Le "pattern ambiant" (une entité opératoire de caractérisation et de conception des ambiances urbaines)

La conception des espaces publics de la vie urbaine s inscrit dans une réflexion globale sur l espace de la ville et ses nombreuses composantes spatiales, fonctionnelles, climatiques, sociales et culturelles d usage de l espace. La démarche conceptuelle développée par les architectes urbanistes, traverse l ensemble de ces disciplines et connaissances dans une approche globale et intuitive. le travail de thèse propose de s appuyer sur les méthodes d investigation de ces disciplines pour contribuer à la mise au point d une méthode plusscientifique d analyse et de caractérisation des ambiances de la ville, qui permet d'avoir une meilleure appréciation des qualités d'ambiance, pour faciliter la conception des lieux de vie urbaine. L'observation de l'usage de l'espace et de ses différents modes d appropriation par les piétons montre non seulement une vie sociale mais aussi une dynamique urbaine et des qualités d'ambiances, spécifiques à chaque moment de la journée et à chaque lieu de la ville. La méthode d'investigation proposée est basée sur l'observation in situ de scènes ou de situations urbaines situées en différents lieux de la ville et à divers moments et séquences de temps. Celles-ci sont analysées de manière à mettre en évidence les interactions qui paraissent déterminantes entre, d'une part les comportements et les usages, d'autre part, les facteurs spatiaux et les conditions microclimatiques. Toutefois compte tenu de la multiplicité des facteurs d ambiances, la recherche limite le champ d investigation en retenant trois dimensions majeureset les paramètres d ambiances suivants: La dimension climatique et les paramètres de l ensoleillement, le vent, l humidité, la température ambiante. Les facteurs lumineux et sonores. La dimension architecturale et spatiale, et les paramètres de la centralité, la morphologie, la composition urbaine, les matériaux. La dimension comportementale et des usages de l espace, les paramètres de la conduite physique et vestimentaire, les figures d usage et d appropriation collectif de l espace. La notion de pattern ambiant qui doit émerger de cette analyse, repose sur une structuration organisée des différentes composantes (spatiales, temporelles, climatiques, comportementales...). Elle implique de recenser les paramètres déterminants, secondaires ou influents de tels ou tels comportements et usages, d'identifier des scènes caractéristiques et de faire apparaître leurs conditions d'occurrence. 120 scènes ont été retenues pour construire, du point de vue du comportement piéton, une typologie de ces scènes urbaines. 18 types majeurs d'appropriation spatiale apparaissent porteuses de qualités spécifiques d'ambiances. A l'intérieur de ces types majeurs, certaines combinaisons significatives de facteurs spatio-climato-comportemental ont été identifiées. Leur récurrence permet de mettre en lumière des figures d'ambiance types, formant "pattern ambiant". Cette recherche contribue donc à la formalisation d une méthode de caractérisation et de conception des ambiances urbaines, ouvrant de larges possibilités de recherches tant sur les méthodes d investigation que sur diverses problématiques d ambiances appliquées à la conception des espaces urbains, voire à la constructions d ambiances urbaines spécifiques. Au delà, les résultats acquis autour de la notion de Pattern ambiant permettent d'envisager des recherches à visée plus opérationnelle pour intégrer les ambiances urbaines dans les phases de programmation et de conception des espaces urbains.The design of urban outdoor public spaces needs a global thinking about the urban territory and its various spatial, functional, climatic, human and sociological components. Faced to the generally empiric and intuitive integrative approach used by architects and urban designers, this thesis work aims to develop a "scientific" method to analyse and characterise the urban ambiances, enabling thus to have a better assessment and understanding of ambiance qualities and to help to the design of urban places taking into account the living conditions of people.From this viewpoint, the observation of how urban space is used and lived by people, how it can be appropriated during various sequences of time by pedestrian, can be seen as the expression of a social life and of an urban dynamic but also as the revelation of urban ambiance specifities and qualities. Therefore, the proposed investigation method is based on the in situ observation of urban scenes and urban situations located in different places in town and at different times and seasons. Each scene is then analysed in order to highlight significant interactions between the pedestrian behaviours and uses of the space and the spatial and microclimatic conditions. Nevertheless, due to the large number of ambient factors, the research limits the investigation field to the three main dimensions and to their corresponding ambient parameters that are:-The climatic dimension with parameters like sun, wind, humidity, air outdoor temperature and the physical parameters linked to the light and the sound. -The architectural and spatial dimension and parameters like centrality, morphology, urban layout and materials.-The behavioural and use dimension related to physical attitude and clothing aspect, and the uses of space in term of use figures and space collective appropriation ways. The concept of "ambient pattern" that must come to light from this combined and multi-criteria analysis is based on an organised structure of spatial, time-dependant, climatic and behavioural components. It must be built from a rigorous inventory of essential, secondary or influential parameters that may induce particular behaviour and enable the identification of typical scenes with their occurrence conditions. 120 urban scenes have been observed and analysed to build, on a behavioural point of view, a typological classification. 18 main types of spatial appropriation that express specific ambiance qualities, have been isolated. Inside these types, some significant combination of spatial, climatic and behavioural factors constituting an organized scheme have been identified. Their recurrence enables to propose urban ambient figures that constitute "ambient patterns". Significant results have already been obtained and this work has enabled to formalize a method for a better characterization and design of outdoor spaces favouring ambient qualities of spaces. The "ambient pattern" opens large opportunities to pursue researches on investigation and observation methods of living conditions in public spaces, and at the same time, it enables to carry out a more operational work on the way to integrate ambiances approach in the programming and design of urban public spaces.NANTES-BU Sciences (441092104) / SudocNANTES-Ecole Centrale (441092306) / SudocNANTES-BU Technologie (441092105) / SudocSudocFranceF

