Un rapport emblématique de l’actualité migratoire et de l’architecture évolutive de la protection des droits

Le rapport annuel de l’Agence des droits fondamentaux de l’Union européenne (FRA) a nécessairement été marqué par les événements tragiques de l’année 2015 (attentats, flux importants de migrants vers l’Europe et situation humanitaire catastrophique en Syrie et en Irak, etc). Or, ces circonstances sont un terreau idéal au développement de toutes formes de xénophobie et à l’installation d’un climat de haine et de défiance envers autrui. D’où l’importance, pour l’Agence des droits fondamentaux, d’un juste équilibre entre sécurité et liberté, afin que les droits fondamentaux puissent continuer d’être garantis à tous. Dans cette perspective, le dispositif de protection des droits fondamentaux par le droit de l’Union européenne offre des virtualités conséquentes même si les défis sont nombreux, en particulier en matière de migrations

Learning together for and with the Martuwarra Fitzroy River

Co-production across scientific and Indigenous knowledge systems has become a cornerstone of research to enhance knowledge, practice, ethics, and foster sustainability transformations. However, the profound differences in world views and the complex and contested histories of nation-state colonisation on Indigenous territories, highlight both opportunities and risks for Indigenous people when engaging with knowledge co-production. This paper investigates the conditions under which knowledge co-production can lead to improved Indigenous adaptive environmental planning and management among remote land-attached Indigenous peoples through a case study with ten Traditional Owner groups in the Martuwarra (Fitzroy River) Catchment in Western Australia’s Kimberley region. The research team built a 3D map of the river and used it, together with an interactive table-top projector, to bring together both scientific and Indigenous spatial knowledge. Participatory influence mapping, aligned with Traditional Owner priorities to achieve cultural governance and management planning goals set out in the Fitzroy River Declaration, investigated power relations. An analytical framework, examining underlying mechanisms of social learning, knowledge promotion and enhancing influence, based on different theories of change, was applied to unpack the immediate outcomes from these activities. The analysis identified that knowledge co-production activities improved the accessibility of the knowledge, the experiences of the knowledge users, strengthened collective identity and partnerships, and strengthened Indigenous-led institutions. The focus on cultural governance and management planning goals in the Fitzroy River Declaration enabled the activities to directly affect key drivers of Indigenous adaptive environmental planning and management—the Indigenous-led institutions. The nation-state arrangements also gave some support to local learning and decision-making through a key Indigenous institution, Martuwarra Fitzroy River Council. Knowledge co-production with remote land-attached Indigenous peoples can improve adaptive environmental planning and management where it fosters learning together, is grounded in the Indigenous-led institutions and addresses their priorities

The Influence of Number and Timing of Pregnancies on Breast Cancer Risk for Women With BRCA1 or BRCA2 Mutations

International audienceBACKGROUND:Full-term pregnancy (FTP) is associated with a reduced breast cancer (BC) risk over time, but women are at increased BC risk in the immediate years following an FTP. No large prospective studies, however, have examined whether the number and timing of pregnancies are associated with BC risk for BRCA1 and BRCA2 mutation carriers.METHODS:Using weighted and time-varying Cox proportional hazards models, we investigated whether reproductive events are associated with BC risk for mutation carriers using a retrospective cohort (5707 BRCA1 and 3525 BRCA2 mutation carriers) and a prospective cohort (2276 BRCA1 and 1610 BRCA2 mutation carriers), separately for each cohort and the combined prospective and retrospective cohort.RESULTS:For BRCA1 mutation carriers, there was no overall association with parity compared with nulliparity (combined hazard ratio [HRc] = 0.99, 95% confidence interval [CI] = 0.83 to 1.18). Relative to being uniparous, an increased number of FTPs was associated with decreased BC risk (HRc = 0.79, 95% CI = 0.69 to 0.91; HRc = 0.70, 95% CI = 0.59 to 0.82; HRc = 0.50, 95% CI = 0.40 to 0.63, for 2, 3, and ≥4 FTPs, respectively, P trend < .0001) and increasing duration of breastfeeding was associated with decreased BC risk (combined cohort P trend = .0003). Relative to being nulliparous, uniparous BRCA1 mutation carriers were at increased BC risk in the prospective analysis (prospective hazard ration [HRp] = 1.69, 95% CI = 1.09 to 2.62). For BRCA2 mutation carriers, being parous was associated with a 30% increase in BC risk (HRc = 1.33, 95% CI = 1.05 to 1.69), and there was no apparent decrease in risk associated with multiparity except for having at least 4 FTPs vs. 1 FTP (HRc = 0.72, 95% CI = 0.54 to 0.98).CONCLUSIONS:These findings suggest differential associations with parity between BRCA1 and BRCA2 mutation carriers with higher risk for uniparous BRCA1 carriers and parous BRCA2 carriers

