Adiposity, hormone replacement therapy use and breast cancer risk by age and hormone receptor status: a large prospective cohort study

INTRODUCTION: Associations of hormone-receptor positive breast cancer with excess adiposity are reasonably well characterized; however, uncertainty remains regarding the association of body mass index (BMI) with hormone-receptor negative malignancies, and possible interactions by hormone replacement therapy (HRT) use. METHODS: Within the European EPIC cohort, Cox proportional hazards models were used to describe the relationship of BMI, waist and hip circumferences with risk of estrogen-receptor (ER) negative and progesterone-receptor (PR) negative (n = 1,021) and ER+PR+ (n = 3,586) breast tumors within five-year age bands. Among postmenopausal women, the joint effects of BMI and HRT use were analyzed. RESULTS: For risk of ER-PR- tumors, there was no association of BMI across the age bands. However, when analyses were restricted to postmenopausal HRT never users, a positive risk association with BMI (third versus first tertile HR = 1.47 (1.01 to 2.15)) was observed. BMI was inversely associated with ER+PR+ tumors among women aged ≤49 years (per 5 kg/m2 increase, HR = 0.79 (95%CI 0.68 to 0.91)), and positively associated with risk among women ≥65 years (HR = 1.25 (1.16 to 1.34)). Adjusting for BMI, waist and hip circumferences showed no further associations with risks of breast cancer subtypes. Current use of HRT was significantly associated with an increased risk of receptor-negative (HRT current use compared to HRT never use HR: 1.30 (1.05 to 1.62)) and positive tumors (HR: 1.74 (1.56 to 1.95)), although this risk increase was weaker for ER-PR- disease (Phet = 0.035). The association of HRT was significantly stronger in the leaner women (BMI ≤22.5 kg/m2) than for more overweight women (BMI ≥25.9 kg/m2) for, both, ER-PR- (HR: 1.74 (1.15 to 2.63)) and ER+PR+ (HR: 2.33 (1.84 to 2.92)) breast cancer and was not restricted to any particular HRT regime. CONCLUSIONS: An elevated BMI may be positively associated with risk of ER-PR- tumors among postmenopausal women who never used HRT. Furthermore, postmenopausal HRT users were at an increased risk of ER-PR- as well as ER+PR+ tumors, especially among leaner women. For hormone-receptor positive tumors, but not for hormone-receptor negative tumors, our study confirms an inverse association of risk with BMI among young women of premenopausal age. Our data provide evidence for a possible role of sex hormones in the etiology of hormone-receptor negative tumors

Enquête sur le portage de Staphylocoque doré résistant à la méticilline en salle de surveillance post-interventionnelle

Les salles de surveillance post-interventionnelles sont des structures en salle commune avec une charge de soins infirmiers importante pouvant être à l'origine de la transmission croisée du SARM.Dans cette étude prospective réalisée sur une période de 15 jours, nous avons recherché à évaluer la prévalence du portage de SARM parmi les patients de SSPI, les facteurs de risques de ce portage et le risque de transmission, évalue par le nombre de patients ayant été en contact au sein de la SSPI avec un patient porteur de SARM.Parmi les 255 patients étudiés, 7 patients, correspondant à 10 admissions, étaient porteurs de SARM. Les facteurs de risque retrouvés en analyse univariée d'un portage de SARM étaient une classe ASA et Altemeier supérieures à 2, la durée d'hospitalisation dans l'année et en pré-opératoire, une antibiothérapieedans l'année et la présence d'une sonde vésicale. Malgré une faible prévalence du portage de SARM(2.7%), prés d'un tiers de l'ensemble des patients a été en contact avec au moins un porteur de SARM. Ces résultats démontrent le risque potentiel important de transmission croisée et plaident pour l'application de mesures strictes d'hygiéne en SSPI.PARIS7-Villemin (751102101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