Les critères diagnostiques du pseudoxanthome élastique: une revue systématique de la littérature

ANGERS-BU Médecine-Pharmacie (490072105) / SudocSudocFranceF

Infrared spectra of primary melanomas can predict response to chemotherapy: The example of dacarbazine

Metastatic melanomas are highly aggressive and median survival is 6-9. months for stage IV patients in the absence of treatment with anti-tumor activity. Dacarbazine is an alkylating agent that has been widely used in the treatment of metastatic melanomas and that could be still used in combination with targeted or immune therapies. Indeed, therapeutic benefits of these treatments in monotherapy are poor and one option to improve them is to combine drugs and/or to better anticipate the individual response to a defined treatment. To our best knowledge and to date, there is no test available to predict the response of a patient to dacarbazine. We show here that examination of melanoma histological sections by infrared micro-spectroscopy reveals the sensitivity of the cancer to dacarbazine. Unsupervised analysis of the FTIR spectra evidences spontaneous and significant clustering of infrared spectra into two groups that match the clinical responsiveness of the patients to dacarbazine used as a first-line treatment. A supervised model resulted in 83% of the patient status (responder/non-responder) being correctly identified. The spectra revealed a key modification in the nature and quantity of lipids in the cells of both groups.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Distinction between clonal and paraclonal cutaneous involvements in VEXAS syndrome

VEXAS (vacuoles, E1 enzyme, X-linked, auto-inflammatory, somatic) syndrome is an inflammatory disorder with hematological and systemic features. A recent study demonstrated that the dermal infiltrate in neutrophilic dermatosis from VEXAS patients is derived from the pathological UBA1-mutated myeloid clone. Neutrophilic dermatosis is, however, only one of the various skin involvements observed in VEXAS syndrome. We analyzed 10 formalin-fixed paraffin-embedded skin biopsies from genetically confirmed VEXAS syndrome. UBA1 mutation was found in the biopsies related to neutrophilic dermatitis but in none of the other histological patterns (leukocytoclastic vasculitis and septal panniculitis). This could lead to a distinction between clonal and paraclonal cutaneous involvements in VEXAS syndrome, which could in turn improve therapeutic outcomes

Clinical Features of Spontaneous Partial Healing During Mycobacterium ulcerans Infection

International audienceBackground. Buruli ulcer, caused by Mycobacterium ulcerans, is a necrotizing skin disease leading to extensive cutaneous and subcutaneous destruction and functional limitations. Spontaneous healing in the absence of medical treatment occurs in rare cases, but this has not been well described in the literature. Methods. In a retrospective case study in an area of Benin where this disease is highly endemic, we selected 26 Buruli ulcer patients presenting features of spontaneous healing from a cohort of 545 Buruli ulcer patients treated between 2010 and 2013. Results. The 26 patients studied had a median age of 13.5 years and were predominantly male (1.4:1). Three groups of patients were defined on the basis of their spontaneous healing characteristics. The first group (12 patients) consisted of patients with an ulcer of more than 1 year′s duration showing signs of healing. The second (13 patients) group contained patients with an active Buruli ulcer lesion some distance away from a first lesion that had healed spontaneously. Finally, the third group contained a single patient displaying complete healing of lesions from a nodule, without treatment and with no relapse. Conclusions. We defined several features of spontaneous healing in Buruli ulcer patients and highlighted the difficulties associated with diagnosis and medical management. Delays in consultation contributed to the high proportion of patients with permanent sequelae and a risk of squamous cell carcinoma. Early detection and antibiotic treatment are the best ways to reduce impairments

No antibody response in acral cutaneous manifestations associated with COVID-19 ?

International audienceSkins symptoms during COVID‐19 have been recently described but their relation to SARS‐CoV‐2 is unclear while results for real‐time reverse transcriptase polymerase chain reaction (rRT‐PCR) testing were variable. Recalcati et al. reported 14 cases of patients with skin symptoms consistent with previous described COVID‐19 lesions but all the patients were tested negative. They asked for a serology to validate the hypothesis that these lesions are related to COVID‐19

Le devenir à long terme des engelures induites par une exposition au SARS-CoV-2

International audienc

Long-term Outcome of Chilblains Associated with SARS-CoV-2

International audienceNumerous cases of chilblains have been observed in the course if the COVID-19 pandemic. The aims of this study were to provide comprehensive follow-up data for patients reporting chilblains, and to determine the risk factors for incomplete recovery. Patients referred to 5 hospitals in France between March and May 2020 for chilblains were surveyed on December 2020. A teleconsultation was offered. Among 82 patients reporting chilblains, 27 (33%) reported complete recovery, 33 (40%) had recurrences of chilblains after their hands and feet had returned to normal, and 22 (27%) developed persistent acral manifestations, mostly acrocyanosis, with or without further recurrences of chilblains. Most recurrences of chilblains occurred during the following autumn and winter. A past history of chilblains was not associated with recurrences or persistent acral manifestations. Women had a significantly higher risk of developing recurrences or persistent acral manifestations (odds ratio 1.30; 95% confidence interval 1.06-1.59). In conclusion, two-thirds of patients reporting chilblains at the start of the COVID-19 pandemic experienced persistent or recurrent acral manifestations after a 10-month follow-up