Primo-prescription de fluoroquinolones dans les services de neurologie et réévaluation à 48-72 heures : une expérience du Centre hospitalier universitaire de Toulouse

RésuméObjectif : L’objectif de l’étude est de connaitre les pratiques de prescriptions des fluoroquinolones dans des services de neurologie en France, en évaluant la réévaluation à 48-72 heures de la mise en place d’une telle antibiothérapie.Mise en contexte : Les fluoroquinolones sont des antibiotiques largement prescrits. De nombreuses démarches permettent d’améliorer la qualité de la prescription des antibiotiques, notamment la réévaluation de l’antibiothérapie à 48-72 heures.Résultats : Cette étude descriptive et prospective, portant sur le recueil des prescriptions informatisées de fluoroquinolones, a été réalisée dans les services de neurologie pendant une période de trois mois. En tout, 23 prescriptions de fluoroquinolones ont été sélectionnées. Dix-neuf (83 %) des infections traitées étaient nosocomiales et 16 (70 %) étaient probabilistes (ou empiriques). La médiane des valeurs de la protéine C-réactive était de 23,8 mg/ml (intervalle : 0,7 à 69,8 mg/ml) et celle des taux de leucocytes était de 9,6 g/l (intervalle de 7,3 à 19,7 g/l). La durée moyenne d’antibiothérapie était de six jours. La réévaluation de l’antibiothérapie à 48-72 heures était mentionnée dans le dossier du patient dans 39 % des cas.Conclusion : Il convient de réserver l’usage des fluoroquinolones à des infections documentées pour diminuer le risque de résistance envers cette classe d’antibiotiques. La création de protocoles de prise en charge probabiliste (ou empirique) d’infections nosocomiales peut être envisagée. La réévaluation de l’antibiothérapie à 48-72 heures est primordiale et doit être généralisée. L’informatisation de ces étapes peut aider à y parvenir.AbstractObjective: The objective of this study was to explore fluoroquinolone prescribing practices in neurology departments in France, with a focus on the reassessment at 48 to 72 hours after initiation of the antibiotic therapy.Background: Fluoroquinolones are widely prescribed antibiotics. There are many approaches for improving the quality of antibiotic prescribing. One of them is a reassessment of the antibiotic therapy at 48 to 72 hours.Results: This descriptive, prospective study based on a compilation of computerized prescriptions for fluoroquinolones was carried out in neurology departments over a 3-month period. Twenty-three fluoroquinolone prescriptions were selected. Nineteen (83%) of the treated infections were nosocomial, and 16 (70%) were empirical. The median C-reactive protein level was 23.8 mg/mL (range: 0.7 to 69.8 mg/mL), and the median leucocyte count was 9.6 g/l (range: 7.3 to 19.7 g/l). The mean duration of antibiotic therapy was six days. A reassessment of the antibiotic therapy at 48 to 72 hours was mentioned in the patient’s chart in 39% of the cases.Conclusion: The use of fluoroquinolones should be reserved for targeted infections to reduce the risk of resistance to this class of antibiotics. Consideration might be given to creating protocols for the empirical management of nosocomial infections. Reassessing antibiotic therapy at 48 to 72 hours is essential and should be generalized. Computerizing these steps could help achieve this

A nonlocal electron transport model in the diffusion scaling of hydrodynamics

International audienceWe analyze a model of nonlocal electron transport named P1-diffusion based on a spherical harmonic expansion in velocity space and a diffusion scaling, which makes it compatible with assumptions from magneto-hydrodynamics (MHD). An iterative, fully implicit (CFL-free, as defined by the Courant Friedrich Levy condition) and asymptotic preserving discretization is proposed, which necessitates the inversion of a possibly large number of—but small—linear systems. It is found accurate with respect to reference solutions from a Vlasov–Fokker–Planck–Maxwell code (based on a Polynomial expansion of order N, or PN expansion) on a series of tests, which are representative of the conduction zone in laser-created plasmas. Thereby, the present approach is a good candidate for being embedded in multi-D MHD codes

Does arthroscopic resection of a too-long anterior process improve static disorders of the foot in children and adolescents ?

