundred of these images were randomly selected and analyzed by two blinded reviewers, according to a scoring system (0-6 points). Criteria retained in the score were complete palate bone horizontal plate, presence of two pterygoid processes, visible alveolar ridge, and horizontal axis of insonation. A score >=4 defined images of good quality. Inter- and intra-reviewer reproducibility was assessed. RESULTS: Inter-reviewer reproducibility was excellent with significant correlation (Pearson coefficient 0.953; P~\textless~.0001), global adjusted \kappa coefficient (0.86, 95% CI 0.79-0.94) and individual criteria adjusted \kappa coefficient always \textgreater~0.8. Rates of images of good quality (score >=~4) were 75%-77%, also with excellent agreement (\kappa coefficient 0.89, 95% CI 0.79-0.99). Intra-reviewer reproducibility retrieved the same results (excellent agreement) except for the axis of insonation (satisfactory agreement). CONCLUSIONS: This simple image scoring system for the fetal palate is easy, has excellent inter- and intra-reviewer reproducibility and could also help sonographers to correctly identify the palate structure

Are colorectal cancer patients at risk for COVID-19 infection during the postoperative period? The Covid-GRECCAR study

International audienceIntroduction: During the COVID-19 pandemic, cancer patients have been regarded as having a high risk of severe events if they are infected with SARS-CoV-2, particularly those under medical or surgical treatment. The aim of this study was to assess the posttreatment risk of infection by SARS-CoV-2 in a population of patients operated on for colorectal cancer 3 months before the COVID-19 outbreak and who after hospitalization returned to an environment where the virus was circulating.Materials and methods: This French, multicenter cohort study included consecutive patients undergoing elective surgery for colorectal cancer between January 1 and March 31, 2020, at 19 GRECCAR hospitals. The outcome was the rate of COVID-19 infection in this group of patients who were followed until June 15, 2020.Results: This study included 448 patients, 262 male (58.5%) and 186 female (41.5%), who underwent surgery for colon cancer (n = 290, 64.7%), rectal cancer (n = 155, 34.6%), or anal cancer (n = 3, 0.7%). The median age was 68 years (19-95). Comorbidities were present in nearly half of the patients, 52% were at least overweight, and the median BMI was 25 (12-42). At the end of the study, 448 were alive. Six patients (1.3%) developed COVID-19 infection; among them, 3 were hospitalized in the conventional ward, and none of them died.Conclusion: The results are reassuring, with only a 1.3% infection rate and no deaths related to COVID-19. We believe that we can operate on colorectal cancer patients without additional mortality from COVID-19, applying all measures aimed at reducing the risk of infection

Associations between the severity of medical and surgical complications and perception of surgeon empathy in esophageal and gastric cancer patients

International audienceObjective: To assess the impact of global physician empathy and its three subdimensions (establishing rapport, emotional and cognitive processes) on the severity of postoperative complications in a sample of cancer patients.Methods: We retrospectively analyzed data on 256 patients with esogastric cancer from the French national FREGAT database. Empathy and its subdimensions were assessed using the patient-reported CARE scale and the severity of medical and surgical complications was reported with the Clavien-Dindo classification system. The usual covariates were included in multinomial logistic regression analyses.Results: Physician empathy predicted the odds of reporting major complications. When patients perceived high empathy, they were less likely to report major complications compared to no complications (OR = .95, 95% CI = [.91-.99], p = .029). Among the three dimensions, only "establishing rapport" (OR = .84, 95% CI = [.73-.98], p = .019) and the "emotional process" (OR = .85, 95% CI = [.74-.98], p = .022) predicted major complications.Conclusions: Physician empathy is essential before surgery. Further research is needed to understand the mechanisms associating empathy with health outcomes in cancer. Physicians should be trained to establish good rapport with patients, especially in the preoperative period