Recent progress in inverse methods in France

Given the current level of jet engine performance, improvement of the various turbomachinery components requires the use of advanced methods in aerodynamics, heat transfer, and aeromechanics. In particular, successful blade design can only be achieved via numerical design methods which make it possible to reach optimized solutions in a much shorter time than ever before. Two design methods which are currently being used throughout the French turbomachinery industry to obtain optimized blade geometries are presented. Examples are presented for compressor and turbine applications. The status of these methods as far as improvement and extension to new fields of applications is also reported

La recherche sur estampe : où en est-on ?

Cette table ronde a discuté de la recherche en estampe ancienne en explorant deux directions. Une première partie a constitué davantage en un bilan historiographique sur les recherches menées depuis deux décennies dans le domaine de l’estampe ancienne, et une deuxième partie a traité de problématiques plus larges. Maxime Préaud a inauguré la table ronde en rappelant qu’il s’était livré à un bilan similaire sur les recherches menées depuis plus de trente ans en matière d’estampe ancienne, et p..

Strategies of initiation and streamlining of antibiotic therapy in 41 French intensive care units

CIAR (Club d'infectiologie en Anesthésie-Réanimation) Study Group: Pr B Allaouchiche (HCL, CHU Lyon), Pr C Arich (CHU Nimes), Pr C Auboyer (CHU St-Etienne), Dr JP Caramella (CHG Nevers), Dr JF Cochard (CHU Bordeaux), Dr A Combes (CHG Meaux), Dr P Courant (CHG Avignon), Dr J Durand-Gasselin (CHG Toulon), Pr J Duranteau (APHP, CHU Bicetre), Dr H Floch (CHU Nantes), Dr F Fraisse (CHG St Denis), Pr M Freysz (CHU Dijon), Dr B Garrigues (CHG Aix-en-Provence), Dr B Georges (CHU Toulouse), Pr F Gouin (APHM, CHU Marseille), Pr L Jacob (APHP, CHU St Louis), Pr P Juvin (APHP, CHU Beaujon), Dr J Keinlen (CHU Montpellier), Dr AM Korinek (APHP, CHU Pitie Salpetriere), Dr C Lamer (Institut Mutualiste Montsouris, Paris), Pr JY Lefrant (CHU Nimes), Dr O Lesieur (CHG La Rochelle), Dr Yazine Mahjoub (CHU Amiens), Pr Y Malledant (CHU Rennes), Pr C Martin (APHM, CHU Marseille), Pr O Mimoz (CHU Poitiers), Pr C Paugam-Burtz (APHP, CHU Beaujon, Clichy), Dr PF Perrigault (CHU Montpellier), Pr T Pottecher (CHU Strasbourg), Pr JL Pourriat (APHP, CHU Hotel Dieu), Dr JF Poussel (CHG Metz), Dr A Rabbat (APHP, CHU Hotel Dieu), Dr J Reignier (CHG La Roche sur Yon), Dr P Sichel (CHG Cherbourg), Dr JP Sollet (CHG Argenteuil), Dr D Thevenin (CHG Lens), Dr G Viquesnel (CHU Caen).International audienceINTRODUCTION: Few studies have addressed the decision-making process of antibiotic therapy (AT) in intensive care unit (ICU) patients. METHODS: In a prospective observational study, all consecutive patients admitted over a one-month period (2004) to 41 French surgical (n = 22) or medical/medico-surgical ICUs (n = 19) in 29 teaching university and 12 non-teaching hospitals were screened daily for AT until ICU discharge. We assessed the modalities of initiating AT, reasons for changes and factors associated with in ICU mortality including a specific analysis of a new AT administered on suspicion of a new infection. RESULTS: A total of 1,043 patients (61% of the cohort) received antibiotics during their ICU stay. Thirty percent (509) of them received new AT mostly for suspected diagnosis of pneumonia (47%), bacteremia (24%), or intra-abdominal (21%) infections. New AT was prescribed on day shifts (45%) and out-of-hours (55%), mainly by a single senior physician (78%) or by a team decision (17%). This new AT was mainly started at the time of suspicion of infection (71%) and on the results of Gram-stained direct examination (21%). Susceptibility testing was performed in 261 (51%) patients with a new AT. This new AT was judged inappropriate in 58 of these 261 (22%) patients. In ICUs with written protocols for empiric AT (n = 25), new AT prescribed before the availability of culture results (P = 0.003) and out-of-hours (P = 0.04) was more frequently observed than in ICUs without protocols but the appropriateness of AT was not different. In multivariate analysis, the predictive factors of mortality for patients with new AT were absence of protocols for empiric AT (adjusted odds ratio (OR) = 1.64, 95% confidence interval (95%CI): 1.01 to 2.69), age ≥60 (OR = 1.97, 95% CI: 1.19 to 3.26), SAPS II score >38 (OR = 2.78, 95% CI: 1.60 to 4.84), rapidly fatal underlying diseases (OR = 2.91, 95% CI: 1.52 to 5.56), SOFA score ≥6 (OR = 4.48, 95% CI: 2.46 to 8.18). CONCLUSIONS: More than 60% of patients received AT during their ICU stay. Half of them received new AT, frequently initiated out-of-hours. In ICUs with written protocols, empiric AT was initiated more rapidly at the time of suspicion of infection and out-of-hours. These results encourage the establishment of local recommendations for empiric AT

Estimating Attributable Mortality Due to Nosocomial Infections Acquired in Intensive Care Units