L'eau, enjeux politiques et théologiques, de Sumer à la Bible

La présente thèse investit un corpus d'inscriptions royales et de textes littéraires, plus particulièrement mythologiques et bibliques, sur plusieurs millénaires depuis Sumer jusqu'à la Bible, afin d'identifier les motifs littéraires de l'eau, de repérer leur transmission, leur évolution, les possibilités d'emprunt, et surtout d'interroger leurs fonctions au sein de l idéologie du temps, leurs enjeux politiques et théologiques. Trois motifs littéraires sont ainsi étudiés de manières approfondies : la traversée, le déluge et l'eau d abondance. L'étude montre des fonctionnements littéraires divers dans leur évolution, leur transmission et leur réception. Pourtant, en Mésopotamie, ils révèlent leur enjeu commun au sein d'une théologie politique de la médiation royale. Le roi, déluge de son dieu traverse sans cesse au- delà du déluge afin de puiser l eau d'abondance, l'eau pérenne d'une civilisation éternelle. Les emprunts bibliques fonctionnent dès lors comme des "dés-emprunts" au service d une théologie de la révélation de la Torah et non de la médiation royale.This thesis investigates a corpus of royal inscriptions and literary texts, with special emphasis on those that are mythological and biblical, stretching over several millennia from the early days of Sumer to the bibilical period, in order to determine the ways in which the concept of water was used. It traces the transmission and evolution of these motifs, their interrelationship, and in particular the way they function in the political and theological ideology of their time. Three literary motifs are the object of a careful study: the crossing of water, the flood and the water of abundance. Though their study shows diversity in their evolution, transmission and reception, it appears that their function is common at the heart of the Mesopotamian political theology of royal mediation. The king as the deluge of his god crossess the flood again and again in order to have the primeval waters of abundance and life flow for the eternity of civilisation and royal institution. The same could not be said biblical reception where the motifs though borrowedd serve a radically "new" theology revealing the Torah at its heart.PARIS4-BU Serpente (751052129) / SudocSudocFranceF

Design Patterns pour l’évaluation des apprenants dans un EIAH

This paper presents a structured set of 17 Design Patterns (DP for short). These DPs target the design of learning systems that assess learners while solving problems, for example problems in mathematics, logic or programming. Learners’ assessment is a three step approach : first collect and analyse data while a learner solves a problem, second overview of a learner’s activity across a set of exercises and third overview of the activity of a group of learners on a set of exercises. This set of DPs has emerged as a way of capitalizing on the work done by the co-authors while sharing their experience in this area. We show that these DPs do account for other experiences taken from the literature. In our opinion, writing sets of DPs is a way to facilitate communication in pluridisciplinary teams for the design of e-learning systems. The present set is a step in that direction.Dans cet article nous présentons un premier ensemble de 17 Design Patterns (DP) pour la conception d’EIAH qui évaluent des apprenants en situation de résolution de problèmes. La démarche d’évaluation décrite par ces DPs comporte trois étapes : premièrement, recueil et analyse des informations sur un seul apprenant pour un seul exercice, deuxièmement construction d’une vue générale sur l’activité individuelle d’un apprenant sur un ensemble d’exercices et, troisièmement élaboration d’une vue générale sur l’activité de toute une classe sur un même ensemble d’exercices. Nous montrons que cet ensemble de DPs capitalisant l’expérience de plusieurs projets menés par les co-auteurs rend compte également de la conception de l’évaluation des apprenants dans d’autres EIAH décrits dans la littérature. Nous soutenons que l’approche Design Pattern facilite la communication entre les disciplines intervenant dans la conception des EIAH et permet de capturer leur expérience de conception pour faciliter la réutilisation dans des projets à venir. L’ensemble de DPs présentés ici est un premier pas en ce sens.Delozanne Elisabeth, Le Calvez Françoise, Merceron Agathe, Labat Jean-Marc. Design Patterns pour l’évaluation des apprenants dans un EIAH. In: Sciences et Technologies de l'Information et de la Communication pour l'Éducation et la Formation, volume 14, 2007. Les Dimensions émotionnelles de l'interaction dans un EIAH/Analyses des traces d'utilisation dans les EIAH. pp. 45-80

Number and Replating Capacity of Endothelial Colony‐Forming Cells are Telomere Length Dependent: Implication for Human Atherogenesis

International audienceBackground Short leukocyte telomere length (TL) is associated with atherosclerotic cardiovascular disease. Endothelial repair plays a key role in the development of atherosclerosis. The objective was to examine associations between TL and proliferative dynamics of endothelial colony‐forming cells (ECFCs), which behave as progenitor cells displaying endothelial repair activity. Methods and Results To isolate ECFCs, we performed a clonogenic assay on blood samples from 116 participants (aged 24–94 years) in the TELARTA (Telomere in Arterial Aging) cohort study. We detected no ECFC clones in 29 (group 1), clones with no replating capacity in other 29 (group 2), and clones with replating capacity in the additional 58 (group 3). Leukocyte TL was measured by Southern blotting and ECFCs (ECFC‐TL). Age‐ and sex‐adjusted leukocyte TL (mean±SEM) was the shortest in group 1 (6.51±0.13 kb), longer in group 2 (6.69±0.13 kb), and the longest in group 3 (6.78±0.09 kb) ( P <0.05). In group 3, ECFC‐TL was associated with the number of detected clones ( P <0.01). ECFC‐TL (7.98±0.13 kb) was longer than leukocyte TL (6.74±0.012 kb) ( P <0.0001) and both parameters were strongly correlated ( r =0.82; P <0.0001). Conclusions Individuals with longer telomeres display a higher number of self‐renewing ECFCs. Our results also indicate that leukocyte TL, as a proxy of TL dynamics in ECFCs, could be used as a surrogate marker of endothelial repair capacity in clinical and laboratory practice because of easy accessibility of leukocytes. Registration URL: https://www.clinicaltrials.gov ; Unique identifier: NCT02176941