International audiencePURPOSE:A too-long anterior process of the calcaneus is a common cause of pain and hind-foot instability. Our goal was to evaluate the early results of arthroscopic resection in terms of static foot disorders in children and adolescents.METHODS:We retrospectively studied 11 ft (10 patients). The inclusion criteria were treatment of TLAP by arthroscopic resection and a minimum follow-up period of six months. Surgery was indicated in cases with persistent symptomatic TLAP resistant to orthopaedic treatment.RESULTS:The mean age at surgery was 11 (range, 7-15) years. The mean follow-up duration was 15 (range, 8-28) months. Pre-operatively, we diagnosed four flat feet, two cavus feet and five feet with normal footprints, but loss of physiological hind-foot valgus. All patients presented with subtalar joint stiffness. At the last follow-up, four feet with no hind-foot valgus were normal, two were unchanged and the other feet had improved. The mean AOFAS increased from 61.9 (range, 47-73) to 89.1 (range, 71-97; P = 0.009). The mean radiological angles were near normal, exhibiting significant improvements in the lateral talo-metatarsal and Djian-Annonier angles.CONCLUSIONS:Arthroscopic resection of a TLAP is safe. In the short term, the restoration of subtalar mobility reduces pain, and improves instability and static disorders. Longer follow-up of a larger patient series is required

Festivalisation(s)

Bien qu’elle s’inscrive dans une histoire plus ancienne, la « festivalisation » des « musiques du monde » a connu un prodigieux essor au cours des vingt-cinq dernières années. Mais au delà de leurs similitudes formelles, ces manifestations n’obéissent-elles pas à des logiques distinctes et parfois même antagonistes ? En quoi se démarquent-elles des concerts « normaux » ? N’évoluent-elles pas au fil du temps, générant chacune des effets singuliers ? Afin de répondre à ces questions, le présent dossier vise à instaurer un dialogue transatlantique en offrant la parole à des chercheurs provenant d’horizons variés. Outre certaines réflexions historiques et méthodologiques, ce dossier aborde les enjeux identitaires, politiques, économiques et touristiques négociés autour des patrimoines musicaux dans un cadre de globalisation avancée. Les festivals y apparaissent comme des lieux emblématiques, à la fois relais, nœuds de réseaux, laboratoires d’utopies et d’innovations, mais aussi réservoirs de clichés contribuant à entretenir les clivages entre Ici et Ailleurs

Comprehensive biomarkers analysis to explain resistances to PD1-L1 ICIs: The precision immuno-oncology for advanced non-small cell lung cancer (PIONeeR) trial

International audienceAbstract Background: Resistance to PD1/L1 immune checkpoint inhibitors (ICIs) in advanced NSCLC patients is observed in about 80% of individuals with no robust predictive biomarker yet. The PIONeeR trial (NCT03493581) aims to predict such resistances through a comprehensive multiparametric biomarkers analysis. Methodology: Among the &gt;300 advanced NSCLC patients (pts) recruited in PIONeeR, we focused on the first 137 ≥2nd line ECOG PS0-1 pts treated with single-agent nivolumab, pembrolizumab or atezolizumab. Tumor tissue was collected at baseline and pts were re-biopsied at 6 weeks, and blood-sampled every cycle throughout the 24 weeks post C1D1. Response to PD1/L1 ICIs was assessed by RECIST 1.1 every 6 weeks. Immune contexture was characterized in tumor & blood of each pt through FACS for circulating immune cell subtypes quantification and endothelial activation, blood soluble factors dosage, dual- & multiplex IHC/digital pathology to quantify immune cells infiltrating the tumor, WES for TMB & ICI plasma dosage, leading to 331 measured biomarkers in addition to routine clinical parameters. Multivariable (MV) logistic regression was used to examine the association of each biomarker (controlled by sex, age, smoking status, histological type & PDL1+ Tumor Cells) with the risk of Early Progression (EP), i.e. within 3.5 months of treatment. Multivariable Cox regression analysis was conducted for association with PFS and OS. Results: Overall, the 137 pts were mainly male (64%), smokers (92%) and &lt;70yrs (68%). Tumors were mainly non-squamous (79%) with &gt;1% PDL1+ TC in 36% of the cases, and 21% of pts were still on treatment at data cut-off. Archived samples were available for 80% of pts at inclusion and re-biopsy was available in 52.9% of these cases. The median follow up was 19.8 months, 22.5% of pts did not progress at data cut-off while 62% presented EP. Tumor Cytotoxic T-cells density, especially PD1+ were lower in EP (MV OR=0.45, p=0.022); conversely, higher proportions of circulating cytotoxic T-cells and activated T-cells (HLA-DR+) were observed in EP (MV OR=3.8, p&lt;0.001). Among other biomarkers, Tregs (MV OR=0.44, p=0.018), NK cell subsets (MV OR≤0.44, p&lt;0.05), albumin (MV OR=0.4, p&lt;0.01) and PDL1 TC % (MV OR=0.27, p&lt;0.01) were decreased whereas alkaline phosphatase was increased (OR=3, p=0.018). &gt;65% inter-pt variability was observed in plasma exposures for all ICIs, with 8-10% of pts displaying trough levels below the target engagement threshold. Data will be presented through unsupervised clustering algorithms & multi-modal supervised learning methods. Changes after 6 weeks of treatment will be analyzed to further investigate drugs mechanisms of action. Conclusion: The PIONeeR trial provides with the 1st comprehensive biomarkers’ analysis to establish predictive models of resistance in advanced NSCLC pts treated with PD1/L1 ICIs and highlights how tumor and circulating biomarkers are complementary