Background. The strength of the association between intensive care unit (ICU)-acquired nosocomial infections (NIs) and mortality might differ according to the methodological approach taken. Objective. TO assess the association between ICU-acquired NIs and mortality using the concept of population-attributable fraction (PAF) for patient deaths caused by ICU-acquired NIs in a large cohort of critically ill patients. Setting. Eleven ICUs of a French university hospital. Design. We analyzed surveillance data on ICU-acquired NIs collected prospectively during the period from 1995 through 2003. The primary outcome was mortality from ICU-acquired NI stratified by site of infection. A matched-pair, case-control study was performed. Each patient who died before ICU discharge was defined as a case patient, and each patient who survived to ICU discharge was denned as a control patient. The PAF was calculated after adjustment for confounders by use of conditional logistic regression analysis. Results. Among 8,068 ICU patients, a total of 1,725 deceased patients were successfully matched with 1,725 control Patients. The adjusted PAF due to ICU-acquired NI for patients who died before ICU discharge was 14.6% (95% confidence interval [CI], 14.4%—14.8%). Stratified by the type of infection, the PAF was 6.1% (95% CI, 5.7%-6.5%) for pulmonary infection, 3.2% (95% CI, 2.8%-3.5%) for central venous catheter infection, 1.7% (95% CI, 0.9%-2.5%) for bloodstream infection, and 0.0% (95% CI, -0.4% to 0.4%) for urinary tract infection. Conclusions. ICU-acquired NI had an important effect on mortality. However, the statistical association between ICU-acquired NI and mortality tended to be less pronounced in findings based on the PAF than in study findings based on estimates of relative risk. Therefore, the choice of methods does matter when the burden of NI needs to be assesse

De la sphère privée à la sphère publique

Dans la suite de l’ouvrage somme de Pauline Prevost-Marcilhacy, Les Rothschild. Une dynastie de mécènes en France (Louvre/BNF/Somogy, 2016) et dans le cadre du développement du programme Les collections Rothschild dans les institutions publiques françaises à l’INHA, les actes du colloque « De la sphère privée à la sphère publique », qui s’est tenu les 4, 5 et 6 décembre 2018, se proposent de dresser un panorama des dons aux institutions publiques venus des différents membres de la famille Rothschild, en s’intéressant plus particulièrement aux ensembles moins étudiés jusqu’à aujourd’hui. Ce sont des antiquités, des partitions musicales, des écailles piquées, des pipes, des manuscrits, des porcelaines chinoises, des curiosités, autant d’objets qui furent donnés aux musées et aux institutions publiques à partir de 1863, au moment où l’espace public s’institue aussi comme lieu de partage et d’exposition de la culture

Le sombre tryptique de la presse française

Trois «géants » en crise, trois illustrations des problèmes actuels de la presse française. France-Soir perd régulièrement ses lecteurs : cette masse de faits divers ne constitue pas un service d'information concurrentiel et ne crée pas d'attachement au journal, qui ne représente pour le lecteur qu'un «bruit de fond». D'autre part les tentatives de créer des journaux «populaires » plus libéraux échouent. Assiste-t-on à un clivage entre deux cultures étrangères l'une à l'autre, celle des élites, des maîtres, culture de l'efficacité sociale qui aurait un quasi-monopole de l'écrit, et celle des masses, des esclaves, culture de pure consommation ? Au Parisien libéré, la lutte est engagée entre le patron le plus réactionnaire de la presse française et un syndicat du livre tout-puissant qui maintient l'ensemble de l'imprimerie de presse française dans l'ère artisanale. On a si bien laissé pourrir la situation que, quelle que soit l'issue de la bataille, c'est la presse toute entière qui se trouve menacée par ce conflit. Le Figaro ne maintient ses tirages qu'artificiellement, faute de pouvoir renouveler sa clientèle en attirant ces nouvelles couches de la bourgeoisie qui ne s'identifient pas à la droite traditionnelle. Très prospère il y a cinq ans, le journal est maintenant déficitaire et sa structure de recettes déséquilibrée vient aggraver la situation. Le remède appliqué risque fort d'achever le malade.Lepape Pierre. Le sombre tryptique de la presse française. In: Communication Information, volume 1 n°2, hiver 1976. pp. 3-12

L’autorité Littéraire en démocratie

Depuis la Révolution française, la création artistique en général et la création littéraire en particulier – est mal à l’aise avec la démocratie. Non pas avec la démocratie au sens strictement politique d’un certain type d’organisation des pouvoirs, mais avec la démocratie au sens anthropologique, comme mode d’existence et comme horizon mental et affectif de la société, organisé autour du sentiment de l’égalité entre les hommes. Je ne vais pas refaire ici la longue histoire de ce malaise. On ..

Journalistes et hommes de lettres. Les positions de l'Encyclopédie

Pierre Lepape : Journalists and Men of Letters. The Encyclopédie's Position. The 18th-century literary elite had little respect for journalists or journalism, which it considered as the lower chamber of literature, and the opposition was strengthened by the great success of the periodical press. Competition took the form of commercial war, the fight for prestige and intellectual rivalry. In many Encyclopédie articles the contempt for journalism is developed, but Diderot's article JOURNALISTE takes a different stand. By laying down laws for journalism in the service of the public good, he provided men of letters and journalists with common rules for an aesthetics, a logic and an ethics of intellectual communication.Lepape Pierre. Journalistes et hommes de lettres. Les positions de l'Encyclopédie. In: Recherches sur Diderot et sur l'Encyclopédie, n°18-19, 1995. pp. 105-113