46 research outputs found
Le partenariat au service de l’évaluation des projets d’éducation relative à l’environnement
Évaluer des projets d’éducation relative à l’environnement (ErE) avec tous les acteurs concernés et impliqués dans le projet, est-ce seulement une utopie de chercheurs ? À travers l’analyse de deux expériences, cet article cherche à démontrer la cohérence d’un partenariat dans l’évaluation de projets avec les objectifs poursuivis par l’ErE. Il précise le terme « partenariat », analyse les avantages vécus et précise les problèmes rencontrés lors d’évaluations menées à plusieurs selon les types de projets d’ErE et selon les moments de l’action. Un ensemble de questions est proposé, questions que tout praticien pourra se poser avant de se lancer dans une telle démarche aussi riche que complexe.Is it a researchers’ utopia to evaluate environmental education (EE) projects with all concerned and involved actors ? This paper, through the analysis of two experiences, aims to demonstrate the coherence of partnership in the evaluation of projects, with the pursuit of EE objectives. This paper also defines the term “partnership”, analyses the advantages experienced and details the problems encountered in evaluations conducted in a collaborative process, according to the types of EE projects and the moments of action. A series of questions is proposed which questions all practitioners may ask themselves before getting involved in such a rich and complex process
New Fluorinated 1,2,4-Benzothiadiazine 1,1-Dioxides: Discovery of an Orally Active Cognitive Enhancer Acting through Potentiation of the 2-Amino-3-(3-hydroxy-5-methylisoxazol-4-yl)propionic Acid Receptors
In the search of a potent cognitive enhancer, a series of 3,4-dihydro-2H-1,2,4-benzothiadiazine 1,1-dioxides have been synthesized and evaluated as positive allosteric modulators of the AMPA receptors. In the present work, we focused our efforts on the insertion of mono- or polyfluoro- substituted alkyl chains at the 4-position of the thiadiazine ring in an attempt to enhance the pharmacokinetic behavior of previously described compounds. Among all the described compounds, 7-chloro-4-(2-fluoroethyl)-3,4-dihydro-2H-1,2,4-benzothiadiazine 1,1-dioxide, 12b, was shown to exert a strong activity on AMPA receptors in vitro and a marked cognitive-enhancing effect in vivo after oral administration to Wistar rats. Considering its in vivo activity, the metabolic degradation of 12b was studied and compared to that of its nonfluorinated analogue 9b. Taken together, results of this study clearly validated the positive impact of the fluorine atom on the alkyl chain at the 4-position of benzothiadiazine dioxides on activity and metabolic stability
Resource utilization and costs during the initial years of lung cancer screening with computed tomography in Canada
Background
It is estimated that millions of North Americans would qualify for lung cancer screening and that billions of dollars of national health expenditures would be required to support population-based computed tomography lung cancer screening programs. The decision to implement such programs should be informed by data on resource utilization and costs.
Methods
Resource utilization data were collected prospectively from 2059 participants in the Pan-Canadian Early Detection of Lung Cancer Study using low-dose computed tomography (LDCT). Participants who had 2% or greater lung cancer risk over 3 years using a risk prediction tool were recruited from seven major cities across Canada. A cost analysis was conducted from the Canadian public payer's perspective for resources that were used for the screening and treatment of lung cancer in the initial years of the study.
Results
The average per-person cost for screening individuals with LDCT was USD453 (95% confidence interval [CI], USD400–USD505) for the initial 18-months of screening following a baseline scan. The screening costs were highly dependent on the detected lung nodule size, presence of cancer, screening intervention, and the screening center. The mean per-person cost of treating lung cancer with curative surgery was USD33,344 (95% CI, USD31,553–USD34,935) over 2 years. This was lower than the cost of treating advanced-stage lung cancer with chemotherapy, radiotherapy, or supportive care alone, (USD47,792; 95% CI, USD43,254–USD52,200; p = 0.061).
Conclusion
In the Pan-Canadian study, the average cost to screen individuals with a high risk for developing lung cancer using LDCT and the average initial cost of curative intent treatment were lower than the average per-person cost of treating advanced stage lung cancer which infrequently results in a cure
Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Distress Syndrome associated with COVID-19: An Emulated Target Trial Analysis.
RATIONALE: Whether COVID patients may benefit from extracorporeal membrane oxygenation (ECMO) compared with conventional invasive mechanical ventilation (IMV) remains unknown. OBJECTIVES: To estimate the effect of ECMO on 90-Day mortality vs IMV only Methods: Among 4,244 critically ill adult patients with COVID-19 included in a multicenter cohort study, we emulated a target trial comparing the treatment strategies of initiating ECMO vs. no ECMO within 7 days of IMV in patients with severe acute respiratory distress syndrome (PaO2/FiO2 <80 or PaCO2 ≥60 mmHg). We controlled for confounding using a multivariable Cox model based on predefined variables. MAIN RESULTS: 1,235 patients met the full eligibility criteria for the emulated trial, among whom 164 patients initiated ECMO. The ECMO strategy had a higher survival probability at Day-7 from the onset of eligibility criteria (87% vs 83%, risk difference: 4%, 95% CI 0;9%) which decreased during follow-up (survival at Day-90: 63% vs 65%, risk difference: -2%, 95% CI -10;5%). However, ECMO was associated with higher survival when performed in high-volume ECMO centers or in regions where a specific ECMO network organization was set up to handle high demand, and when initiated within the first 4 days of MV and in profoundly hypoxemic patients. CONCLUSIONS: In an emulated trial based on a nationwide COVID-19 cohort, we found differential survival over time of an ECMO compared with a no-ECMO strategy. However, ECMO was consistently associated with better outcomes when performed in high-volume centers and in regions with ECMO capacities specifically organized to handle high demand. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/)
LA PLACE DE L'IRRADIATION PAR BETATRON DANS LE TRAITEMENT DES CANCERS DU RECTUM
Treatment of 103 rectal tumours and 3 tumours of the anal canal with the betatron (35 MeV) is described. Patients were divided into categories according to operability, the type of operation performed, and the irradiation schedule. The authors concluded that postoperative irradiation is indicated after anterior resection and abdominoperineal resection when the lymph nodes are invaded, and that, when the tumour is inoperable, irradiation gives palliative results, satisfactory in that mean survival is prolonged, and the patient's way of life is improved.SCOPUS: ar.jinfo:eu-repo/semantics/publishe
Phlegmarine, a likely key intermediate in the biosynthesis of the Lycopodium alkaloids
info:eu-repo/semantics/publishe
130 Ovarian carcinomas treated by intraperitoneal injection of radioactive gold
SCOPUS: NotDefined.jinfo:eu-repo/semantics/publishe
EORTC protocol for the study of CCNU in the treatment of irradiated, operated, malignant glioma of the brain
The EORTC protocol for brain tumor is described. In addition to survival time, an attempt is made to determine remission rate. CCNU is compared to a group without chemotherapy in a randomized trial. © 1973.SCOPUS: ar.jinfo:eu-repo/semantics/publishe
Q fever endocarditis involving a porcine bioprosthesis
SCOPUS: le.jinfo:eu-repo/semantics/publishe