Le patrimoine géologique en France

Initiée dans La Lettre de l’OCIM en 2015 à l’occasion des 30 ans de l'OCIM, la rubrique "Quoi de neuf ?" propose un retour sur un article marquant de l’histoire de la revue. À partir d’un corpus d’articles sélectionnés par la rédaction de La Lettre de l’OCIM, les membres du comité des Publications de l'OCIM ont sélectionné plusieurs contributions. Dans cette perspective, il a été demandé à l’auteur ou à un expert du domaine de revisiter la problématique exposée dans l’article à la lueur des changements intervenus, notamment dans les pratiques professionnelles, depuis son écriture et de proposer des éléments prospectifs sur la question. Les auteurs font un retour sur l’article de Patrick De Wever Un inventaire du patrimoine géologique pour la France publié en 2009 dans le n° 121 de La Lettre de l’OCIM et qui présentait les principaux éléments de la démarche engagée pour la réalisation de l’inventaire du patrimoine géologique français

Geoheritage, a National Inventory in France

International audienceGood protection measures for geological heritage should begin with an inventory of geosites. In France, for example, a law enacted in 2002 grants formal recognition to the notion of geological heritage. An inventory and evaluation were then established on a region-by-region basis. By April 2007, the French Ministry of Environment launched the inventory programme for the nation’s geological heritage and the data are now being collected at a regional scale. The data are being gathered and homogenised, and then transferred to the French National Museum of Natural History for examination.The ratified site data are stored and available for public use on a website (http://inpn.mnhn.fr) in a similar structure to natural data that are also processed and stored (flora, fauna, ecosystems, habitats). Today, protecting global heritage is understood as a dynamic process. Instead of placing objects beneath a display case, the conservation approach is now a more modern, active effort, which facilitates access for knowledge and researc

Análise dos riscos e benefícios da versão cefálica externa no parto pélvico

A posição pélvica no momento do nascimento pode dificultar o parto natural, almejado por muitas mulheres e acaba levando a um número maior de cesáreas desnecessárias. Neste cenário, pode-se aplicar a manobra de Versão Cefálica Externa (VCE), após a trigésima sexta semana, com o intuito de converter o bebê até que ele esteja em apresentação cefálica. A manobra em si exige pouca tecnologia, mas por possuir riscos se faz necessário um ambiente controlado, com presença de profissionais adequados e suporte caso alguma intervenção seja necessária. Nesse trabalho foi analisado e discorrido os riscos e benefícios desse procedimento para a mãe e para o bebê. Dessa forma, mesmo com poucas pesquisas acerca de VCE, esse trabalho tem a finalidade de realizar uma revisão integrativa capaz de atualizar e reunir os principais estudos relacionados ao tema a fim de ressaltar a importância da capacitação e conhecimento os profissionais da saúde acerca da manobra. Foram utilizados artigos publicados em bases de dados eletrônicas e assim espera-se elucidar a importância dessa manobra e a falta de dados e estáticas que provem isso

Survival with ambiguity

We analyze a market populated by expected utility maximizers and smooth ambiguity-averse consumers. We study conditions under which ambiguity-averse consumers survive and affect prices in the limit. If ambiguity vanishes with time or if the economy exhibits no aggregate risk, ambiguity-averse consumers survive, but have no long-run impact on prices. In both scenarios ambiguity-averse consumers are fully insured against ambiguity in equilibrium and thus behave as expected utility maximizers with correct beliefs. If ambiguity-averse consumers are not fully insured against ambiguity, their behavior mimics expected utility maximizers with wrong beliefs and a stochastic discount factor which might be consistently higher or lower than their actual discount factor. We use this insight to analyze a Markov economy with large persistent ambiguity. Consumers with decreasing absolute ambiguity aversion whose prudence with respect to ambiguity exceeds twice their absolute ambiguity aversion a.s. survive in the presence of expected utility maximizers with correct beliefs. If the economy further exhibits aggregate risk, they drive the expected utility maximizers out of the market and determine prices in the limit. In contrast, consumers with increasing or constant absolute ambiguity aversion only survive in the absence of aggregate risk and have no impact on limit prices

The Importance of Geosites and Heritage Stones in Cities—a Review

International audienceGeology, as a scientific discipline, is often viewedas most applicable in high mountains or in deserts or coastalareas—or more generally in ‘natural areas’ where rock exposuresare most conspicuous—and, therefore, not to be experiencedby most visitors and tourists. In contrast, most geoscientistsare convinced that geology can be practised on aneveryday basis, as it is part of our daily life as a facet of thenatural environment that humans have used for 100 s of thousandsof years. Even in places where the natural world seemsfar from its original condition, one can still experience geology.This consideration is of increasing importance, as today,more than half the world’s population lives in towns and cities.In this context, we can still present geology to an interestedpublic through establishing leisure walks, either guiding orusing leaflets, easily carried booklets and even web ‘apps’.The style chosen aims to be accessible to a broader public,but crucially, in an urban context, there should always be anaim to demonstrate the relationship between geology and society,as well as architecture and history. Indeed, the realisation of many participants in such activities that buildingstones can belong to, and provide evidence of, both a naturaland a built heritage can be a revelation

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

AIM: The SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery. METHODS: This was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin. RESULTS: Overall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P < 0.001). After adjustment, delay was not associated with a lower rate of complete resection (OR 1.18, 95% CI 0.90-1.55, P = 0.224), which was consistent in elective patients only (OR 0.94, 95% CI 0.69-1.27, P = 0.672). Longer delays were not associated with poorer outcomes. CONCLUSION: One in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease

Intraperitoneal drain placement and outcomes after elective colorectal surgery: international matched, prospective, cohort study

Despite current guidelines, intraperitoneal drain placement after elective colorectal surgery remains widespread. Drains were not associated with earlier detection of intraperitoneal collections, but were associated with prolonged hospital stay and increased risk of surgical-site infections.Background Many surgeons routinely place intraperitoneal drains after elective colorectal surgery. However, enhanced recovery after surgery guidelines recommend against their routine use owing to a lack of clear clinical benefit. This study aimed to describe international variation in intraperitoneal drain placement and the safety of this practice. Methods COMPASS (COMPlicAted intra-abdominal collectionS after colorectal Surgery) was a prospective, international, cohort study which enrolled consecutive adults undergoing elective colorectal surgery (February to March 2020). The primary outcome was the rate of intraperitoneal drain placement. Secondary outcomes included: rate and time to diagnosis of postoperative intraperitoneal collections; rate of surgical site infections (SSIs); time to discharge; and 30-day major postoperative complications (Clavien-Dindo grade at least III). After propensity score matching, multivariable logistic regression and Cox proportional hazards regression were used to estimate the independent association of the secondary outcomes with drain placement. Results Overall, 1805 patients from 22 countries were included (798 women, 44.2 per cent; median age 67.0 years). The drain insertion rate was 51.9 per cent (937 patients). After matching, drains were not associated with reduced rates (odds ratio (OR) 1.33, 95 per cent c.i. 0.79 to 2.23; P = 0.287) or earlier detection (hazard ratio (HR) 0.87, 0.33 to 2.31; P = 0.780) of collections. Although not associated with worse major postoperative complications (OR 1.09, 0.68 to 1.75; P = 0.709), drains were associated with delayed hospital discharge (HR 0.58, 0.52 to 0.66; P &lt; 0.001) and an increased risk of SSIs (OR 2.47, 1.50 to 4.05; P &lt; 0.001). Conclusion Intraperitoneal drain placement after elective colorectal surgery is not associated with earlier detection of postoperative collections, but prolongs hospital stay and increases SSI risk

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study

PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks