Observation de la mobilité et des dynamiques urbaines : indicateurs d'accessibilité automobile aux équipements structurants des aires urbaines : application à 10 aires urbaines

L'objectif de cette étude est de proposer des indicateurs d'accessibilité automobile aux équipements structurants des aires urbaines, non pas en fonction des distances parcourues, mais en fonction des «espaces temps» dans lesquels évoluent les gens. Ces « espaces temps » sont envisagés ici sous forme de courbes isochrones à partir des principaux grands types d'équipements. L'approche proposée s'appuie sur une modélisation du réseau routier de la BDCarto de l'IGN afin de déterminer une heure de pointe. Cette heure de pointe varie selon les aires urbaines. La première partie du document définit le cadre général de l'étude, son contexte et ses objectifs. La seconde partie décrit la méthode mise en place et les indicateurs développés. La troisième partie présente une synthèse des résultats obtenus. Enfin, les compléments de méthode et l'ensemble des résultats sont reportés en annexe du document

Comparison of the Hemostatic Efficacy of Pathogen-Reduced Platelets vs Untreated Platelets in Patients With Thrombocytopenia and Malignant Hematologic Diseases: A Randomized Clinical Trial

Importance: Pathogen reduction of platelet concentrates may reduce transfusion-transmitted infections but is associated with qualitative impairment, which could have clinical significance with regard to platelet hemostatic capacity. Objective: To compare the effectiveness of platelets in additive solution treated with amotosalen-UV-A vs untreated platelets in plasma or in additive solution in patients with thrombocytopenia and hematologic malignancies. Design, Setting, and Participants: The Evaluation of the Efficacy of Platelets Treated With Pathogen Reduction Process (EFFIPAP) study was a randomized, noninferiority, 3-arm clinical trial performed from May 16, 2013, through January 21, 2016, at 13 French tertiary university hospitals. Clinical signs of bleeding were assessed daily until the end of aplasia, transfer to another department, need for a specific platelet product, or 30 days after enrollment. Consecutive adult patients with bone marrow aplasia, expected hospital stay of more than 10 days, and expected need of platelet transfusions were included. Interventions: At least 1 transfusion of platelets in additive solution with amotosalen-UV-A treatment, in plasma, or in additive solution. Main Outcomes and Measures: The proportion of patients with grade 2 or higher bleeding as defined by World Health Organization criteria. Results: Among 790 evaluable patients (mean [SD] age, 55 [13.4] years; 458 men [58.0%]), the primary end point was observed in 126 receiving pathogen-reduced platelets in additive solution (47.9%; 95% CI, 41.9%-54.0%), 114 receiving platelets in plasma (43.5%; 95% CI, 37.5%-49.5%), and 120 receiving platelets in additive solution (45.3%; 95% CI, 39.3%-51.3%). With a per-protocol population with a prespecified margin of 12.5%, noninferiority was not achieved when pathogen-reduced platelets in additive solution were compared with platelets in plasma (4.4%; 95% CI, -4.1% to 12.9%) but was achieved when the pathogen-reduced platelets were compared with platelets in additive solution (2.6%; 95% CI, -5.9% to 11.1%). The proportion of patients with grade 3 or 4 bleeding was not different among treatment arms. Conclusions and Relevance: Although the hemostatic efficacy of pathogen-reduced platelets in thrombopenic patients with hematologic malignancies was noninferior to platelets in additive solution, such noninferiority was not achieved when comparing pathogen-reduced platelets with platelets in plasma. Trial Registration: clinicaltrials.gov Identifier: NCT01789762

The identification of α -clustered doorway states in 44, 48, 52 Ti using machine learning

Abstract: A novel experimental analysis method has been developed, making use of the continuous wavelet transform and machine learning to rapidly identify α-clustering in nuclei in regions of high nuclear state density. This technique was applied to resonant scattering measurements of the 4He(40,44,48Ca,α) resonant reactions, allowing the α-cluster structure of 44,48,52Ti to be investigated. Fragmented α-clustering was identified in 44Ti and 52Ti, while the results for 48Ti were less conclusive, but suggest no such clustering

Alpha clustering in Ti isotopes: 40, 44, 48Ca+ α resonant scattering

Measurements were made of the 4He(40,44,48Ca,α) resonant scattering reactions at 180° and up to Ec.m. ~ 11.5MeV, using the Thick Target Inverse Kinematics technique. These measurements are discussed, with a focus on assessing their usefulness for investigating α-clustering in medium mass 44,48,52Ti nuclei

The SIB Swiss Institute of Bioinformatics' resources: focus on curated databases

The SIB Swiss Institute of Bioinformatics (www.isb-sib.ch) provides world-class bioinformatics databases, software tools, services and training to the international life science community in academia and industry. These solutions allow life scientists to turn the exponentially growing amount of data into knowledge. Here, we provide an overview of SIB's resources and competence areas, with a strong focus on curated databases and SIB's most popular and widely used resources. In particular, SIB's Bioinformatics resource portal ExPASy features over 150 resources, including UniProtKB/Swiss-Prot, ENZYME, PROSITE, neXtProt, STRING, UniCarbKB, SugarBindDB, SwissRegulon, EPD, arrayMap, Bgee, SWISS-MODEL Repository, OMA, OrthoDB and other databases, which are briefly described in this article

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/)

Observation de la mobilité et des dynamiques urbaines : indicateurs d'accessibilité automobile aux équipements structurants des aires urbaines : application à 10 aires urbaines

L'objectif de cette étude est de proposer des indicateurs d'accessibilité automobile aux équipements structurants des aires urbaines, non pas en fonction des distances parcourues, mais en fonction des «espaces temps» dans lesquels évoluent les gens. Ces « espaces temps » sont envisagés ici sous forme de courbes isochrones à partir des principaux grands types d'équipements. L'approche proposée s'appuie sur une modélisation du réseau routier de la BDCarto de l'IGN afin de déterminer une heure de pointe. Cette heure de pointe varie selon les aires urbaines. La première partie du document définit le cadre général de l'étude, son contexte et ses objectifs. La seconde partie décrit la méthode mise en place et les indicateurs développés. La troisième partie présente une synthèse des résultats obtenus. Enfin, les compléments de méthode et l'ensemble des résultats sont reportés en annexe du document