Les effets du tramway sur la fréquentation du transport public. Un bilan des agglomérations françaises de province

Cet article propose d’actualiser un bilan réalisé en 2006 des effets de la réintroduction du tramway sur la fréquentation du transport public dans les agglomérations françaises de province. Sa démarche se légitime par la multiplication des mises en service, permettant de doubler le panel, et par l’ouverture d’un débat sur les effets réels du tramway, mis en question par des approches empiriques et socio-psychologiques. L’analyse se construit à partir de la fréquentation du transport public publiée annuellement dans les annuaires statistiques du CERTU. Se fondant sur les mises en service de tramway entre 1985 et 2007, elle s’interroge à la fois sur ses effets sur la fréquentation du transport collectif, et sur celle de leur évolution diachronique au cours des deux décennies étudiées. Les résultats confirment que l’introduction du tramway a un effet fort sur la fréquentation, quoiqu’elle soit légèrement sensible aux aléas conjoncturels. Néanmoins, ses effets semblent minimes en termes de report modal depuis l’automobile, tandis que deux points méritent d’être approfondis pour une meilleure compréhension : le rôle dans ce succès de la refonte du réseau de transport, et les motivations socio-psychologiques à l’origine du choix modal du tramway.This article aims to update the 2006 assessment of the tram reintroduction on public transport use in the provincial French urban areas. It is justified by growing implementations, which double the sample group, and by the opening of a debate on real tram effects on public transport use, which are questioned by empirical and socio-psychological approaches. The analysis is built on public transport use published in annual statistical yearbooks edited by the CERTU. It is based on tram implementations between 1985 and 2007, and it questions both the reality of the reintroduction effects on public transport use, and the reality of a diachronic evolution within the two decades. Results tend to confirm the strong effect of tram implementation on public transport use, though slightly sensitive to socio-economic hazards. However, its effects on modal shift from the car seem low, and two points need to be stressed out for a better understanding: the role in the tram success of the transport network overhaul, and the socio-psychological motives regarding tram modal choice

Surgical and Oncological Outcomes After Preoperative FOLFIRINOX Chemotherapy in Resected Pancreatic Cancer : An International Multicenter Cohort Study

Background. Preoperative FOLFIRINOX chemotherapy is increasingly administered to patients with borderline resectable (BRPC) and locally advanced pancreatic cancer (LAPC) to improve overall survival (OS). Multicenter studies reporting on the impact from the number of preoperative cycles and the use of adjuvant chemotherapy in relation to outcomes in this setting are lacking. This study aimed to assess the outcome of pancreatectomy after preoperative FOLFIRINOX, including predictors of OS.Methods. This international multicenter retrospective cohort study included patients from 31 centers in 19 European countries and the United States undergoing pancreatectomy after preoperative FOLFIRINOX chemotherapy (2012-2016). The primary end point was OS from diagnosis. Survival was assessed using Kaplan-Meier analysis and Cox regression.Results. The study included 423 patients who underwent pancreatectomy after a median of six (IQR 5-8) preoperative cycles of FOLFIRINOX. Postoperative major morbidity occurred for 88 (20.8%) patients and 90-day mortality for 12 (2.8%) patients. An R0 resection was achieved for 243 (57.4%) patients, and 259 (61.2%) patients received adjuvant chemotherapy. The median OS was 38 months (95% confidence interval [CI] 34-42 months) for BRPC and 33 months (95% CI 27-45 months) for LAPC. Overall survival was significantly associated with R0 resection (hazard ratio [HR] 1.63; 95% CI 1.20-2.20) and tumor differentiation (HR 1.43; 95% CI 1.08-1.91). Neither the number of preoperative chemotherapy cycles nor the use adjuvant chemotherapy was associated with OS.Conclusions. This international multicenter study found that pancreatectomy after FOLFIRINOX chemotherapy is associated with favorable outcomes for patients with BRPC and those with LAPC. Future studies should confirm that the number of neoadjuvant cycles and the use adjuvant chemotherapy have no relation to OS after resection.Peer reviewe

Évolution des schémas, permanence des tracés : la planification de la région parisienne au prisme des réseaux ferroviaires

La littérature scientifique souligne la mutation des modèles de la planification urbaine. Ces modèles peuvent être définis comme des configurations particulières d’acteurs, de valeurs et de méthodes. Le développement de modèles inspirés des courants stratégique et collaboratif renouvelle l’approche traditionnelle. L’observation des pratiques de la planification spatiale de la région parisienne illustre ces évolutions. Toutefois l'analyse des projets de transport ferré conduit à relativiser cette perspective en constatant la permanence des tracés et des choix techniques.Scientific literature emphasizes the transformation of urban planning models with the emergence of new currents of thought, both strategic and collaborative, renewing traditional approaches. The observation of spatial planning practices in the Paris region illustrates these evolutions. However, the analysis of rail transit projects puts this into perspective by noting the permanence of route-ways and technical choices

New dynamical observer for a batch crystallization process based on solute concentration

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The Role of Surgery After Remission of Nonsystemic Extensive Periorbital Basal Cell Carcinoma Treated by Vismodegib: A Systematic Review

International audience BACKGROUND Eyelid basal cell carcinoma (BCC) is usually cured by surgery. However, for a minority of patients, extensive disease progression and recurrence contraindicate surgery or radiotherapy because of severe ocular morbidity. The hedgehog signaling pathway inhibitor vismodegib is becoming the key treatment for this specific form. OBJECTIVE The aim of this review was to define the role of surgery after vismodegib treatment. MATERIALS AND METHODS A literature search of the PubMed, Cochrane Library, ScienceDirect, and Embase databases was conducted for all articles published up to March 2021 to identify studies that examined treatment of BCC of the eyelid by vismodegib. RESULTS Level 1 evidence was found for the use of vismodegib as neoadjuvant therapy in locally advanced eyelid BCC contraindicated to surgery and/or radiotherapy with a rather good tolerance of treatment. Level 3 evidence was found for the role of surgical excision of residual clinically suspicious lesions as for the indication of eyelid reconstruction after mapping or during residual tumoral resection if frozen sections or Mohs surgery were performed. CONCLUSION Vismodegib is a well-tolerated treatment for advanced periorbital BCC. The hedgehog signaling pathway inhibitor vismodegib is a potential treatment option in patients with these challenging tumors. </jats:sec

Adjuvant chemotherapy benefit according to T and N stage in small bowel adenocarcinoma: a large retrospective multicenter study

International audienceBACKGROUND: Small bowel adenocarcinoma is a rare cancer, and the role of adjuvant chemotherapy for localized disease is still debated. METHODS: This retrospective multicenter study included all consecutive patients who underwent curative surgical resection for localized small bowel adenocarcinoma between 1996 and 2019 from 3 French cohort studies. Prognostic and predictive factors of adjuvant chemotherapy efficacy were analyzed for disease-free survival and overall survival. The inverse probability of treatment weighting method was applied in the Cox regression model using the propensity score derived from multivariable logistic regression. RESULTS: A total of 354 patients were included: median age, 63.5 years; duodenum location, 53.5%; and tumor stage I, II, and III in 31 (8.7%), 144 (40.7%), and 179 (50.6%) patients, respectively. The adjuvant chemotherapy was administered in 0 (0%), 66 (48.5%), and 143 (80.3%) patients with stage I, II, and III, respectively (P &lt; .0001). In the subgroup analysis by inverse probability of treatment weighting method, a statistically significant disease-free survival and overall survival benefit in favor of adjuvant chemotherapy was observed in high-risk stage II (T4 and/or &lt;8 lymph nodes examined) and III (T4 and/or N2) but not for low-risk stage II (T3 and ≥8 lymph nodes examined) and III (T1-3/N1) tumors (Pinteraction &lt; .05). Furthermore, tumor location in jejunum and ileum was also a statistically significant predictive factor of response to adjuvant chemotherapy in stage II and III tumors (Pinteraction &lt; .05). CONCLUSION: In localized small bowel adenocarcinoma, adjuvant chemotherapy seems to provide a statistically significant survival benefit for high-risk stage II and III tumors and for jejunum and ileum tumor locations

Current practice of pressurized intraperitoneal aerosol chemotherapy (PIPAC): Still standardized or on the verge of diversification?

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