Fronts de sciences 2018. Conseil scientifique de la Fondation pour la recherche sur la biodiversité

le cadre de ses missions de prospective et de conseil stratégique auprès de la FRB, le conseil scientifique a conduit en 2016 et 2017 un travail de réflexion et d’expertise sur les « fronts de sciences » dans le champ de la recherche sur la biodiversité. Le travail présenté ici permet de faire le point sur l’évolution du paysage de la recherche depuis les prospectives réalisées par le CS et publiées en 2009 et 2015. Ces deux rapports qui ont marqué les premières années de la FRB dressaient un tableau d’ensemble des grands enjeux et chantiers scientifiques dans le domaine de la biodiversité. Tout en s’inscrivant dans le prolongement de ces travaux structurants, le conseil scientifique souhaite mettre en lumière les évolutions parfois très rapides de la science dans certains domaines. Il s’agit donc d’analyser l’état de la recherche sur certains « fronts de science » qui ont émergé depuis, qui ont progressé rapidement, ou qui pourraient prendre de l’ampleur dans les années à venir. Ce travail, qui se poursuivra chaque année, n’a pas une visée exhaustive, ni ne constitue en soi une proposition d’orientation des stratégies de recherche. Il vise avant tout à donner un aperçu de quelques sujets en plein développement ou d’enjeux appelant de nouvelles recherches, ainsi qu’à éclairer l’actualité de la recherche sur la biodiversité pour un public non spécialiste. Certains des sujets choisis s’inscrivent clairement dans des enjeux et débats de société, mais d’autres relèvent de problématiques conceptuelles et méthodologiques de nature plus fondamentale

Barriers and facilitators to bracing in adults with painful degenerative scoliosis: a single-centred mixed-method feasibility study

Abstract Background Conservative treatments including bracing and exercise therapy are prescribed on the first-line in adults with degenerative scoliosis. However, adherence to conservative treatments is low. We aimed to assess barriers and facilitators to bracing in adults with painful degenerative scoliosis. Methods We conducted a single-centred mixed-method pilot and feasibility study. All patients scheduled for a multidisciplinary custom-made bracing consultation, from July 2019 to January 2020, in a French tertiary care centre, were screened. Patients were eligible if they had painful adult degenerative scoliosis and a prescription for a rigid custom-made lumbar-sacral orthosis. The primary outcome was barriers and facilitators to bracing assessed by a qualitative approach using semi-structured interviews. Secondary outcomes were back pain, spine-specific activity limitations, symptoms of depression and satisfaction with bracing post-intervention assessed by a quantitative approach. Results Overall, 56 patients were screened and 14 (25%) were included. Mean age was 68.2 (12.3) years. Mean follow-up was 9.8 (2.0) months. Barriers to bracing were increased limitations in some activities, discomfort in hot weather and burden of aesthetic appearance. Facilitators to bracing were reduced pain, improved activities of daily living, suitable weight and improved spinal alignment. Participants self-implemented solutions to enhance adherence. The mean reduction from baseline in pain intensity was 1.7 (2.3) of 10 points, and 6 of 13 patients (46%) had pain intensity < 4 of 10 points. Conclusion Bracing is a feasible intervention for people with painful adult degenerative scoliosis. Patients self-implemented their own solutions to enhance adherence

Impact of Dexamethasone and Inhaled Nitric Oxide on Severe Acute Kidney Injury in Critically Ill Patients with COVID-19

International audienceBackground: Acute kidney injury (AKI) is the second most frequent condition after acute respiratory distress syndrome (ARDS) in critically ill patients with severe COVID-19 and is strongly associated with mortality. The aim of this multicentric study was to assess the impact of the specific treatments of COVID-19 and ARDS on the risk of severe AKI in critically ill COVID-19 patients. Methods: In this cohort study, data from consecutive patients older than 18 years admitted to 6 ICUs for COVID-19-related ARDS requiring invasive mechanical ventilation were included. The incidence and severity of AKI, defined according to the 2012 KDIGO definition, were monitored during the entire ICU stay until day 90. Patients older than 18 years admitted to the ICU for COVID-19-related ARDS requiring invasive mechanical ventilation were included. Results: 164 patients were included in the final analysis; 97 (59.1%) displayed AKI, of which 39 (23.8%) had severe stage 3 AKI, and 21 (12.8%) required renal replacement therapy (RRT). In univariate analysis, severe AKI was associated with angiotensin-converting enzyme inhibitors (ACEI) exposure (p = 0.016), arterial hypertension (p = 0.029), APACHE-II score (p = 0.004) and mortality at D28 (p = 0.008), D60 (p < 0.001) and D90 (p < 0.001). In multivariate analysis, the factors associated with the onset of stage 3 AKI were: exposure to ACEI (OR: 4.238 (1.307–13.736), p = 0.016), APACHE II score (without age) (OR: 1.138 (1.044–1.241), p = 0.003) and iNO (OR: 5.694 (1.953–16.606), p = 0.001). Prone positioning (OR: 0.234 (0.057–0.967), p = 0.045) and dexamethasone (OR: 0.194 (0.053–0.713), p = 0.014) were associated with a decreased risk of severe AKI. Conclusions: Dexamethasone was associated with the prevention of the risk of severe AKI and RRT, and iNO was associated with severe AKI and RRT in critically ill patients with COVID-19. iNO should be used with caution in COVID-19-related ARDS

Réponses et adaptations aux changements globaux : quels enjeux pour la recherche sur la biodiversité ? Prospective de recherche.

Réponses et adaptations aux changements globaux : quels enjeux pour la recherche sur la biodiversité ? Prospective de recherche

Réponses et adaptations aux changements globaux : quels enjeux pour la recherche sur la biodiversité ? Prospective de recherche.

Réponses et adaptations aux changements globaux : quels enjeux pour la recherche sur la biodiversité ? Prospective de recherche