Soundspaces

« Soundspace » fait écho et contrepoint à « soundscape », notion créée et théorisée par Murray Schafer et l’écologie sonore dans les années 1970. Pas d’ambition paysagère ici, mais le projet de construire de nouveaux espaces de savoir et d’action. Penser les liens entre « espace » et « son » invite à réexaminer les catégorisations de ces notions, la diversité de leurs agencements. Ainsi, géographes, ethnologues, sociologues, historiens et analystes de l’art et des arts du spectacle, urbanistes et paysagistes, architectes, politistes, ingénieurs du son et acousticiens, mais aussi artistes et acteurs culturels apportent différents outils, écoutes, manières de faire, modèles et interrogations. Dans quelle mesure l’écriture sonore se déploie-t-elle en espace ? L’attention à l’écoute permet-elle de considérer la spatialité autrement ? Une série d’études explore ces questions dans différents champs artistiques. Comment les dispositifs techniques engendrent-ils de nouveaux imaginaires spatiaux ? Et quelle place donner aux archives audio dans la structuration de la recherche et des connaissances ? Il s’agit ensuite de l’expérience aurale des lieux, des identités sonores et de leur genèse, de la façon dont les sensibilités sont encadrées par des codes, normes et règles de comportements. L’expérience sonore est explorée dans ses diverses polyphonies et dans une perspective polysensorielle – dans les rues, le métro, l’hôpital. Quels sont les outils du chercheur ? Comment créer de nouvelles expérimentations sensibles ? Il est établi un hiatus croissant entre, d’une part, la place occupée par les ressentis et vécus, mais aussi les souhaits de participation habitante dans les réalités socio-spatiales de l’environnement, et, de l’autre, la pensée encore largement normative de politiques malgré tout de plus en plus territorialisées. Comment interroger les cadres cognitifs, référentiels et outils de l’action ? Et pour cela, comment repenser les codifications scientifiques et les figures de l’expertise savante, qu’elles soient d’essence modélisatrice, phénoménologique ou participative ? À la croisée entre sciences physiques et de l’ingénieur, sciences humaines et sociales, sciences politiques et approches esthétiques, Soundspaces donne un aperçu des changements, des dépassements, des enjeux et des zones de blocages dans les réflexions et études sur le sonore. Pointant certaines surdités théoriques ou verrous cognitifs, l’ouvrage engage une réflexion intégrée sur le sonore que tant d’acteurs appellent aujourd’hui de leurs vœux

A new hybrid record linkage process to make epidemiological databases interoperable: application to the GEMO and GENEPSO studies involving BRCA1 and BRCA2 mutation carriers

International audienceBackground: Linking independent sources of data describing the same individuals enable innovative epidemiological and health studies but require a robust record linkage approach. We describe a hybrid record linkage process to link databases from two independent ongoing French national studies, GEMO (Genetic Modifiers of BRCA1 and BRCA2), which focuses on the identification of genetic factors modifying cancer risk of BRCA1 and BRCA2 mutation carriers, and GENEPSO (prospective cohort of BRCAx mutation carriers), which focuses on environmental and lifestyle risk factors.Methods: To identify as many as possible of the individuals participating in the two studies but not registered by a shared identifier, we combined probabilistic record linkage (PRL) and supervised machine learning (ML). This approach (named "PRL + ML") combined together the candidate matches identified by both approaches. We built the ML model using the gold standard on a first version of the two databases as a training dataset. This gold standard was obtained from PRL-derived matches verified by an exhaustive manual review. Results The Random Forest (RF) algorithm showed a highest recall (0.985) among six widely used ML algorithms: RF, Bagged trees, AdaBoost, Support Vector Machine, Neural Network. Therefore, RF was selected to build the ML model since our goal was to identify the maximum number of true matches. Our combined linkage PRL + ML showed a higher recall (range 0.988-0.992) than either PRL (range 0.916-0.991) or ML (0.981) alone. It identified 1995 individuals participating in both GEMO (6375 participants) and GENEPSO (4925 participants).Conclusions: Our hybrid linkage process represents an efficient tool for linking GEMO and GENEPSO. It may be generalizable to other epidemiological studies involving other databases and registries