Functional Impairment of Endothelial Colony Forming Cells (ECFC) in Patients with Severe Atherosclerotic Cardiovascular Disease (ASCVD)

International audienceEndothelial dysfunction is a key factor in atherosclerosis. However, the link between endothelial repair and severity of atherosclerotic cardiovascular disease (ASCVD) is unclear. This study investigates the relationship between ASCVD, markers of inflammation, and circulating endothelial progenitor cells, namely hematopoietic cells with paracrine angiogenic activity and endothelial colony forming cells (ECFC). Two hundred and forty-three subjects from the TELARTA study were classified according to the presence of clinical atherosclerotic disease. ASCVD severity was assessed by the number of involved vascular territories. Flow cytometry was used to numerate circulating progenitor cells (PC) expressing CD34 and those co-expressing CD45, CD34, and KDR. Peripheral blood mononuclear cells ex vivo culture methods were used to determine ECFC and Colony Forming Unit- endothelial cells (CFU-EC). The ECFC subpopulation was analyzed for proliferation, senescence, and vasculogenic properties. Plasma levels of IL-6 and VEGF-A were measured using Cytokine Array. Despite an increased number of circulating precursors in ASCVD patients, ASCVD impaired the colony forming capacity and the angiogenic properties of ECFC in a severity-dependent manner. Alteration of ECFC was associated with increased senescent phenotype and IL-6 levels. Our study demonstrates a decrease in ECFC repair capacity according to ASCVD severity in an inflammatory and senescence-associated secretory phenotype context

Fantômes d’écrivains

Par quoi les écrivains sont-ils habités ? Souvent par d’autres écrivains. Pas seulement parce qu’ils s’influencent ou s’inspirent les uns les autres mais parce que parfois ils écrivent à l’ombre de l’œuvre d’un autre, à la lumière du rayonnement laissé par un confrère célèbre, vivant ou mort, qu’ils admirent, qu’ils fuient, qui les enrichit ou les entrave. Ils écrivent alors en contrepoint de l’œuvre d’un autre, en dialogue ou en résistance. Ils sont travaillés par la présence d’un aîné ou d’un contemporain qui est pour eux une autorité à honorer, à dépasser, à combattre. Ce rapport à l’écrivain est une occasion de fécondité, de rivalité, au pire un véritable empêchement. Dans tous les cas, cette intime obsession, cette hantise les oblige à trouver leur propre voix, chercher leur propre espace et plus largement, décider du sens qu’ils donnent à leur propre quête. Ces fantômes d’écrivains sont donc bien ce qui hante leur création : ils la visitent et l’inquiètent, la rendent plus vivante, plus personnelle, la forcent à affirmer ses contours, fût-ce dans la destruction de cette figure intérieure qu’elle porte en elle et que tout à la fois elle enfouit et exhibe. Il s’agissait donc de traquer les fantômes dont est peuplée la littérature… Les articles de ce recueil explorent divers cas de relation intime entre un écrivain et un autre, diverses conditions singulières de création « hantée »

Design, assembly and validation of the Filter Exchange System of LSSTCam

International audienceThe Filter Exchange System (FES) of the Legacy Survey of Space and Time camera (LSSTCam) for the Vera C. Rubin Observatory has been integrated into the camera assembly before shipping to Chile. It holds five 75-cm filters weighing 25.5 to 38 kg. The main requirement for the FES is to perform each exchange in under 90s, with 100-μm positioning in the focal plane, while operating within the envelope of the camera body. The FES is split into three motorized subsystems: the Carousel stores the filters and rotates the selected filter to the standby position, the Autochanger moves the filter between the standby position and the focal plane, and the Loader can be mounted on the camera body to swap filters in and out during daytime, allowing the use of the full 6-filter set of LSSTCam. The locking mechanisms are also motorized, and their designs and qualifications account for seisms up to magnitude 7. Additional design constraints come from the temperature range at the Observatory and the cleanliness requirements for the filters and lenses. Programmable Logic Controllers enforce the safety equations of the system, and the control of the FES has been integrated into the overall Camera Control System software. After assembly of a full-scale prototype, the FES has been assembled and tested in France on a test-stand simulating telescope attitude, then integrated into the camera body at SLAC National Accelerator Laboratory. It meets its required performances, including an average exchange time of 83s